Staffing as a Nursing Problem (5 Whys Method)

Topic: Nursing
Words: 1645 Pages: 6


In recent years, one of the most critical problems worldwide has become a deficiency of medical professionals. At the same time, the pandemic has not only caused a shortage of nursing staff but has also endangered the lives of current workers. Nurses complain that the absence of adequate numbers of staff members results in the neglect of many patients. In order for the patients to receive the care they require, nurses sometimes have to sacrifice their own needs. Thus, the reasons for the shortage of nursing staff and possible solutions should be identified.

The Formulation of the Problem and Key Findings

Nurse staffing is a serious issue facing healthcare organizations across the country. This theme is highly relevant since nurses are essential to the normal functioning of the health care system. They comprise more than half of the entire healthcare workforce and are on the front lines of disease control. Nevertheless, there is a worldwide shortage of nursing staff, which could be a real disaster in the context of the COVID-19 coronavirus pandemic (Xu, Intrator, and Bowblis, 2020). At the same time, during the pandemic, healthcare administrations realized that they needed to expand their staff and employ experienced and interested nurses. It is significant that the absence of staff leads to nurses and doctors working overtime, which negatively affects the quality of patient care (Griffiths et al., 2020). The increase in staffing demand in the health sector is caused by an expanding global population, which raises the risk of non-communicable diseases. Domestic and international migration of health workers is further exacerbating the imbalance between regions.

It should be summarized from the previous research and indicated that hospital staffing is a challenge that requires an immediate solution. Moreover, it can be solved quantitatively and qualitatively, which will help to establish the reasons for the issue (Griffiths et al., 2020). Therefore, studies of questions such as payment for additional hours and additional state funding for equipment purchases that would help reduce the pressure on nursing staff are important to discuss. Moreover, local healthcare leaders should focus on developing policies to improve workforce development in the long term (Xu, Intrator, and Bowblis, 2020). Thus, preliminary research concludes that enhancing motivation and additional payment to nurse sets could resolve the challenge.

The Theoretical Framework

It is significant to emphasize that variable and non-variable characteristics are used to identify a problem. For example, variable conditions include hours, workload, and number of patients under the care of medical staff. However, immutable attributes include staff perceptions of the work environment, satisfaction with the conditions of the job, and sufficiency of education to address the needs of patients. Hence, these basic concepts provide a framework for investigating the problem of understaffing of healthcare workers in hospitals. Accordingly, the theoretical framework can be defined as staffing – number of employees, workload – work hours, stress – negative review of physicians’ experience, and patient outcomes – the result of their interaction with nurses (Rogers, De Brún and McAuliffe, 2020). Importantly, to solve the identified problem, it is essential to apply “The 5 Whys Analysis”. This method is designed to identify the root cause of the issue and address it immediately. Therefore, the staffing challenge arose because of the high patient flow during the COVID-19 pandemic, which affected overcrowded hospitals and a deficiency in professional personnel.

The analysis assists in establishing the primary factors influencing the decision of physicians and nurses to leave their jobs. Accordingly, applying the way of answers to the five basic problems. There is failure to pay for additional hours of work, hospital conditions, absence of additional equipment, mismanagement of funds and the recent confinement of the issue can find a solution (Xu, Intrator, and Bowblis, 2020). Thus, it is imperative to change policies in this area and raise the conditions and standards for providing nurses’ work.

A Literature Analysis

It is significant to mention that even though the problem of insufficient medical staff is widespread, there is a shortage of research on this theme. Uchmanowicz (2017) notes that the main reason for inadequate patient care is the absence of sufficient medical staff in hospitals. The author has created a conceptual model, according to which he studies neglected care. According to this model, structural elements contributing to neglected care contain work resources, material aids, collaboration, and communication. If any of these resources are missing, nurses are required to prioritize their objectives. As a consequence, nursing care may not be provided in a timely manner or at all to specific patients. Uchmanowicz (2017) indicates that staffing levels and teamwork are the most significant predictors of missed nursing care. He further argues that more attention needs to focus on this concern at the official level because it becomes a cause of potentially dangerous medical errors.

It should be noted that there is research in the literature that aims to investigate the reasons for the shortage of nurses in Poland and other countries. Marć et al. (2019) examine the reasons for nurses’ aging, by observing the patient. Accordingly, they argue that the lack of recruitment of young nurses leads to aging staff, which negatively affects the performance of assignments. The authors observe that there has been a recent human resource crisis worldwide due to an insufficient supply of existing staff and demographic and educational issues (Marć et al., 2019). The theoretical basis of the article is based on the established causal connections between the improvement of working conditions and employment, the provision of additional training opportunities, and the quality of service delivery. In addition, the use of medical innovations and the reduction of nursing workload (Marć et al., 2019). In this way, the authors propose establishing connections between these factors and finding methods of solving the issue.

The scientific literature has investigated the challenge of education and its impact on reducing the healthcare workforce. Doosty, Maleki, and Yarmohammadian (2019) noted that the human factor has the most significant role in providing health services, which is why nurses and physicians must do their jobs well. The authors indicate a problem of misallocation of resources, which leads to an insufficient number of medical staff in hospitals. As a consequence, this affects quality and patient satisfaction. The article’s theoretical framework is based on the Workload Indicator of Staffing Need strategy, which measures the ratio of the existing workforce to the workforce needed to perform missions (Doosty, Maleki, and Yarmohammadian, 2019). Thus, they argue that the actual workload of a nurse is too significant. This is influenced by various factors, such as an insufficient institution to educate nurses and not wanting to work in an imperfect work environment. Doosty, Maleki, and Yarmohammadian (2019) suggest improving the quality of education, which will increase the number of young nurses who can reduce the burden on existing personnel. It will enhance the work environment for medical setters and attract new people to enter the profession.

The Ethical and Cultural Factors

It is significant to mention that culture is a historically determined level of development of society, a person’s creative forces, and abilities. It is expressed in the types and forms of organization of people’s lives and activities and the material and spiritual significance formed by them (Perez-Alvaro, 2019). The problem of business ethics is connected to the issue of the culture of production, associated, among other factors, with the development of a careful attitude to resources, products of labor, and the environment.

The specific nature of the work of medical professionals differs significantly from other types of human activity. First of all, lies in need for constant, daily, hourly communication between the nurse and the patient (Searight, 2019). It is essential to remember that a patient with health issues differs from a person who has no such concerns by the nature of their thinking and the strength of their psycho-emotional tension. Therefore, it is necessary to consider the moral factors that will allow the nurse to meet the requirements of patients.

Finally, healthcare workers require sensitivity, responsiveness, kindness, cordiality, caring, and attention in their daily work. Hence, the study should be conducted in such a way as to establish the practices in which these traits can be developed in healthcare personnel. This is due to the concept of a Christian worldview. There are also correlated ethical and cultural factors that must be present in healthcare workers (Searight, 2019). They should show respect for life, dignity, and human rights on every patient’s face. This is also consistent with secular guidelines that prohibit discrimination against patients through nationality, race, faith, color, age, gender, political beliefs, and social status. They have to maintain the highest level of nursing care that can be had in a particular situation.

In performing their professional duties, nurses are required to sustain a level of personal conduct that would create a good reputation for the profession. Thus, these ethical and cultural factors should be considered in the research. This is because it is essential not only to address the shortage of medication personnel but also to enhance cultural and ethical considerations (Searight, 2019). Accordingly, raising salaries, training, and reasonable allocation of resources will encourage people who espouse a Christian and secular worldview to become health professionals.


Therefore, the problem of shortage of medical personnel is highly relevant today. In order to effectively address the challenge, it is necessary to use “The 5 Whys Analysis”. Accordingly, the lack of training, heavy workloads, and unpaid work hours affect the depletion of the nursing staff. This leads to staff reductions in the face of increasing numbers of patients. For example, this situation was particularly evident during the COVID-19 pandemic. The scientific literature also points to a theoretical framework designed to address the problem of significant workloads on nursing staff. However, ethical and cultural factors should be considered when exploring methods to enhance the performance of existing staff and attract new employees.


Doosty, Farzaneh, Mohammad Maleki, and Mohammad Yarmohammadian. 2019. “An Investigation on Workload Indicator of Staffing Need: A Scoping Review”. Journal of Education and Health Promotion 8 (22): 1-8. Web.

Griffiths, Peter, Christina Saville, Jane Ball, Jones Jeremy, Natalie Pattison, Thomas Monks, and Safer Nursing Care Study Group. 2020. “Nursing Workload, Nurse Staffing Methodologies and Tools: A Systematic Scoping Review and Discussion”. International Journal of Nursing Studies 103: 103487. Web.

Marć, Małgorzata, Anna Bartosiewicz, Joanna Burzyńska, Zdzisława Chmiel, and Pawel Januszewicz. 2019. “A Nursing Shortage–A Prospect of Global and Local Policies”. International Nursing Review 66(1): 9-16. Web.

Perez-Alvaro, Elena. 2019. Underwater Cultural Heritage: Ethical concepts and practical challenges. Abingdon: Routledge.

Rogers, Rebekah, Alain De Brún, and William McAuliffe. 2020. “Defining and Assessing Context in Healthcare Implementation Studies: A Systematic Review.” BMC Health Services Research 20 (1): 1-24. Web.

Searight, Russell. 2019. Ethical Challenges in Multi-Cultural Patient Care: Cross Cultural Issues at the End of Life. New York: Springer.

Uchmanowicz, Izabella. 2017. “Missed Nursing Care–What Went Wrong?” Central European Journal of Nursing and Midwifery 8(2): 609.

Xu, Huiwen, Orna Intrator, and John R. Bowblis. 2020. “Shortages of Staff in Nursing Homes During the COVID-19 Pandemic: What are The Driving Factors?” Journal of the American Medical Directors Association 21 (10): 1371-1377. Web.

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