Nurse staffing is a significant challenge faced by healthcare organizations nationwide, and it contains ethical and practical considerations that influence providers’ work and patient outcomes. The gap can be identified through increasing turnover, lack of continuing education, and practitioners’ well-being-related issues (Xu et al., 2020). The staffing necessary to provide services properly and efficiently differs based on the type of care, organization, number of patients, and workload structure.
The problem occurs when the staff is insufficient to cover all the needs, and fewer practitioners are enabled to spend more hours at their workplace or have an over-filled shift schedule (Griffiths et al., 2018). The COVID-19 outbreak became an important lesson for healthcare organizations and an example for researchers of how crucial it is to address nurse staffing issues. The unsafe work conditions, lack of experience working at the infection units, anxiety, and burnout caused the increased shortage of practitioners and forced different hospitals to address this practice gap immediately (Xu et al., 2020). A healthcare organization can identify the problem by analyzing their employees’ satisfaction, checking for a tendency to worsen patient outcomes, and comparing the shifts’ schedule with ethical and legal workload regulations.
Nurse staffing is a problem that can be defined quantitatively as the inadequately small number of employees, yet its outcomes and causes can be explored qualitatively as the practitioners’ experience. Furthermore, the variable concepts are categorized by shift hours, workload by patient quantity, and employee turnout (Griffiths et al., 2018). The non-variable aspects are based on providers’ job satisfaction, perception of workload, the sufficiency of education, and the workplace environment. Based on these concepts, theoretical definitions are the following: staffing – quantity of employees, workload – the shifts’ hours, stress – negative feedback about the practitioners’ experience, and patient outcomes – the result of their interaction with nurses. Researching the problem and offering an effective solution requires addressing the aspects measurably (Rogers, De Brún, & McAuliffe, 2020). Consequently, the operational definitions are for the staffing if there is a lack of them compared to initial requirements. For workload, if more than 20% of employees are forced to work extra hours, for stress if they repeatedly use this word in their feedback, and for patient outcomes – the number of returns.
The 5 Whys analysis is an appropriate tool to identify the root causes and reveal possible solutions for the challenging issue of nurse staffing in healthcare organizations. The first question is why the staffing problem recently occurred, and the answer is due to the pandemic overload and increased turnover. Consequently, the question of why more nurses leave their jobs is relevant, and the response depends on the hospital’s conditions: for example, the turnover rate increases because the extra hours are not properly paid (Xu et al., 2020). The third question is why the payment system did not address the emergency, and the answer is that the government’s funding was invested in additional equipment buying.
Then, it is appropriate to ask why the decision was made this way and the response that the hospital executives were the key decision-makers. The fifth question is why the directors did not locate the funds differently can be answered that they had no reports about the issue from managers or local Boards of Nursing. Based on the 5 Whys analysis, increased extra hours payments can address the nurse staffing problem.
Griffiths, P., Saville, C., Ball, J., Jones, J., Pattison, N., Monks, T., & 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.
Rogers, L., De Brún, A., & McAuliffe, E. (2020). Defining and assessing context in healthcare implementation studies: A systematic review. BMC Health Services Research, 20(1), 1-24. Web.
Xu, H., Intrator, O., & Bowblis, J. R. (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.