Resolving the Challenge of Nurse Staffing Ratios Research Paper

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Leadership and Management

In the medical field, the recent topic of debate relates to Nurse Staffing Ratios where many argue that governments need to intervene in setting minimum staffing laws. Currently, the only state that has enacted a law is California and nurse unions in other states are fighting for the implementation of the same in their workplaces. However, most of the attempts made by other states to implement California's strategy have failed since hospitals fail to participate (Schultz, 2013). The argument of many hospitals is that the laws do not give them the opportunity or ability to make decisions regarding staffing and at the same time be a financial burden (Schultz, 2013, par. 3). As seen from many nursing unions, hospitals have abused the system to the point of employing few nurses and yet the patients are ever increasing. Inappropriate staffing ratios influence the safety of patients, the satisfaction of nurses, and contribute to the further deterioration of work environment due to job stress and burnout. Nursing staffing ratios is a debate, and the only way to improve the situation is to use effective approaches for leading and managing the hospital environment. Thereby, avoiding negative effects that are inappropriate for nurse-to-patient ratios.

According to Aiken et al., a positive relationship exists between nurse-staffing ratios and preventable patient death (2002). Arguments raised consider legislations to be having a high potential of leading political and economic devaluation of the nursing profession due to the fixed ratios. Therefore, failure to deal with nursing staffing ratios will be rampant. The mandatory proponents for staffing ratios argue that it will improve quality of care. Since the satisfaction of patients and nurses is enhanced, the nursing work environment will be improved. Improvement in the work environment attracts new nurses and licensed nurses who are not working currently. Staffing critics argue that by mandating specific staffing ratios in environments where the shortage is on the high, leads to the reduction of hospital services, increased unit closures, increased diversions in the emergency room, increased hospital expense due to additional costs related to labor for temporary agency nurses and overtime.

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The American Organization of Nurse Executives (AONE) has a responsibility to manage patient care and give them an assurance of having a focused environment that looks at quality and safety in their operations. Staffing ratios are complex with multiple variables and using the mandated staffing ratios approach does not guarantee a healthy working environment for nurses. Additionally, the safety and quality levels are not sufficient in preventing the adverse patient outcomes. AONE's position on mandatory staffing ratios asserts that it serves only to increase stress on systems in the health care as it is overburdened with escalating shortage of professionally registered nurses both nationally and internationally. Thus, the mandatory staffing ratios approach has a potential of creating greater risks to the safety of the public (AONE, par. 4).

Leadership and Manager Approach Comparison to the Issue

According to Hughes et al., the distinction between leaders and managers is as follows (2006):

Leaders develop, managers maintain

Leaders originate, managers initiate

Leaders innovate; managers administer

In terms of status quo leaders' challenge, managers accept it

Leaders view is long-term, managers use short-term view

Leaders inspire, managers control

Leaders ask why and what, managers ask when and how.

However, a leader is not made from an individual's job title only, but rather his/her behavior is the determinant. It is always expected that a leader can inspire, innovate, challenge and, guide as stated above. However, the underlying question is whether these behaviors and practices are present in today's nursing leaders (Curtis et al., 2011, p. 307).

Nursing staffing ratios impacts manager's responsibility since a shortage of nurses increases the chance of error due to the improper treatment accorded to patients….....

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