Safe Staffing for Nurses


Nurses play a very important role in healthcare institutions. They help in administering medication, monitoring the progress of the patients, providing safety to the patients, coordinating the activities of the doctors, among many other activities. The efficiency of the nurses not only depends on their level of qualification but also their number within a given institution. The ratio of nurse to patients matters a lot in ensuring that nurses give their patients the best attention they need. When one nurse is forced to serve several patients, then such a nurse will be forced to stretch his or her services to all the patients, and it compromises on the quality. That is why the issue of safe staffing for nurses has emerged as a major policy issue in the United States. There is a need for lawmakers to come up with a policy that defines the minimum ratio of nurses to that of patients allowable in both public and private institutions of healthcare. In this paper, the researcher will critically look at this policy issue with a view of giving suggestions on how it can be tackled.

Safe Staffing for Nurses

Safe staffing for nurses is not an issue that emerged in recent times. When New York Nurses Association was founded, one of its main objectives was to champion for safe staffing for nurses which was spearheaded by American Nurses Association. The American Nurses Association has been championing safe staffing for nurses since 1897 when it was founded and the current status of this issue can be found on their website (Thomas, 2004). The website provides updates about the progress made in improving the ratio of nurses to patients within the country. It means that this is not a new policy issue. It is a problem that has existed for a very long time and the country has continued to ignore it. Since nurse staffing is an issue that should be managed by the state governments, having federal-level policies may help in finding a national solution to this problem. The successive administrations have promised a lot but delivered very little in terms of improving the ratio of nurses to that of patients. The American public is often concerned about the safe staffing for nurses when they or their loved ones are hospitalized. Once they leave these hospitals, the issue of safe staffing becomes a less significant issue to them. That explains why this policy has not received public attention to the magnitude that it requires.

Evidence that Supports Safe Staffing for Nurses

Studies have been conducted to help in understanding the issue of safe staffing for nurses. According to a study by Cherry and Jacob (2016), safe staffing for nurses is one of the ways of improving the services of nurses in healthcare institutions. Nurses work best when they are assigned tasks that are equal to their capacity. A study conducted by New York State Nurses Association revealed that public expectation of what to expect from the nurses exceeds what the nurses can deliver (Farrar & Krau, 2015). This is not because the nurses are too lazy to deliver on these expectations but because they are strained. In most cases, they work under a lot of pressure and for long hours without any additional remuneration. Society has a belief that given the nature of the work of nurses, they are expected to be compassionate and willing to go a step further in delivering quality services to their patients. However, what many people forget is that these nurses are human beings who can be fatigued when they are overworked.

A study by Clarke (2007) shows that in most of the public institutions within the United States, nurses find themselves working for extra hours without pay because of their desire to save people’s lives. At the end of their shift, they are faced with a situation where they have to attend to a patient who needs emergency medical care before they can be effectively replaced by others. Sometimes their shift may come to an end when they are in the theatres helping the doctors to save a patient whose life hangs in the balance. Based on humanitarian grounds and the desire to help, they stay a while longer for unofficial hours which in most cases they do not receive any compensation. The situation demoralizes these nurses, which in turn affects their productivity.

Importance and Impact of Safe Staffing for Nurses to nursing

This policy issue may help address several issues that have been identified to affect nurses in their normal duties. Donnellan (2003) notes that safe staffing for nurses helps in reducing medical and medication errors. In most cases, these errors often arise when the nurses are overworked. When fatigued, nurses may end up mixing the prescriptions for different patients, an error that may have serious consequences on the patient. This error is eliminated when they work within the normal hours and with the recommended number of patients.

A study by Martin (2003) revealed that patients’ mortality is directly proportionate to nursing negligence. Sometimes nurses may ignore an urgent patient’s need and prefer to take some time to rest because they are overstretched. In such cases, the life of a patient may be lost because the nurses did not respond within the right time. In other cases, nurses may make silly mistakes that may cost a patient his or her life. Cases have been reported where surgical equipment such as forceps or tissues is forgotten in the patients’ bodies. Such mistakes can have fatal consequences and are attributed to fatigue. These mistakes can be eliminated through safe staffing.

Job satisfaction is very important when it comes to retaining nurses within this profession and their institutions of work. Many nurses have quit this profession after taking just a few years of practice. Most of them site fatigue and stress as the main reasons for considering other professions. Currently, the ratio of nurses to that of patients is below the recommended level. If the current nurses consider quitting this profession for others who are less stressed, then the condition will be worse in our hospitals. The remaining nurses will be overstretched and the quality of services that they give will be worse. We may likely witness more complaints from the patients because they will be underserviced. In such situations, Wiseman (2001) says that even those taking nursing courses will reduce because of the fear of the stress associated with the job. As such, the problem of few nurses in our hospitals will never be resolved.


American society needs to realize that nurses can only be effective if they work within their capacity. This can only happen when the ratio of nurses to that of patients is within the recommended level. Safe staffing for nurses is an issue that should not be ignored any longer. The policymakers must understand that this is the only way of improving the quality of service of the nurses.


Cherry, B., & Jacob, S. R. (2016). Contemporary nursing: Issues, trends, & management. Hoboken, NJ: Elsevier.

Clarke, S. P. (2007). Registered Nurse Staffing and Patient Outcomes in Acute Care: Looking Back, Pushing Forward. Medical Care, 45(12), 1126–1128.

Donnellan, C. (2003). Washington Watch: Safe Staffing Bill Introduced in the Senate. The American Journal of Nursing, 103(7), 29–29.

Farrar, F. C., & Krau, S. D. (2015). Transformational tool kit for front line nurses. New York, NY: Cengage.

Martin, S. (2003). Issues Update: Solidarity. The American Journal of Nursing, 103(8), 65–69.

Thomas, S. P. (2004). Transforming nurses’ stress and anger: Steps toward healing. New York, NY: Springer Pub. Co.

Wiseman, R. (2001). Issues Update: The ANA Develops Bill of Rights for Registered Nurses. The American Journal of Nursing, 101(11), 55–57.