Hello, and welcome to episode 21 of The Haelan Nurse Chronicles. I’m Dr. Lorre Laws, your host, and today we’ll be diving into a crucial study on insufficient staffing with RNs and nurse support staff in hospitals. This study sheds light on the impact of low staffing levels on patient outcomes and the increased risk of patient death. It highlights the importance of how the effects of the silent epidemic – nurse-specific traumatization – is impacting nurse staffing levels for every single day of a patient’s stay in the hospital.
As we explore the findings of this study, we’ll discuss the effectiveness of temporary staff in reducing the risk of patient death, as well as the associated risks of higher proportions of temporary RNs and nurse support staff. We’ll also delve into the challenges that hospitals face in addressing nursing shortages and the potential consequences of insufficient nurse staffing on patient care quality and outcomes. It’s crucial to understand the complexities of nurse staffing levels and their impact on patient safety. It’s also crucial to understand how the systemic and avoidable nurse-specific trauma exposure is impacting nurse-patient ratios, nurse AND patient safety, and quality of care. Join me as we explore the implications of this study in the context of unaddressed nurse-specific trauma exposure, most of which is avoidable, and discuss ways to enhance nurse staffing for optimal patient care.
Hire to Fire Staffing Model
The common “Hire to Fire” staffing model used by healthcare organizations is one that assumes that there is an infinite pool of nurses from which to hire when needed. In this staffing model, which is widely used but never openly discussed, nurses are hired as pawns on corporate chess boards with the purpose of being used, manipulated, and overworked until such time that they (a) desensitize and shut down emotionally or (b) they burnout out, become compassion fatigued, or are among the nearly 1 in 4 nurses that meet the diagnostic criteria for PTSD.
It’s a C-Suite strategy designed to maximize profits at the expense of its nurses, which indirectly and negatively affects patient safety, outcomes, and care quality. It’s like there’s a revolving door, a churn-and-burn approach to staffing. We’ll hire as many nurses as we can. Those who don’t burn out will be promoted. Those who do burnout can quit. We’ll just hire another nurse to replace them.
I’m not saying that every unit, every healthcare organization is taking a hire to fire or churn and burn approach to staffing. But many (many) are, particularly in the era of venture-capital driven healthcare delivery. To fill any gaps in staffing, the hiring of temporary or travel nurses will fill that void.
That model never works well for the nurse. And now, it’s not working well for the employer, either. Why? Because millions of nurses are saying “buh bye” to the profession, refusing to be oppressed and marginalized while working in unsafe conditions.
Study Investigates the Impact of Temporary Staffing & Patient Mortality
In a recent study conducted by Griffiths et. al (2024), it is important to note the effectiveness of temporary staff in reducing the risk of patient death. The study reveals that while temporary staff can help alleviate staffing shortages, the risk of patient death remains elevated compared to baseline levels. Additionally, the increased risk of death is associated with a higher proportion of temporary RNs and nurse support staff, emphasizing the importance of safe, adequately staffed and resourced units, and familiar conditions for nurse employment to combat staffing shortages.
The study highlights how temporary staff, whether hired through external agencies or employed by the hospital as bank staff, can impact patient outcomes due to their unfamiliarity with the care setting, which includes the nature and frequency of nurse-specific trauma exposures and the resources to support nurses in mitigating or ameliorating traumatization. Understanding these risks is crucial in addressing the challenges hospitals face in managing nursing shortages and ensuring optimal patient care quality.
Impact of Temporary Staffing & Shortage of Nurses Willing to Work in Unsafe Settings
In discussing the challenges of addressing nursing shortages, it’s crucial to recognize that many hospitals in the U.S. and the U.K. rely on temporary staffing out of “necessity” and “efficiency.” While employing temporary staff may alleviate immediate staffing shortfalls, it does not solve the fundamental problem of insufficient nurse staffing in hospitals. Nor does it address one of the root causes of these staffing challenges – the unsafe, often violent, and toxic work cultures that result in nurse-specific traumatization. That is what is actually driving nurses from the profession. Just ask any nurse who has tapped out. I’ve interviewed hundreds of them. Or take a peek at your favorite social media channel – there is no lack of heartfelt testimonials of nurse suffering.
Furthermore, the consequences of insufficient nurse staffing are profound, impacting patient outcomes and care quality. The study highlighted the association between low RN staffing and nurse support staffing levels with increased risks of patient death within 30 days of admission. Interestingly, the research also found a correlation between a higher proportion of senior RN staff and a reduced risk of patient death. However, the inclusion of senior staff alone is not a panacea for addressing nursing shortages. It’s essential to focus on improving overall nurse working conditions and staffing levels to create a sustainable and supportive healthcare environment that prioritizes nurse AND patient safety, nurse professional wellbeing, and optimal care quality.
As hospitals continue to grapple with nursing shortages . . .or rather, a shortage of nurses unwilling to work in harsh, toxic, and unsafe settings . . . it’s crucial to recognize the limitations of focusing on a single outcome in studies on nurse staffing and patient care. While the impact of low staffing on patient mortality is significant, it’s just one aspect of the broader implications of inadequate nurse staffing levels. But it does point a spotlight as to the root causes that lie deep within the underbelly of many health systems and organizations. Until we address the avoidable nurse-specific traumatization, healthcare organizations will continue to draw upon the services of temporary and travel nurses – placing both the patient and the nurse at risk for unsafe conditions and related sequelae.
In Summary . . .
In conclusion, it is evident that the study on insufficient staffing with RNs and nurse support staff in hospitals has shed light on the critical impact of low staffing levels on patient outcomes and the increased risk of patient death. One of the key factors contributing to the staffing challenge is the avoidable nurse-specific traumatization that many nurses experience in their work environments. This trauma not only affects their mental and emotional wellbeing but also contributes to high turnover rates and a shortage of nurses willing to work in unsafe settings.
Addressing avoidable nurse-specific traumatization is crucial in creating stable, safe, and familiar conditions for nurse employment to combat staffing shortages and ensure optimal patient care outcomes. By focusing on improving overall nurse working conditions and staffing levels while addressing the root causes of nurse dissatisfaction, healthcare organizations can create a sustainable and supportive environment that prioritizes nurse and patient safety, professional wellbeing, and quality care. It is essential for hospitals to recognize the systemic issues that lead to nurse-specific traumatization and work towards creating a healthcare system that values and supports its nurses, ultimately leading to better outcomes for both nurses and patients.
If you or someone you know has been affected by nurse-specific traumatization, please seek support immediately. I and my team are standing by to support nurses however possible. Please join my Nurse Trauma Masterclass or schedule a personal call with me to explore the best healing options for you.
Until next time, thank you for all that you are and do.
I see you.
I feel you.
I hear you.
And I am here for you.
From my healer’s heart to yours,
Dr. Lorre 💕
