Nursing Shortage Consequences


Proper nursing care is extremely important as it allows us to address the issues that can significantly decrease the quality of life of patients. Nevertheless, there are many important problems connected to the field that can hurt the quality of care and patients’ experiences. Speaking about these problems, it is necessary to mention understaffing that occurs in many hospitals all over the world. As for a specific location studied in this paper, Palmetto Hospital also faces some problems related to the discussed sphere. This is why it is necessary to conduct research that would help to understand how inpatients with the need for acute care perceive the effects of understaffing in nursing while being provided with acute care by nurses. What is more, it is important to take into consideration the poor knowledge base of many healthcare professionals working there. To better understand the effects that can be produced on inpatients in such a situation, it is necessary to review the studies that have already been conducted and can be regarded as relevant for the present research.

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Understand the problem of staff shortages and its impact on patients

Speaking about the studies in the field that can help to understand the problem of understaffing and its effects on patients, it is necessary, to begin with, a range of research questions that were identified by the researchers who have analyzed a lot of data to present the results possessing certain practical relevance. The authors of the articles seem to have regarding the topic from different points of view establishing the links between understaffing and other negative phenomena that may occur in healthcare professionals’ practice. Thus, Ball, Murrells, Rafferty, Morrow, and Griffiths (2013) studied the relationship between staffing levels and missed nursing care whereas Kalisch, Tschannen, and Lee (2012) focused on its possible connection with patient falls. Glance et al. (2012) researched to study the connection between nurse staffing levels and negative health outcomes in the same manner as Zhu et al. (2012) who studied the situation in China. A similar study was also conducted by Park, Blegen, Spetz, Chapman, and de Groot (2012) who were focusing on nurse staffing levels and patient outcomes. The effects of staffing regulations in California on patients’ health were assessed by Cook, Gaynor, Stephens, and Taylor (2012).

Also, many researchers focused on safety and mortality rates in connection with staffing levels; for instance, Spetz, Harless, Herrera, and Mark (2013) analyzed possible changes in patient safety caused by staffing changes whereas Liang, Tsay, and Chen (2012) studied cases in Taiwan to establish the connection between nurse staffing levels and mortality rates. What is also important, many authors studied the factors that could influence patients’ satisfaction levels. For example, Stimpfel, Sloane, and Aiken (2012) focused on exploring the effects of extended shifts on patient satisfaction. Another research connected to patient satisfaction levels was conducted in Turkey by Tekindal, Pinar, Ozturk, and Alan (2012) who studied its connection with the level of burnout in nurses. Having analyzed the articles mentioned and the research questions formulated by their authors, it is possible to conclude that the topic of staffing levels and its positive and negative effects seem to be quite popular among the researchers. Therefore, the results of these studies may help to analyze the data collected within the frame of the present research. Nevertheless, not all the studies were conducted in connection with acute care. As it is clear, the authors conducted their studies in different locations; due to that, the conclusions made by the authors from other countries may be different from the ones connected to Palmetto Hospital.

Analyzing the relevance of the discussed studies for the present research, it is also important to speak about the sample populations that were used by the researchers. To begin with, authors of all studies have managed to analyze large amounts of data as it is clear from the sections where the processes of data collection and sampling are described. Due to that, it can be stated that all the studies are credible as they are based on data reported by great numbers of participants. The studies were conducted in different countries including the United States, China, Taiwan, Turkey, and the United Kingdom, and the participants whose interviews were used to answer the research questions were of different nationalities. Speaking about the size of the samples used by the researchers, it is necessary to say that all of the studies involved at least 448 participants as in the research by Tekindal and his colleagues. As for the research that involved the largest number of participants, it was conducted by Park and other researchers. The importance of the conclusions made by these researchers should not be underestimated as the total number of participants whose cases and personal details were used was around one million. Moreover, the samples used by the authors usually included both nurses and patients (some studies focusing on patients’ perceptions also involved patients’ relatives).

As for the limitations of the discussed studies, it is necessary to realize that they were closely interconnected with the research methods chosen by the authors. For instance, those studies that were conducted with the focus on qualitative data allowed the researchers to make conclusions that could be called less precise. On the other hand, quantitative data cannot be always useful to reflect participants’ opinion and the main ideas related to their personal experience. Speaking about the limitations that were the most common for the discussed studies, it is important to remember about subjective perception. Thus, an important limitation for many groups of researchers including Ball and her colleagues was connected to the inability to significantly reduce the influence of patients’ and nurses’ subjective experiences on the results of the studies. Thus, it was important for the researchers to take into consideration that some participants could understand certain notions related to the research topics in their way.


In the end, the discussed studies can be called extremely significant for the field as they allow to better understand the effects of different staffing levels on nurses’ work performance and various factors that may influence patient satisfaction levels in different countries. About the recommendations that can be made based on the analysis of previous studies, it is necessary to clearly define all the terms that can be used during interviewing patients to find out how they perceive the effects of understaffing in nursing while being provided with acute care in Palmetto Hospital. Due to that, it will be possible to secure uniformity of the evaluations and develop the most effective solutions that will help to ameliorate the situation and incorporate new staffing strategies.


Ball, J. E., Murrells, T., Rafferty, A. M., Morrow, E., & Griffiths, P. (2013). ‘Care left undone’ during nursing shifts: Associations with workload and perceived quality of care. BMJ Quality & Safety, 1(1), 1-10.

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Cook, A., Gaynor, M., Stephens Jr, M., & Taylor, L. (2012). The effect of a hospital nurse staffing mandate on patient health outcomes: Evidence from California’s minimum staffing regulation. Journal of Health Economics, 31(2), 340-348.

Glance, L. G., Dick, A. W., Osler, T. M., Mukamel, D. B., Li, Y., & Stone, P. W. (2012). The association between nurse staffing and hospital outcomes in injured patients. BMC Health Services Research, 12(1), 247.

Kalisch, B. J., Tschannen, D., & Lee, K. H. (2012). Missed nursing care, staffing, and patient falls. Journal of nursing care quality, 27(1), 6-12.

Liang, Y. W., Tsay, S. F., & Chen, W. Y. (2012). Effects of nurse staffing ratios on patient mortality in Taiwan acute care hospitals: A longitudinal study. Journal of Nursing Research, 20(1), 1-8.

Park, S. H., Blegen, M. A., Spetz, J., Chapman, S. A., & De Groot, H. (2012). Patient turnover and the relationship between nurse staffing and patient outcomes. Research in nursing & health, 35(3), 277-288.

Spetz, J., Harless, D. W., Herrera, C. N., & Mark, B. A. (2013). Using minimum nurse staffing regulations to measure the relationship between nursing and hospital quality of care. Medical Care Research and Review, 70(4), 380-399.

Stimpfel, A. W., Sloane, D. M., & Aiken, L. H. (2012). The longer the shifts for hospital nurses, the higher the levels of burnout and patient dissatisfaction. Health Affairs, 31(11), 2501-2509.

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Tekindal, B., Pinar, G., Ozturk, F., & Alan, S. (2012). Nurses’ burnout and unmet nursing care needs of patients’ relatives in a Turkish State Hospital. International journal of nursing practice, 18(1), 68-76.

Zhu, X. W., You, L. M., Zheng, J., Liu, K., Fang, J. B., Hou, S. X.,… & Wu, Z. J. (2012). Nurse staffing levels make a difference on patient outcomes: A multisite study in Chinese hospitals. Journal of Nursing Scholarship, 44(3), 266-273.

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