The Problem of Low Nurse Staffing in Hospital Settings

The focus of the capstone project will be on low staffing of nurses in hospital settings. Low nurse staffing is a critical practice issue that is prevalent in the United States, as well as in Europe and Asia. The problem is of great importance to nursing practice, as it affects the quality of care provided in hospitals, nurse work environment, and patient outcomes. The present paper will describe the chosen issue and review the evidence in support of its importance.

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Low nurse staffing can often be observed in hospitals, and thus acute care hospitals are the primary context of this problem. The main cause of low nurse staffing in hospitals is cost-cutting activities. According to Aiken et al. (2014), hospitals often attempt to reduce expenditures by decreasing the number of nurses employed. Also, staffing problems can be caused by high nurse turnover, which may occur due to low pay and poor working conditions.


Nurse staffing is a term used to describe the number of nurses employed by a facility. Whether nurse staffing is low, adequate, or high is defined based on the average nurse-to-patient ratio (Cho et al., 2015). For instance, in a small hospital with few patients, a low number of nurses employed would not necessarily lead to inadequate nurse staffing. However, in a large hospital with over 200 beds, a much higher number of nurses on duty will be required to maintain a high level of staffing.


The impact of nurse staffing on patient outcomes, quality of care, and work environment has been detailed by various studies. For example, Cho et al. (2015) and Aiken et al. (2014) report that low nurse staffing is associated with increased patient mortality in acute care hospitals. Similarly, nurse staffing was connected with an increased risk of complications, including infections, as well as readmissions (McHugh, Berez, & Small, 2013; Rogowski et al., 2013). These influences are often a direct result of low nurse-to-patient ratios, as inadequate nurse staffing creates a risk of medical errors, rushed treatment decision-making, and impaired communication between patients and nurses. Low nurse staffing also affects nurses’ motivation and well-being, as it can lead to burnout, stress, and job dissatisfaction (Aiken, Sloane, Bruyneel, Van den Heede, & Sermeus, 2013; Khamisa, Peltzer, & Oldenburg, 2013). Finally, inadequate nurse staffing also impacts the hospital’s financial performance. According to a study by Everhart, Neff, Al-Amin, Nogle, and Weech-Maldonado (2013), low nurse staffing rates are connected with decreased overall care quality, and thus impair the financial performance of hospitals operating in competitive markets.


The influence of nurse staffing on hospital performance, care quality, and nurses wellbeing is critical. Thus, studying this issue in detail could create opportunities for nurses and hospitals to cooperate in improving staffing levels and working conditions. By ensuring adequate nurse staffing, healthcare organizations can obtain some significant benefits, thus achieving a balance between employee wellbeing, patient experiences, and financial performance.


Solutions for inadequate nurse staffing levels target hiring and retention practices of the organization. On the one hand, it is crucial to attracting educated and experienced nurses to join the organization. On the other hand, it is vital to retain nurses in order to reduce turnover and promote stable nurse staffing levels. Both goals can be achieved by improving nurses’ work environment (Van den Heede et al., 2013). For instance, organizations could offer excellent employment value propositions (EVPs), which include a fair salary, health and training benefits, and career development opportunities. Moreover, hospitals could attempt to improve scheduling and reduce shift length. This could help to reduce stress and burnout while also decreasing the incidence of medical errors and improving patient outcomes.


Overall, the project will focus on low nurse staffing, which is a critical issue for hospitals. Nurse staffing levels influence the quality of care, patient outcomes, and financial performance of hospitals. By developing and implementing appropriate interventions to increase nurse staffing, organizations can become more profitable while also achieving a more motivated and loyal workforce.

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Aiken, L. H., Sloane, D. M., Bruyneel, L., Van den Heede, K., Griffiths, P., Busse, R.,… Sermeus, W. (2014). Nurse staffing and education and hospital mortality in nine European countries: A retrospective observational study. The Lancet, 383(9931), 1824-1830.

Aiken, L. H., Sloane, D. M., Bruyneel, L., Van den Heede, K., & Sermeus, W. (2013). Nurses’ reports of working conditions and hospital quality of care in 12 countries in Europe. International Journal of Nursing Studies, 50(2), 143-153.

Cho, E., Sloane, D. M., Kim, E. Y., Kim, S., Choi, M., Yoo, I. Y.,… Aiken, L. H. (2015). Effects of nurse staffing, work environments, and education on patient mortality: An observational study. International Journal of Nursing Studies, 52(2), 535-542.

Everhart, D., Neff, D., Al-Amin, M., Nogle, J., & Weech-Maldonado, R. (2013). The effects of nurse staffing on hospital financial performance: Competitive versus less competitive markets. Health Care Management Review, 38(2), 146-155.

Khamisa, N., Peltzer, K., & Oldenburg, B. (2013). Burnout in relation to specific contributing factors and health outcomes among nurses: A systematic review. International Journal of Environmental Research and Public Health, 10(6), 2214-2240.

McHugh, M. D., Berez, J., & Small, D. S. (2013). Hospitals with higher nurse staffing had lower odds of readmissions penalties than hospitals with lower staffing. Health Affairs, 32(10), 1740-1747.

Rogowski, J. A., Staiger, D., Patrick, T., Horbar, J., Kenny, M., & Lake, E. T. (2013). Nurse staffing and NICU infection rates. JAMA Pediatrics, 167(5), 444-450.

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Van den Heede, K., Florquin, M., Bruyneel, L., Aiken, L., Diya, L., Lesaffre, E., & Sermeus, W. (2013). Effective strategies for nurse retention in acute hospitals: A mixed method study. International Journal of Nursing Studies, 50(2), 185-194.

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StudyCorgi. (2021) 'The Problem of Low Nurse Staffing in Hospital Settings'. 21 July.

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