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Introduction
Understaffing is a serious issue in every sphere where trained professionals use their skills to provide a complicated service to people. In a clinical setting shortage of nurses may result in slowing down the work of the whole clinic and thereby lowering the quality of service. However, there are economic effects of such a shortage such as changes in health policy that try to address the gap. The relationship between understaffing and health policy is a complex issue that requires studying the causes of the former, main stakeholders, and current policy issues. Understaffing in this key area of professional activity has serious consequences for many people, which makes the extent of this influence a fascinating topic to study.
Causes of Understaffing in Nursing
To assess the impact of understaffing in nursing the roots of the problem need to be briefly observed first. To begin with, the level of salary among the nurses across the U.S. ranges from 8 to 20 dollars per hour, which is not much considering the specifics of the occupation. Additionally, Nurses face great amounts of stress as they work with a large flow of clients and the time of service is limited. In the circumstances of a constant rush and long shift hours, the work seems unbearable to many who first come into this profession. The low prestige of this profession diverts young and ambitious people who want to make a career in medicine from nursing towards more noble and professions such as a surgeon, psychologist, and so on. All these reasons combined make the nursing profession unattractive, which, in turn, causes the lack of fresh interns who stay and become APRNs.
Stakeholders
It is also paramount to know who are the most important people in the process of changing health policy in order to combat the shortage of professionals. One of the main stakeholders is the nurses themselves. In the understaffed clinic, nurses often tend to work longer hours with increased workloads, especially, if some members of the nursing staff decided to quit and a clinic has not found suitable candidates yet. Another stakeholder is a patient. It is they who suffer the consequences of an improper staffing policy at a clinic or from an overall unfavorable job market environment. The third stakeholder is a clinic that losses clients and prestige as the numbers of their most essential workers dwindle and with it rises the average service time. The fourth stakeholder is professional nursing organizations such as American Nurses Association (ANA) that advocates for better working conditions and fairer pay for nurses across the U.S.
Nursing Staffing Policy
To cope with the problem of understaffing in nursing, the state and national governments issue policies that set the requirements for clinics and other employers that regulate hiring, work environment, and so on. As of now, there is no adequate and thorough nationwide legislation on staffing in nursing. Under the 42nd Code of Federal Regulations that regulates working relationships in healthcare, hospitals are required to have an adequate number of nurses ( 42 CFR 482.23 Condition of participation: Nursing services, 2018). Such vague wording allows for an improper understanding of policies and may even further worsen the situation with a shortage of nurses. Such organizations as the previously mentioned ANA, try to lobby the Registered Nurse Staffing Act that would allow establishing a certain minimum of nurses in a hospital such as one nurse per one or two patients (ANA, 2018). As of now, only two states including California and Massachusetts have such a ratio (ANA, 2018).
The Impact of Understaffing in Nursing on Health Policy
Judging from the legal situation described above, nurses in hospitals across the U.S. are still work in imperfect conditions. According to Tubbs-Cooley, Cimiotti, Silber, Sloane, and Aiken (2013), even in California, around 30% of hospitals are at the ratio of 1:4 and lower. Regarding health policy, such a state of affairs would mean increasing pressure on legislators from worker unions and eventual changes in regulations. When the majority of the population will not be satisfied with the increased average wait time in hospitals due to understaffing, they will be more eager to back unions in their claims. Considerable time should pass before a staffing policy changes on a national level. It is more likely that a shortage of nurses in a majority of state hospitals will trigger alterations in state legislation that will hopefully set a state minimum requirement for the nurse-patient ratio. This will likely trigger clinics to make changes to the work environment such as increasing wages, lowering working hours to attract nurses and meet the state policy criteria. Thus, a fair health policy creates workplaces for nurses and a decent environment. A shortage of workers creates a ground for policy improvement.
Conclusion
Understaffing in nursing affects not only nurses harming their work environment but also patients, who receive services of lower quality and wait longer to receive help. Organizations such as ANA advocate for changing nursing staffing policies at all levels to improve this situation. Presently, the work progress is slow. However, increasing understaffing will cause more nurses to quit their jobs, and eventually it will lead to changes in health policies at state and national levels. It will happen because the majority of the public will be dissatisfied with services and will help ANA to force officials to introduce minimum requirements for clinics. Thus, understaffing could significantly affect health policymaking, provided the scale is great enough.
References
American Nurses Association (ANA). (2018). Web.
42 CFR 482.23 Condition of participation: Nursing services. (2018). Web.
Tubbs-Cooley, H. L., Cimiotti, J. P., Silber, J. H., Sloane, D. M., & Aiken, L. H. (2013). An observational study of nurse staffing ratios and hospital readmission among children admitted for common conditions. BMJ, 22(9), 735-742.
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