This blog was originally published on Calling all Nurses – One of the greatest challenges in today’s rapidly changing healthcare system is maintaining the highest standards for patient safety. Last week, we talked about the issue of low staffing ratios. This week, we’ll focus on another area that requires our attention—the disproportionate ratio of new nurses versus experienced nurses.
As nurses, we are bound by our oath to give quality care to every single one of our patients. This means making sure every hospital has a sufficient number of experienced nurses on staff at all times to ensure patient safety and support new nurses. Unfortunately, this is not always the case.
What’s the problem?
“I don’t know how to do that” is something that experienced nurses are hearing more often from new hires. To their dismay, hospitals are employing nurses with less than two years of experience more often than those who are more seasoned. In fact, some nursing units have up to 75% underqualified nurses, which poses many patient safety concerns for two main reasons:
First and foremost, less experienced nurses do not possess the nursing skills needed to handle both the physical and emotional demands of the job. Not even the best nursing schools or top NCLEX scores can take the place of real-life, practical experience.
Secondly, burnout rates are increasing among more experienced nurses. As the overwhelming need for training, coaching, and mentoring consumes much of the time and energy of the nursing staff, seasoned nurses are forced to take on a greater workload.
According to The American Nurse, “Research indicates that staffing numbers alone don’t always tell the whole story or assure positive outcomes for patients in the absence of other considerations. Other factors related to staff expertise, including RN education level, employment status and skill mix, as well as collegiality of nurse-physician relations exert a positive impact on select patient outcomes, such as 30-day mortality and hospital readmission rates.”
The Joint Commision echoes these concerns: “Nurses are the frontline of patient surveillance—monitoring patients’ conditions, detecting problems, ready for rescue. Spread too thinly or lacking the appropriate skill set, the nurse is at risk of missing early signs of a problem, or missing the problem altogether.”
What’s the reason?
There are several contributing factors that lead to staffs with inadequate nursing skills. One is hospital budget constraints, resulting in freezes on nurse salary increases. Without room for growth, more experienced nurses might look for work elsewhere.
Another potential cause is poor efforts in healthcare towards institutional nurse retention, resulting in high staff turnover rates. If experienced nurses don’t feel valued by an institution, whether financially or otherwise, they are less likely stay at that particular job.
Nurses report that low job satisfaction is primarily related to heavy workloads, an inability to ensure patient safety, and low salaries.
What’s being done?
Many national healthcare efforts are being made to enhance nurse retention programs and increase the salaries and incentives for their nursing staff. Here are a couple already in progress:
- The Nurse Residency Program. To enhance nurse retention, many institutions have begun implementing nurse residency programs. Research shows that nurse residency programs are a key strategy to retain new grad nurses. Residency programs are longer than traditional orientation programs and can range from 6-12 months or more. Unlike mere orientations, they promote strong connections among workplace colleagues and work-life balance.
- Nursing wage and incentive increases. The American Nurses Association recently created a Bill of Rights, which states nurses have the right to fair compensation for their work, that is consistent with their educational preparedness, knowledge, experience and professional duties. As a result, many nursing leaders have begun research initiatives to prove that higher salaries for nursing will result in better outcomes for everyone.
As a result of such healthcare initiatives, salaries and bonuses for nurses have been on the rise as hospitals strive to attract more longevity within their nursing staff.
As we continue to work hard in correcting the disproportionate nursing skills within our healthcare system, I am confident that our devotion to upholding the highest standards for patient safety will lend itself to creating positive change for all.