Identifying Staffing Issues in Nursing

NURS-FPX4010 Assessment 2: Identifying Staffing Issues in Nursing

Introduction

Extensive clinical literature demonstrates a strong link between nursing workload and patient safety.When there aren’t enough staff members, the quality of care goes down, and ethical boundaries become compromised. This assessment concentrates on the application of ethical principles to recognize and rectify persistent staffing deficiencies in an acute care environment.

Identification of the Issue: The Medical-Surgical Gap

The nurse-to-patient ratio in the target unit has changed from 1:5 to 1:7 consistently over the past six months. This change is associated with a 15% increase in medication administration errors and a decline in patient satisfaction scores. The Safe Staffing for Nurse and Patient Safety Act emphasizes that adequate staffing is essential for optimal patient outcomes.

Applying Ethical Principles to the Staffing Crisis

Non-maleficence

The principle of non-maleficence (“do no harm”) is compromised when inadequate staffing limits a nurse’s ability to provide safe and effective monitoring. When a nurse is under excessive workload to turn a patient and they get a pressure ulcer, the system has failed its moral duty.

Justice

Justice refers to the equitable distribution of resources, responsibilities, benefits, and burdens. In a staffing crisis, justice is often overlooked because nurses are expected to shoulder excessive workload demands without enough pay or help, which can cause moral injury. For hospital leaders to apply ethical principles, they need to see staffing as a basic part of social justice at work, not as a cost that can change.

Beneficence

Beneficence involves acting in the patient’s best interest. High-acuity patients require frequent assessments and interventions. When staffing is inadequate, the nurse may be forced to ration care, choosing which patients’ needs are most important—a practice that contradicts the holistic nature of nursing.

Evidence-Based Resolution: Acuity-Based Staffing

A potential solution to the identified staffing issue is the implementation of an Acuity-Based Staffing tool. Unlike traditional census-based models, acuity-based models assign patients based on the intensity of care required. Research published by theNational Institute of Health (NIH) suggests that acuity-based systems improve nurse satisfaction and reduce “missed care” incidents.

Conclusion

Identifying staffing issues represents an initial step in addressing systemic challenges. Nurses play a critical advocacy role by applying ethical principles to promote policy and organizational changes that support safe and equitable care delivery.