Ethics Issue in Nursing- Staffing Shortage

Ethical Issue in Nursing – Staffing Shortage
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Abstract
The dilemma in augmenting nurse staffing can be conceptualized via the merits and demerits of achieving optimal staffing levels. The current nurse staffing systems are typically inflexible and antiquated. The report reiterated the significance of optimal staffing in ensuring professional nursing practice and value. The most significant concern related to achieving optimal nurse-patient ratios is anchored on cost. The path to achieving optimal nurse staffing levels imposes substantial hospitals and discredits their contribution to staffing decisions. According to the utilitarianism decision-making model, achieving optimal nurse staffing thresholds is increasingly beneficial and optimizes all the stakeholders’ happiness. The nursing role as a change agent in addressing the ethical dilemma is anchored on advocating for optimal staffing levels in the practice context. This requires implementing the principles of participation, appropriate timing, change resistance, self-understanding, and flexibility toward achieving optimal nurse-patient ratios. In demonstrating service to humanity and God, the nurse should address the ethical issue while considering the key ethical principles in healthcare practice.
Ethical Issue in Nursing – Staffing Shortage
Introduction
With the healthcare organizations downsizing, nursing shortage, and budget cuts in the United States (U.S.), it is not surprising that the American Nurses Association research established that 54 percent of their nurse subjects did not have enough time to attend to each patient’s needs. The previous decades have been characterized by understaffing and overcrowding, resulting in longer working hours and increasingly stressful nurse shifts. As a result, nursing professionals have recorded higher burnout thresholds and reduced retention rates. However, there are ethical concerns in making decisions related to increasing or decreasing nurse-patient staffing ratios. The path towards optimal staffing levels is constrained by the benefits and detriments such decisions could pose. This paper evaluates the ethical dilemma related to nursing staff shortage, explains the dilemma as per the utilitarianism decision-making framework, the role of the nurse as a change agent in addressing the ethical problem, as well as their role in serving humanity and God while addressing the identified ethical issue.
The Dilemma in Addressing Nursing Shortage
The dilemma of concern is anchored on instituting measures geared towards addressing the nursing shortage. In light of the view that health is an important determinant of sustainable development, attention has been directed to improving various facets of healthcare to achieve desired outcomes. The solution-seeking discussions have focused on different areas, especially how to address the shortage of nursing staff. The bottom line is that the nurse-patient ratio is problematic yet determines health outcomes. Although the federal mandates for staffing are lacking, it is recommended that healthcare facilities be staffed so that there is one nurse for every four patients. Meanwhile, it is further recommended that the ratio may vary depending on the context to the extent that settings such as intensive care units should have a ratio of one nurse per two patients (Phillips et al., 2021). Since the legal mandate on staffing is lacking, many of the staffing decisions are left at the discretion of the facility owners. On the other hand, the decision to increase the number of nurses often represents additional costs of operation that may impede profitability, growth, and survival. Therefore, there is always a dilemma on whether to improve to nurse-patient staffing ratio.
Advantages of Achieving the Staffing Ratio
Improving the staffing ratio is associated with various advantages, including satisfactory healthcare services, improved working conditions, and improved reputations. According to Griffiths et al. (2018), adequate staffing is important because it results in satisfactory healthcare delivery. Indeed, adequate staffing is associated with desired quality, safety, and patient satisfaction. Ideally, it ensures that nurses are assigned to a manageable number of patients, which limits the chances of strain, which otherwise leads to delays in attendance or medication errors. In doing so, the nurses are best placed to deliver services that meet the expected quality and safety. These standards further beget patient satisfaction.
Secondly, improved staffing also fosters enabling working conditions. Since it ensures that nurses are assigned to a manageable number of patients, it reduces the duration of work, overwhelming tasks, and work-related stress (Chen et al., 2018). The nurses can achieve a healthy work-life balance and become more motivated to work towards delivering quality. These improved working conditions further play a crucial role in minimizing burnout and turnover, which are often costly to health care.
More importantly, improved staffing results in an enhanced organizational profile of a healthcare institution. Indeed, hiring more employees makes the facility dedicated to delivering healthcare services. Furthermore, the improvements in related outcomes, such as quality of healthcare and patient satisfaction, improve the organization’s reputation, which can improve sales, profits, and growth while shunning sanctions from regulatory authorities.
Disadvantages of Achieving the Staffing Ratio
Notwithstanding the stated benefits, increasing the staff size can also be disadvantageous in several ways. In particular, recruiting more nurses implies the increased cost of operation related to human resource management. According to Arnold (2018), the annual salary of hiring a graduate nurse in any part of the United States ranges between $65,000 and $75,000. The additional costs, such as paid time off, including sick leave, vacation days, and personal days can cost as much as $20,000 per year (Arnold, 2018). These costs are significant and can complicate the sustainability and profits of an organization, especially where the return on investment is not guaranteed.
Applying the Decision-Making Model
The most appropriate decision-making model is the rational approach, especially utilitarianism. According to utilitarianism, when an individual is confronted with a dilemma, the first step is identifying alternative solutions. The second step is to weigh the decisions and choose the kind that optimizes the happiness of the individuals involved (Hayry, 2020). The end goal is to ensure that the decision made is beneficial and outweighs the costs. In the presented dilemma, the competing options are hiring additional nurses versus not hiring. As can be seen, hiring more nurses is a more beneficial outcome that can optimize the happiness of all the stakeho...