Nursing Management and Leadership – Discussion

Respond to each of the 2 discussions below. Responses should add to the content of the discussion. Each response should be 1/2 page in length and 1 source each.


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# 1 Respond to TaLana

HRSA has reported that the four major factors of nursing shortage is a growing and aging population, high demand for the highest quality care, RN workforce approaching retirement age, and difficulties attracting new nurses and retaining existing staff. Patient acuity is higher in adult care institutions. Things to consider in nurse patient ratios are that nurses have a lot of tasks to accomplish in a shorter periods of time, hospital length of stay has decreased, higher acuity requires more attention, and the lack of qualified nurses decreases ability to maintain vigilance. Staff shortage can be linked to decreased patient safety due to increased burden, more work hours, medical fatigue, burnout, and stress. Nurse fatigue is a huge issue that combines decreased alertness, vigilance, poor concentration, poor judgement, mood, and performance. As a nurse leader we are responsible to identify unsafe situations. We should collaborate with other nurses to help identify fatigue and how we can help prevent/decrease it. Staffing by ration determines the number of patients a nurse is assigned. I think level of acuity needs to play into staff ratios, working on the ICU some patients are so sick they require 1:1 care but we are unable to do this. Therefor we will assign an easier patient along with the sick patient. This makes it a safer work environment for patients and staff. While we still have staff ratios, we should always consider acuity levels when assigning patients. MAGNET hospitals promote patient safety in many ways. They require nurse residencies, management with nurse specialties, >50% certified nurses, and many other safety measures. Charge nurses should be allowed to set staffing levels on their floors determined by what nurses feel they can safely handle. Basic minimum nurse to patient ratios should be set no higher than those set by your state. Nurse leaders should have the opportunity to implement changes in the work place to improve patient safety.


Galen College of Nursing. (November 2020). Unit 5 Video: Managing Patient Care. Retrieved URL


#2 Respond to Tori-Lynn

1. Right now during the height of COVID, this exact problem is running rampant throughout many hospitals. The acuity of these patients is high, typically (in a perfect world) a one-to-one patient, sometimes even two-to-one. However, with the staff shortage we are seeing high patient to nurse ratios, even in ICU settings. Some are even three-to-one. This is incredibly taxing on the nurses, not to mention very unsafe for the patients. This is less eyes on the patient, increasing probability for a patient fall or other sentinel event.

2. Magnet hospitals are hospitals that have an emphasis on nursing care, satisfaction, and job retention. With that said, the staffing levels have a greater decreasing mortality rate in patients. These nurses also hold a bachelor’s degree or higher, as well as various certifications to maintain their status. This increases patient safety, and with the nurse retention creates a smaller workload for the nurses. This has decreased failure to rescue percentage by 14% within the last year (PMC, 2017).

3. A patient acuity system is a tool that determines the amount of nursing care needed for each patient on the unit based on the level of intensity, nursing care, and tasks needed for each patient (AllinaHealth, 2018) . This would be more effective in providing safe care if the staffing is available to meet the acuity needs of the patient. For example, three patients are high acuity and require one to one nursing care. With the patient acuity system they would each be provided a nurse, to adequately and safely take care of them. On the other hand those same three patients with the same acuity are in another hospital who simply do patient ratios and one nurse is assigned all three patients. There can be lack of care, delay in treatment, worst case scenario sentinel events.

Allina Health. (2018). Acuity Based Staffing. (Links to an external site.)

Lower Mortality in Magnet Hospitals. (2017, May 1). PubMed Central (PMC).\

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