Insufficient Staffing



The Effect of Insufficient Nursing Staffing 2

The Effect of Insufficient Nursing Staffing

The Effect of Insufficient Nursing Staffing

Albert, A., a 29 year old black male was admitted today in the hospital (State Psychiatric Hospital) from Bellevue Hospital and later brought to the admission Unit at 5pm for continuation of care and mental stabilization. Albert was diagnosed with schizoaffective disorder- Bipolar type, cannabis use disorder and other drug and substance use disorders (severe). He was non-compliant with medication, with no medical history. As per Patient record, he had past multiple psychiatric hospitalizations and history of suicide attempts three times with medication overdose and by cutting himself with shape objects. Pt is in crisis – disrobed self, was psychotic, violent and in an imminent danger to self and others. Code Red (Psychiatric Emergency) was initiated, staff responded, and he was medicated x 2. He was disruptive and aggressive, violent attacking staff and was placed on seclusion and on 2:1 observation for violent/assaultive behavior and suicidal precaution for 24hrs.

In the other hand, at this time, there was serious staff shortage both Nurses and Patient Aides (PA), meaning that RN will work with below minimum staffing. She notified her Supervisor of the unit insufficient staffing, informed her of the ward acuity and the need to staff the unit adequately. RN also notified her Supervisor of the new admission, his status, then three other existing special observation that requires one staff for each patient and Pt Fresh Air need at 4pm, Narcotic Anonymous meeting (NA meeting) at 6pm that requires two staff escorts per hospital protocol. Patients get agitated and sometimes attack staff when these needs are not met. In addition, there are other tasks such as medication administration, routine finger stick up to eight patients to be performed, vital sign checks, frequent patient counseling, redirection, supervision and ongoing patient’s assessment by only one RN and few PA. Nurse Administrator claimed that she was not aware of the high acuity of the ward and there is nothing she can do at this time, although, she tried her possible best to get staff for overtime but they all declined to work. Therefore, RN must manage her available resources and work in her best ability. The supervisor blamed Management and outgoing Supervisor for their inability to make provision for sufficient staffing for the next shift. She refused to assist RN in her duties, supervisor never showed up or picks office phone when contacted until the end of the shift.

Consequently, the ward nurse and her staff members were frustrated from the volume of workload shift assignment. Then RN was worried about what will happen if she did not complete all her tasks which includes also documentation, group therapy etc and on time and may affect Patient care. She will be held responsible for any events of medical errors or any mistakes in this shift. The workload was too much for the RN to accomplish so she did her best and protested the assignment. A recent study shows that nurses were unable to complete their assigned duties due to insufficient staffing and how it affected them physically and emotionally. They felt exhausted, and very unhappy and patient quality of care given was compromised (Simpson, Lyndon, Ruhl, 2016). The next day she called-out sick for four (4) days in a roll because she was burned-out, exhausted and very upset as well.


To identify the underlying problems that led to insufficient nursing staffing and then finds solutions to the problem.