At the end of a 12-hour shift, she is fatigued, stressed, and emotionally drained. Barely able to stand, she is mixing up paperwork, attending the wrong rooms, and cannot continue to do the job she loves. Compelling nurses to work more than 10 hours a day can extremely endanger the health of patients and pose a serious threat to overall patient safety. Fatigue slows reaction time, reduces attention to detail, and decreases energy, which are all great contributions to errors. When handling the lives of sick patients in need of reliable medical attention, mistakes due to exhaustion cannot be a concern. Patients trust hospital industries to not only hire qualified individuals, but to assure these professionals are physically able to successfully do their jobs. The healthcare industry is one of the largest, fastest growing sectors in the world, consuming over 12% of GDP in numerous developed nations around the globe (Bonardo). The amount of jobs produced from the hospital industry in the past 10 years is more than any other private sector organization and continues to grow at the most rapid rate (White). However, despite this constant job increase, hospital officials have become primarily concerned with cost cuts and budget management, taking away from the true priority of patient care and safety. Due to these financial complications, hospital administrators have decreased the number of nurses they are willing to hire. This has caused an increase in nurse-to-patient ratios and has put a mental and physical strain on those in this profession. The overworking of nurses is statistically shown to decrease the success of patient outcomes and in order to address this issue, measures must be taken through evidence-based nursing techniques, adopting magnet principles, and mandated nurse-to-patient ratios.

[The increase in nurse stress levels, emotional pressure, and physical exhaustion during their shifts has caused current nurses, future nurses, and nurse activists to become extremely concerned with their ability to do their job effectively. In order to focus on patient safety, the stability of nurse competence must be addressed by creating new policies with hospital officials. ** For example, population and evidence based nursing, methods that give opportunities for the advanced nursing practice professionals to collectively meet the challenges of improving the population’s health. ** In addition, these policies support that nurses working in their communities “need to be part of the higher level of care management and policy decision making,” in combination with these healthcare policy makers (Curley, xiv). This program is designed to facilitate the development of qualified, knowledgeable, and experienced nurses with an emphasis on the integration of population health into their practice and to improve overall health outcomes. An example of evidence-based nursing is the system of hourly rounding, which can be defined as “a systematic, proactive nursing intervention designed to anticipate and address the needs of hospitalized patients” (Hourly Rounding as an Effective Patient Safety Strategy). Hourly rounding works by having a nurse or a nurse’s assistant complete patient rounds every hour during the day and evening shift, and every two hours during the night shift. Because studies have shown that rounding can promote patient safety, quality, and success, it is considered to be an evidence-based nursing practice that is used successfully in many hospitals in the United States. By implementing this policy in all hospitals, patient outcomes will drastically increase nationwide, helping to increase reliability and credibility of hospitals, and decrease the risk of potential lawsuits against inattentive healthcare professionals. Nurses in advanced practice have an “obligation to improve the health of the populations that they serve by providing evidence-based care” (Curley, 109).  Although hospital officials may continue to argue that hospitals may not be able to afford to hire more nurses to achieve population or evidence based nursing, “there is ample evidence of a need for healthcare reform in the United States” to improve not only access to healthcare but the quality of care (Curley, 3). The current financial state of most hospitals in the United States consists to up to $500,000,000, and continues to build as time progresses (Bordonaro). According to a news released survey, nearly 60% of hospital executives said they’ve significantly increased their capital spending in the past 10 years (White).  Along with other initiatives hospitals are also pushed to implement electronic based health record systems (White). These costs take away from the institutions ability to assure they are providing quality care to their patients, by neglecting the concern of hiring enough employees. The implementation of new policies by negotiating financial concerns with hospital officials, will significantly increase patient outcomes and credibility of hospitals, which will therefore increase patient attendance and overall revenue.] 

[Nurses working in the healthcare industry have seen their patient load more than double, and feel unsafe trying to care for more patients than they can handle, making it impossible to provide proper care. In hospitals across the United States there have been potential threats of strikes and nurses leaving the profession due to unreasonable nurse-to-patient ratios. Healthcare officials are unwilling to hire more nurses because they believe it isn’t cost-efficient; however, the result of having inadequate staffing will create excess costs due to the poor patient outcomes. [The Magnet Recognition Program is a system used in countries such as England, that executes core principles such as, knowledge and leadership, which help to increase the quality of nursing excellence. The implementation of Magnet principles could be used to help hospitals reach “Magnet Status” to improves nurses’ work environments (Crockett).] The studies done on this program, ** such as the Rochdale Infirmary study aimed to evaluate for changes in the nurse work facility from * when Rochdale was preparing for Magnet designation, and then after they achieved it. The results showed that nurses were more qualified and capable of successfully doing their jobs, nurse involvement in hospital decision making became remarkably more positive, the proportion of nurses who intended to leave the profession decreased, and the worldwide measure of how nurses viewed their workplace increased tremendously (Aiken). This links to the issue of nurses being overworked because these principles are extremely essential to proper hospital operation and will aid in the improvement of nurse work conditions. In addition, the Magnet Recognition program was also proven to be feasible in the United States. Therefore, in order to address the problem of overworking nurses and improving nurse treatment, magnet principles could be implemented into American hospitals in order to maintain proper quality, management, organization, and professionalism in healthcare industries. Enacting this program will not only enhance nurse success, but it will also increase patient outcomes, while keeping cost cuts at a minimum and not exceeding hospital budgets.]

In addition to these policies, the subject of mandatory nurse-patient ratios remains a widely controversial topic among many nurses and patients, as well as federal and state governments. Mandatory nurse-patient ratios regulate registered nurse staffing in order to increase positive patient outcomes and nurse job satisfaction, while decreasing nursing shortages. According to Blakeman Hodge, better RN staffing results in higher quality patient care and decreased hospitalization (Hodge). Although California remains the only state with mandatory nurse-patient ratios, increased legislative activity shows some stakeholders are lobbying actively for mandatory nurse-patient ratios (DeVandry). Hospitals in California with mandated nurse-patient ratios have shown a significant increase in overall hospital operation and efficiency, along with positive patient results. Healthcare associations argue that the laws would create excess costs, would take away their right to make their own decisions on staffing, and cause patients to wait longer to be treated; therefore, compromising their health even further (Welton). In addition, these officials also claim that success of patients does not solely depend on the quantity of nurses, but the quality of their care is the key aspect. However, with mandated nurse-patient ratios, healthcare industries will still be able to hire the qualified, educated nurses they chose, * by assigning a certain number of nurses to a certain number of patients. ** In addition, although quality of patient care is extremely significant to achieving successful outcomes, if there are not enough nurses assigned to patients, there could be moments when patients are left unattended, giving them the opportunity to rapidly decline due to the absence of proper care. Absent care is one of the most severe reoccurring problems in hospital systems and puts patient health at risk. Therefore, this makes quantity necessary for quality because it will eliminate the concern of staff shortage.

As nurses look after 15 or more cases at a time, they may become occupied with the complications of one case, leaving other hospital patients unintentionally neglected. Nurses have been left crying after letting their patients down, and feel as though the situation was out of their control due to being overloaded (Crockett). When entering the profession of nursing, the passion is not only towards the world of healthcare, but also being by the side of a patient when they need help the most. Nurses are able to feel comfort and provide compassion for their patients, and become not only their health care professional, but their friend. Due to the constant disregard that nurses are extremely overworked, these caregivers are not able to build those strong relationships with patients and be there for them in their time of need (DeVandry).  It is essential for nurse and patient mental and physical health that these healthcare professionals are able to work in a relaxed environment where they are capable of giving their patients genuine care. Without healthcare, the world would not be able to operate how it does today. These professionals give the foundation of sustaining a healthy, long life, and deserve the respect and appreciation as any other employee in any other profession. By implementing programs and policies in more hospitals across the country, the true importance of healthcare will grow outstandingly. Not only with it prevent patients from passing away in their hospital bed, but it will allow them to live a long healthy life. Aside from the significant benefit to patients, these systems will also increase operation efficiency in hospitals, and improve the mental health of working nurses. Just these minor changes will mark a tremendous growth of healthcare industries, without interfering with financial concerns or conflicting with hospital officials. Now with these improvements, after an eight-hour shift, she is energized, relaxed, and can continue to do the job she loves.
