(Solved) Nursing Leadership and Management

Running head: NURSING LEADERSHIP AND MANAGEMENT 1
Nursing Leadership and Management
Name
Institution of Affiliation

Nursing Leadership and Management 2
The number of nursing staff to the patient population for a while has been an issue of
contention in the medical profession. As per the U.S Association of Nurses, “ensuring enough
staff numbers in the award is crucial in reducing patient complications, decreasing nurse
exhaustion, reducing nurse lethargy and decreasing number of mortality cases due to medical
errors” ("Nurse Staffing," n.d.)). Insufficient nurse staffing ratios can lead to adverse
consequences for sick persons such as having a higher duration of stay due to hospital-related
problems and medication errors. It can negatively impact the nursing staff and lead to loss of job
morale, nurse burnout, and fatigue (Lippincott Solutions, 2018). In this paper, the approach of
insufficient nurse ratios in regards to a nurse leader, a nurse manager and a professional
mechanism to solve this issue will be discussed.
Both the patient and the individual nurse are exposed to the risks of this nurse staffing
issue. Healthcare institutions and Insurance organizations are advocating for the need to have
shorter hospital stays. To remain aggressive in terms of service delivery, they have started
rendering service of greater delicacy to patients. (Sink et al., 2010). This kind of transition on the
way of performing functions has made nurses improve their skills and art of managing time in
the ward because they are made to accomplish most roles working with a higher number of
patients. The consistent increasing need for nurses against the high number of patients has
pushed them to commit medical errors due to exhaustion. Nurses are forced to use a short period
in a single patient because of the pressure put on them by an overwhelming number of patients.
Other issues like forgetting to document crucial information about a patient may also arise.
(Purcell et al., 2011).
A better way to correct this challenge is by the nursing management ensuring an adequate
number of nurses is available about the patient population (Iglesias et al., 2013). Soon a nurse-

Nursing Leadership and Management 3
patient ratio has been agreed on, the management should make an effort to sustain this nurse-
patient ratio. The federal and legislative arm of government should also chip in to support this
initiative by formulating acts of laws that are in support of this policy. Creating policies that
ensure not only this ratio is maintained but also support staff for nurses is hired to help in taking
care of patients per hospital. Also, effort should be made to ensure the transition of nurses from
the more experienced one to juniors and interns is efficient. This ensures at any given time there
is a leadership vacuum that will exist in the ward (Paixão et al., 2015).
Nurse Leader Approach
Individual nurses themselves are leaders and guide their fellows. Some of the roles of a
nurse are to ensure the safety and upheld rights of a patient. Nurses can also come in to help his
or her fellow nurses in terms of helping duties or articulating their needs on behalf of them.
Nurses are advocates and leaders by nature. Therefore nurses team up to ensure all is well within
hospital units. A nurse leader may initiate teamwork amongst his juniors in decision making to
outline the challenges they are facing in regards to the nurse-patient ratio (Johansen et al., 2019)
Most of the nurses across almost all states have recognized this issue and tried to
articulate so it could be solved. An example is nurses from California for thirteen years now,
they have been vocal in the fight for an adequate nurse-patient ratio Nurses across the country
have seen unsafe staff nurses to patient ratios and have raised their voices. There is now a bill in
the senate about this issue which could compel the federal government to issue a safe nurse-
patient ratio is adhered to. The Nurse Staffing Standards for Hospital Patient Safety and Quality
Care Act (S.1063), and one in the U.S. House of Representatives, The Nurse Staffing Standards
for Hospital Patient Safety and Quality Care Act (H.R.2392) that urges nurses to write to their
congressman to support this legislation (NNU, n.d.).

Nursing Leadership and Management 4
Nurse Manager Approach
A nurse manager could solve the nursing staff ratio issue differently from how a nurse
leader could handle. Nurse Managers play a bigger role in which they oversee a larger group of
staff members. They are mostly involved in ensuring the well working of the hospital as a whole:
make sure or departments are functioning properly and even improving staff numbers to the
population of patients being received. Nurse Managers have challenges in ensuring this ratio is
adequate due to financial constraints to meet this demand. They are concerned with profit,
therefore, could prefer a lesser number of nurses.
Nurse Managers may prefer to approach this by calling for more additional funding to the
health set up from State or advocate for keenness within the unit. The keenness of both patient
and current nurses will reduce the number of errors made within the hospital, (Yankovic and
Green, 2011). This approach will save on the energy of the available nurses because they are
spared from exhaustion, fatigue and burn out due to mistakes and overwork. Though keenness in
wards as an approach by managers to solve this issue may not solely work out, (Castle and
Anderson, 2011). Nurse Managers may opt for other mechanisms like looking for financial aid to
employ more staff.
Leadership style addressing the issue
Even though funding towards the nurse-patient ratio is a delicate issue, is one of how the
nurse-patient ratio issue can be solved. These funds are supposed to be used in equipping nurses
with more knowledge of patient care. Therefore for an efficient nurse-patient ratio, there is a
need for enough staff in hospital units. The Health Resources and Services Administration
(HRSA) has been involved in offering programs and financial assistance to improve access to
medical services by patients. This institution has majorly invested in activities about nursing

Nursing Leadership and Management 5
education, raising the number of nurses in service, motivating nursing work staff and improving
patient care through funding.
Moreover, institutions like the Association of American Nurses have been providing
scholarships to facilitate the education of students interested to be nurses at higher institutions of
learning. This institution is campaigning for more nurses in the economy hence improved nurse-
patient ratio. Some of the funds from ANA go to help activist groups involved in pushing this
agenda of more nurses in wards. Though the all process of training and enumerating nurses takes
a considerably longer period, costly, and might vary state to state, it’s evident that this process is
the only way patient demands could be met. (Duffield et al., 2011). A small number of nursing
staff could be overwhelmed by the work posed by patients due to lethargy. This cumulatively
increases the cost of managing a health institution due to periodic errors made or the need to hire
contract nurses to cater to the shortage, and expensive ordeal in the long term.
Conclusion
In conclusion, the nurse-staffing ratio is a problem that needs a quick fixation in the U.S
health care system. A solution to this issue will lead to improved nurse-patient care and a better
health system as a whole. Patients will get quality service and also nurses will be contented and
get to enjoy their work. Generally, this improves service delivery to patients and a health system
that is working better to deliver its vision of healthcare for all.

Nursing Leadership and Management 6
References
American Federation of State, County and Municipal Employees (AFSCME). (n.d.) The
Cost of Failure.https://www.afscme.org/news/publications/health-care/solving-the-
nursing-shortage/the-cost-of-failure
Castle, N. G., & Anderson, R. A. (2011). Caregiver Staffing in Nursing Homes and Their
Influence on Quality of Care. Medical Care, 49(6), 545-552.
Duffield, C., Diers, D., O'Brien-Pallas, L., Aisbett, C., Roche, M., King, M., & Aisbett, K.
(2011). Nursing staffing, nursing workload, the work environment and patient
outcomes. Applied Nursing Research, 24(4), 244-255.
Johansen, M. L., De Cordova, P. B., & Weaver, S. H. (2019). Nurse Workforce Environment
Staffing Councils: An Innovative Approach. Nurse Leader, 17(2), 141-146.
Heath, Sara (2018, October). Nurse Staffing Ratios Tied to High Costs, Patient Safety
Savings.
Huber, D. (2014). Leadership & Nursing Care Management (5th ed.). St. Louis:
Saunders/Elsevier.
Iglesias, B., Ramos, F., Serrano, B., Fàbregas, M., Sánchez, C., García, M. J., Cebrian, H. M.,
Aragonés, R., Casajuana, J., & Esgueva, N. (2013). A randomized controlled trial of
nurses vs. doctors in the resolution of acute disease of low complexity in primary care.
Journal of Advanced Nursing, n/a-n/a.
Lippincott Solutions (2018, March). Update on Nursing Staff Ratios.
National Nurses United (NNU). National Campaign for Staff RN-to-Patient Staffing Ratios.
https://www.nationalnursesunited.org/ratios

Nursing Leadership and Management 7
Nurse Staffing. (n.d.). ANA. https://www.nursingworld.org/practice-policy/nurse-staffing/
Paixão, T. C., Campanharo, C. R., Lopes, M. C., Okuno, M. F., & Batista, R. E. (2015). Nursing
staff sizing in the emergency room of a university hospital. Revista da Escola de
Enfermagem da USP, 49(3), 481-487.
Purcell, S. R., Kutash, M., & Cobb, S. (2011). The relationship between nurses' stress and nurse
staffing factors in a hospital setting. Journal of Nursing Management, 19(6), 714-720.
Sink, D. W., Hope, S. A., & Hagadorn, J. I. (2010). Nurse:patient ratio and achievement of
oxygen saturation goals in premature infants. Archives of Disease in Childhood -
Fetal and Neonatal Edition, 96(2), F93-F98.
Yankovic, N., & Green, L. V. (2011). Identifying Good Nursing Levels: A Queuing
Approach. Operations Research, 59(4), 942-955.