Nursing Skill Mix: Challenges and Impact on Patient Outcomes

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NURSING SKILL MIX
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In clinical medicine and nursing, there is need to incorporate adequate human resource
and staff that work together to ensure patient care and safety. Division of labor is important in
clinical practice as there are some people who are better skilled to handle a certain situation than
others. Nursing skill mix refers to the incorporation of varied human resources in the care of a
patient and in the execution of nursing duties (Needleman, 2017). In order to ensure the best
outcome for a patient, it is important to ensure proper delegation of duties. Various clinicians in
any hospital have an area of expertise that they are well suited to perform tasks. They are often
called to action in cases whereby their expertise is required in clinical situations and they act to
the best of their knowledge. As stated by Staggs et al (2017), all medical practitioners and nurses
cannot have the same knowledge in all fields of medical practice. It is important to ensure
adequate division of labor by deploying specialization in order to save resources and ensure
quick recovery of patients. The aim of this essay is to clearly discuss the challenges with nursing
skill mix in contemporary healthcare and how this impacts patients.
Hospitals and healthcare centers require adequate clinicians and nurses in order to
effectively manage patients and ensure every patient is well attended to. In order to ensure
adequate nurses, there is need for hospitals to deploy more nursing staff and this requires
increased financial resources. The nursing staff in hospitals represent the largest element of cost
(Jacob, McKenna & D'amore, 2015). In order to cut hospital costs, the management often
employ less registered nurses. Human resources in hospitals just like any other resource can also
be scarce and this may negatively affect patients receiving care and lead to poor patient
outcomes. The number of registered nurses in a hospital can be limited and many patients may
not be adequately attended to and cared for. According to Shadmi et al, (2017), the shortage of

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nurses can significantly lead to increased workload for the available nurses and this may reduce
the quality of care provision.
In addition to this, there is increased job dissatisfaction associated with shortage of
nurses. Due to being overworked and having limited time to rest, they tend to do shady work
which may negatively impact the patient. The approved and most effective ratio of a registered
nurse to a patient should be 1:1 (Tourangeau et al, 2016). However due to shortage of registered
nurses in a single hospital, this ratio cannot be achieved hence hospitals recruit other unlicensed
nursing assistants in an attempt to ensure adequate care delivery. In order to contain hospital
costs associated with recruiting professional nursing staff, hospitals may opt to recruit other
personnel such as licensed practical nurses and nurse aides. The recruiting of other people apart
from registered nurses to assist in nursing of patients in hospitals forms the basis of nursing skill
mix and has several repercussions (Lovink et al, 2019).
All patients in a hospital or a health center are directly affected by nursing actions.
Nurses spend a lot of time with their patients and therefore understand the patients better than
anyone in the health facility. The quality of care therefore depends on the knowledge and skills
of the care provider in the field. Nursing skill mix directly affects patient outcome in that
inclusion of more nurse aides and unregistered nurses to provide care might lead to increased
errors and adverse happenings (Dall'ora et al, 2017). Replacement of registered nurses in
hospitals in order to cut costs might lead to poor patient outcome as the nursing assistants might
not be well trained. This has negative consequences on the patient outcome as the nurse assistant
might not have enough knowledge and skills to provide the correct nursing intervention as
compared to a trained registered nurse.