A quick glance at the volume of recruitment ads for nurses shows the breadth and depth of nurse staffing shortages throughout healthcare. Social media posts by nurses are rife with expressions of frustration, burnout, and decisions to resign largely because of untenable patient assignments due to staff shortages. Yet, even filling the advertised vacancies may not solve the problem in all settings; the complexity of patient care often calls for greater numbers of staff than budgets allow.
I view the problem as an intake and output equation: Recruitment efforts can bring nurses in, but working conditions can drive nurses out. Until healthcare has a "positive nurse balance" relevant to patient care needs, there will be no cure for the staffing pathology. But will healthcare leaders support the necessary complement of staff? Or will such decisions ultimately become a matter of legislation?
State and national nursing organizations are fully engaged in efforts to define solutions. The challenges and interventions are multifaceted; the need for more nurses is the common denominator. When safe staffing advocacy efforts fail to influence healthcare leaders at the facility level, seeking legislative support becomes the next logical step. Legislators in several states have partnered with nurses to introduce and ultimately pass safe staffing legislation, which may take the form of mandating nurse staffing committees with frontline nursing representation, establishing safe nurse staffing ratios, and public disclosure of staffing plans.1
These bills may not be uniformly popular with corporate healthcare leaders. Case in point: Mayo Clinic threatened to withhold $4 billion of investments in a Minnesota site if the Minnesota legislature passed a bill that required nurse staffing committees to define the number of nurses needed.2 The bill passed, but Mayo Clinic received a written exemption from the new law. Apparently, money talks.
Contrast to Mayo Clinic's position is that of University of Pennsylvania Health System's CEO, Kevin Mahoney, who publicly supports nurse staffing legislation because he wants nurses "to come back to healthcare" and endorses fixing the workplace.3 I applaud Mr. Mahoney's courage for being a nursing ally and taking the road less traveled as a healthcare leader. We need more healthcare leaders to stand with nurses in full partnership and do the right thing. The problem is that many appear to have forgotten what the right thing is.
Until next time,
LINDA LASKOWSKI-JONES, MS, APRN, ACNS-BC, CEN, NEA-BC, FAWM, FAAN
EDITOR-IN-CHIEF, NURSING2023
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