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Ways to Address Nurse Staffing Challenges

Staffing is one of the top issues you’ll face in your nursing career.

The number of nurses staffed in any particular hospital unit can directly affect patient heath. Studies have found that proper RN staffing levels can reduce patient mortality and enhance outcomes, but overloading nurses with patients can increase the likelihood of patient death.*

Clearly, nurse staffing is a vital component of our healthcare system. But getting it right is not a simple matter. There are a lot of issues to understand and consider. Here are some of the top things you need to know.

Ways to Address Nurse Staffing Challenges

Nurse Staffing Is Not Nurse Scheduling

First, it’s important to understand that nurse staffing and nurse scheduling, while intertwined, are not synonymous. Scheduling means determining which nurses will be on which shift. Staffing means determining how many nurses each unit of a hospital needs to operate optimally. To put it another way, staffing is the plan, scheduling is the execution of that plan.

Federal Guidelines Are Lax

The 42 Code of Federal Regulations [42CFR 482.23(b)] requires that hospitals certified to participate in Medicare “have adequate numbers of licensed registered nurses, licensed practical (vocational) nurses, and other personnel to provide nursing care to all patients as needed.” That nonspecific regulation is open to plenty of interpretation. While some states have enacted more specific regulations, the American Nurses Association (ANA) is pushing for stronger federal standards that will ensure hospitals are better staffed.

There Are Three Different Staffing Models

Budget Based: Staff is allocated based on the average number of patients in a 24-hour period. For each patient day, there are a set number of nursing hours available for allocation.
Nurse-Patient-Ratio Based: Where budget-based models allocate nurse hours, nurse-patient ratio models allocate the number of nurses on a per-patient basis (i.e., one nurse for every six patients). This is often used to ensure a base level of nurses on a unit. Any remaining staffing needs are then filled with a budget-based system.
Patient-Acuity Based: The most nuanced model, acuity-based staffing takes patient needs and characteristics into consideration. This model only works when those in charge of staffing consider the entire scope of nursing and how each nurse’s responsibilities will fit into the full breadth of patient needs.

There Is No Magic Number for Nurse-Patient Ratio

Different patients can have dramatically different needs, and each hospital and unit has its own patterns and flow. As such, an inflexible nurse-patient ratio isn’t a good staffing solution. For nurse staffing to be optimal, you must take a lot of variables into account, which is why the ANA recommends that staffing committees be at least 55% composed of nurses involved in direct care. The involvement of direct-care nurses can help ensure the committee takes all pertinent factors into account—from patient needs to nurses’ experience levels to available technology to the layout of the unit.

You Can Help Address Staffing With an RN-to-BSN Degree or an MSN Degree

The right nursing degree from an accredited nursing school can help you advance your career and become a nurse leader. Thanks to online education, there are several convenient paths you can take to earn either a Bachelor of Science in Nursing (BSN) or a Master of Science in Nursing (MSN).

Unlike traditional, campus-based nursing programs, online nursing programs don’t require you to drive to a campus and attend classes at times that interfere with your work schedule. Instead, when you choose to earn a nursing degree online, you can complete the majority of your coursework from home. Plus, an online nursing degree offers significant flexibility, allowing you to arrange your education schedule around your work schedule.

An online university may offer online BSN programs and online MSN programs. If you have already completed an RN program, you can choose to enroll in an RN-to-BSN online program or an RN-to-MSN online program. If you already hold a bachelor’s degree, you can also choose to enroll in a standard master’s in nursing online program. Choosing between the RN-to-BSN, RN-to-MSN, and MSN programs requires you to consider your educational and nursing career goals. For example, if you want to become a nurse practitioner, you’ll need a master’s degree in nursing. If you simply want to position yourself for more career opportunities as an RN—or if you aren’t certain you want to make the RN-to-MSN leap—then an online RN-to-BSN program will meet your needs.

Our healthcare systems needs nurses qualified to make important staffing decisions. Enrolling at an online nursing school can be the first step to becoming a nurse that leads the way on staffing and patient care.

Walden University is an accredited institution offering online Master of Science in Nursing (MSN) and Bachelor of Science in Nursing (RN-BSN) degree programs. No other school produces more MSN graduates than Walden University.§

Expand your career options and earn your degree using a convenient, flexible learning platform that fits your busy life.

*J. Mensik, “What Every Nurse Should Know About Staffing,” American Nurse Today, on the internet at

†American Nurses Association, “Safe Staffing,” on the internet at

‡K. Carlson, “Nurse-Patient Ratios and Safe Staffing: Why You Should Care,”, on the internet at

§National Center for Education Statistics (NCES) IPEDS database. Retrieved July 2017, using CIP code 51.3801 (Registered Nursing/Registered Nurse). Includes 2016 preliminary data.