Hospitals cease to run without nursing staff, so why is it that they are nearly always critically understaffed to the point of burnout?
There is an inherent stress that comes with being a healthcare provider, and there is no way to frame it otherwise. However, just because a fast-paced work environment is to be expected doesn’t mean that nurses should be forced to deal with more stress than they can handle.
According to the Ontario Nurses’ Association (ONA), for every 10 nurses hired in Ontario, six leave their jobs. This is largely due to the lack of legally-mandated minimum nurse-to-patient ratios (mNPRs) in the province. The lower a hospital’s NPR, the more work is expected of hospital staff.
The implementation of mNPRs aims to create a standard for the maximum number of patients that can be assigned to one nurse to combat the increased workload they currently deal with.
The stress that understaffing puts on nurses’ compounds over years of difficult working conditions and leads to burnt out nurses, but this experience is also shared with nurses entering the field. New-grad nurses have been found to have an astonishing burnout rate of 66 per cent.
Not only does the lack of mNPR in Ontario negatively affect hospital staff, but it causes patients to suffer as well.
According to various studies, patient death rate increases for every additional patient that is added to a nurse’s average workload. One study in particular cited that the likelihood of a patient dying within 30 days of admission increased by seven per cent under these conditions. The study further demonstrated that “failure to rescue” rates were found to also increase by seven per cent per additional patient.
Nursing staff are stressed beyond capacity, leading them to leave the profession. Because of this outflow of nurses, it is becoming more difficult for hospitals to keep appropriate numbers on staff, creating a feedback loop that continues to worsen the situation. The ONA reports that Ontario is 25,000 nurses behind the national average.
Considering that Ontario is already operating at the lowest registered nurse-to-population ratio in the country, one may be confused why the solution is to mandate nurse-to-patient ratios in hospitals that are already struggling with staffing.
But the justification is simple. When hospitals provide a safer working environment, we see an influx of nurses returning to the work force.
Manitoba once faced a similar problem to Ontario until earlier this year, when they passed a bill which will hopefully inspire other provinces to follow suit.
Bill 28, which amended the Health System Governance and Accountability Act, allowed Manitoba to set mNPRs for its hospitals. The guidelines include recommendations tailored to each unit, resulting in staffing requirements that were manageable while still ensuring safe and quality care.
Outside of Canada, other countries have implemented similar legislation to great success. After Australia implemented mNPRs, they saw 7,000 nurses return to the field. Likewise, in California, nursing vacancies decreased by 69 per cent within four years of the mNPR’s implementation.
When hospitals prioritize livable working conditions for nurses, there is a cascade of positive change that is brought about in turn. Maintaining a reasonable workload for staff promotes lower rates of burnout and better overall mental health for nurses.
When these nurses are no longer drowning in unmanageable patient assignments, they have more time to give patients the therapeutic care that they deserve, improving overall health outcomes.
Lizzie Poidevin is a second-year Nursing student and one of The Journal’s Copy Editors.
Tags
hospitals, Nursing, nursing shortage
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