Ryan Mcclure

3 posts

Re:Topic 2 DQ 1

Personally, our facility is facing poor nurse-to-patient ratios. Our facility is the least paying facility in the area, but we have always been known for low patient ratios and a great working environment and culture. Now we have expanded, built a brand new state-of-the-art facility, expanded that facility by three additional floors, bought an ACO, and invested in two other building opportunities. Since this expansion, we have seen over thirty leaders be laid-off/fired, over seven departments liquidated, and our patient ratios raise to six to one as a standard, and a reduction in our support staff (pharmacists, techs, dietary, lab, case managers, etc.). In less than six months I have personally seen over fifteen nurses leave our facilities because of these changes. They are going to our competitors, HCA organizations in the area. These facilities have better pay rates, benefits, and the same ratios. This loss of nurses has really added stress to the floor nurses that are left like myself. I find that I am becoming jaded, bitter at times, and really unhappy. I have always loved my job, I mean really really loved it. For me to start to feel like this is a huge red flag for my self. I refuse to let this company change the way I feel about what I do. I am now too considering moving on to something else for job satisfaction reasons. It just seems that the hospital has it’s priorities in the wrong place and now the patients and front line staff are being affected.

“Identifying and maintaining the appropriate number and mix of nursing staff is critical to the delivery of quality patient care. Numerous studies reveal an association between higher levels of experienced RN staffing and lower rates of adverse patient outcomes. Learn more »

When health care employers fail to recognize the association between RN staffing and patient outcomes, laws and regulations become necessary.

A Federal regulation has been in place for some time , 42 Code of Federal Regulations (42CFR 482.23(b)which requires hospitals certified to participate in Medicare to “have adequate numbers of licensed registered nurses, licensed practical (vocational) nurses, and other personnel to provide nursing care to all patients as needed”. This nebulous language and the continued failure of Congress to enact a federal law, The Registered Nurse Staffing Act , has resulted in states taking action to ensure there is optimal nurse staffing appropriate to patients’ needs.” (ANA, 2015).

” Several benefits of retention (table 3) have been identified in the literature, Through the successful implementation of…retention strategies, HCOs may…incur certain downstream benefits of retention, such as becoming a nursing employer of choice.such as patient safety and quality of care, patient satisfaction, nurse satisfaction, and nurse safety (Page, 2004). Toward this end, several strategies have been suggested to improve nurse retention. These strategies include: transforming the work environment by providing strong, top-level nursing leadership and supportive nursing supervision throughout the organization; involving nurses in decision making related to patient care delivery and practice; re-designing nurses work spaces to be more ergonomic and less physically demanding; creating a culture of safety; limiting nurses work hours; ensuring safe staffing levels; offering flexible work schedules and employment opportunities such as job sharing; and improving nurses wages (AHA Commission on Workforce for Hospitals and Health Systems, 2002; Buerhaus, Staiger, & Auerbach, 2004; JCAHO, 2002; Kimball & ONeil, 2002; Page, Spetz & Given, 2003).”(Jones & Gates, 2007).


American Nurses Association. (2015). Nurse staffing. Retrieved from

Jones, C. B., & Gates, M. (2007). The costs and benefits of nurse turnover: A business case for nurse retention. The Online Journal of Issues in Nursing, 12. doi:10.3912/OJIN.Vol12No03Man04