The Issue of the Understaffing in Nursing

Short Staffing in Nursing

Nurses are an essential part of healthcare and make up the most significant part of the medical profession. Nonetheless, it continues to face staff shortages due to a lack of potential teachers, high staff turnover, and unfair workforce distribution. This paper examines two quantitative research studies related to understaffing in nursing, which results in lowered quality of patient care. Hence, the PICOT statement will be the following: How does the lack of nurses in clinical settings, compared to the proper nursing care, will affect patient health outcomes in twelve months?


The first article, titled “Nursing staff retention: Effective factors,” investigates how patient health rates depend on the entire nursing staff. Recently, there has been global interest in the impact of nurses on patient outcomes. The article’s problem is that the staff shortage resulted from a reduction in the number of available nurses due to efforts to contain costs and an increase in the number and severity of patients in the intensive care unit. The research aimed to establish a connection between the nursing workload and quality care. The objective of the study “is to find personal factors (physical, mental-emotional, social) and organizational factors (job stress, social support, and job satisfaction and organizational factors) that influence the nursing staff retention.” (Zhu et al., 2018, p. 680). The main research question was to assess the influence of staff congestion on patients admitted to the ICU.

The other research to be reviewed is entitled “Rationing of nursing care and its relationship with nurse staffing and patient outcomes: The mediation effect tested by structural equation modeling.” This study poses a problem of care rationing and how it affects patients’ health (Mohammad et al., 2017). The topic is relevant in terms of nursing practice since proper rationing significantly impacts one’s ability to assist a patient and ensure positive health outcomes. This study aims to test the indirect effect of nursing rationing and reveal its linkage between the staff and patient outcomes. The study explores the relationships between various aspects of nursing systems using a model of structural equations. Moreover, it seeks to clarify the purpose and features of the mediation effect.

Supporting the Issue

These two articles can help identify a connection between the shortage of nursing personnel and patients’ health outcomes. Both studies provide a detailed literature review and results of surveys and analyses conducted to establish the mentioned relations. The sources provide information about my PICOT question, including the problem, intervention, comparison, outcome, and time. Thus, it is vital to extract this information from the articles.

My PICOT question presumes nursing workload as an intervention that fully corresponds to the one presented in the first article. However, a second study suggests rationing nursing care as a way of intervening. In general, the interventions in both sources can be compared and contrasted. There are no comparison groups presented in both studies; yet, they could be compared to each other or my PICOT question.


The first study has an analytical and descriptive character to determine the personal and organizational factors that impact nursing staff retention and further patient health outcomes. The sample included 500 nursing graduates who had a one or two-year practice at the general hospital (Mohammad et al., 2017). A master’s or higher degree in nursing and work experience of more than three were obligatory to participate in the study. The research environments were selected by random clustering. The data collection instrument is a questionnaire that comprises personal factors, stress triggers at work, and social and organizational features. Descriptive statistics were used to analyze the data; the validity of the content and tests were used for conducting the survey.

The questionnaire is better for collecting information than interviews or observation because the population sample covers a large area. This allows a scholar to investigate the population of an entire country or even the whole world. Since it can cover a large group at the same time, the questionnaire enables practitioners to contact many people who cannot participate in the spot research. Yet, one of its main limitations is that it may solely be applied to those respondents who have a significant amount of education. It cannot be used for the illiterate or the semi-illiterate. Moreover, the questionnaire does not allow collecting valid information from very busy, idle, and indifferent people, or from those respondents who are either frivolous and cheating, or aim to be dishonest. In addition, it does not suit those who unjustifiably contempt any research forms, and people who unnecessarily doubt the intentions, sincerity, dedication, and commitment of the scientist.

Meanwhile, the second research used data from a large cross-sectional research project. The researchers recruited nurses and patients with the help of a four-stage sample of 181 hospitals from 9 provinces, municipalities, and autonomous regions of China. This article analyzed 7,802 nurse surveys and 5,430 patient surveys (Zhu et al., 2018). In the study, a survey of Chinese nurses was conducted voluntarily and anonymously by nurses for direct care.

Because of the usual huge number of people who respond to the survey, the data collected better describes the relative characteristics of the general population involved in the study. Compared to other data collection methods, surveys can extract data close to the exact parts of a larger population. Questions in surveys are always standardized before entering them into subjects. Therefore, the researcher is forced to create problems that are general enough to cover the entire population. However, these general questions may not be as relevant to all participants as they should be.


The results of these studies confirm that the patient’s health outcomes directly depend on the nurses’ involvement. The results presented in both articles firmly uphold the proximity between the quantity of nursing staff and patient health results. As for the results of hospitalization, it was shown that the level of staffing of the department with nurses is the leading factor. The rationing of nursing care has a mediating role in the link between personnel and patient.

Regarding possible implications for clinical practice and managers, the identified problem can define starting points for an interventional program for nurses and managers to promote good patient outcomes. Healthcare organizations need to feel responsible for supporting staff and understanding the nurses’ work-life balance challenges (Mohammad et al., 2017). This research should apply to nursing managers when they build a business case to discuss staff turnover in their organizations and policymakers when developing staff turnover policies. This can lead to nurse shortage and positive organizational and patient outcomes.

Outcomes Comparison

The anticipated outcomes of my PICOT question were that shortage of nursing personnel negatively affects patient health outcomes. Since the lack of nurses is a significant problem for the hospitals, many patients end up receiving less help and inadequate healthcare services. The articles’ results practically correspond to mine since the researchers identified similar problems and posed the same research questions.


Mohammad, H., Bahar, S., & Abdolreza, G. (2017). Nursing staff retention: Effective factors. Annals of Tropical Medicine and Public Heath, 10(6), 1467-1773.

Zhu, X., Zheng, J., Liu, K., & You, L. (2019). Rationing of Nursing Care and Its Relationship with Nurse Staffing and Patient Outcomes: The mediation effect tested by structural equation modeling. International journal of environmental research and public health, 16(10), 1672.

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