Nurse Staffing


Nurse staffing was measured by the use of some variables. The variable includes the proportion of registered nurses relative to the whole nursing staff, proportion of unlicensed nurses and that of licensed practical nurses. However, the shortage of nurses may also be due to an increased admission of students to nursing school thus increased shortage due to lack of already trained nurses to replace the retiring ones. There is also an inclusion of RN and LPN staff since LPN and RN depend on each other. The registered nurses work on a broader array of the central organizational plan more than unlicensed personnel and LPNs. A higher registered nurse proportion is always associated with a low unit overall cost. Sometimes the implication of nurse shortage is a bit different in private and public organizations (Cimiotti, Aiken, Sloane, & Wu, 2012).

Financial implications of nursing shortage

Shortage of nurse staffing in any health organization may be through nurses turn over leads to high cost of replacement since a health facility cannot survive with low numbers of RNs. Nurse Staff shortage implies high bills for any health facility either private or public. Sometimes the nurses’ shortage comes up due to the unavailability of trained nurses and if they are there their supply is very low thus the effect of this comes in as an added cost has to be there to train the available untrained nurses. However, reducing nurse staffing is sometimes done as a way to increase the profitability of a hospital that has financial uncertainty (Velez, & Strom, 2012). Nurse staffing also provides a competitive advantage to health facilities thus may lead to better performance financially especially in more competitive markets. Studies show that there are increased operational costs when there are large numbers of registered nurses, and there have been no significant effects on profit margins due to nurse staffing. That brings the question of why hospitals reduce nurse staffing when undergoing financial hardship. Also, research shows that hospitals that have a greater level of nurse staffing have led to reduced expenditure thus increased cost saving due to reduced readmission of patients, shorter stay time for patients and improved productivity.

Low nurse staffing may lead to increased financial deterioration in both public and private hospitals because, there is a decrease of quality care for patients, increase in contingent staff cost since the organizations depend on contract staff to overcome the shortage (Velez, & Strom, 2012). Lastly, all that reduces the financial progress of health organizations since they are required to recruit and train new nurses so they can replace the vacant spaces. 

Cost analysis of potential training, staffing, equipment

The cost analysis indicated total savings amounting to 1 SD due to increase in registered nurses non-overtime staffing and reduction in registered nurse overtime of approximately US $ 11.64 million that would amount to the US $ 544,000 yearly (Claxton et al,,. 2013). The analysis indicated a financial impact in the modification of nurse staffing that would improve post-discharge utilization. Training untrained nurses, for example, the pediatric nurses it would cost at least $ 1,410 for every nurse to be trained, $ 346 for each nurse to undertake institutional overhead and $ 1,442 per nurse for production losses that is a cost that is associated with the training time in 17 weeks. Thus for nurses like a pediatrician would amount to $ 3,197 for each nurse that is very costly for any health organization to train a new nurse that they can use latter hire due to nurse staffing shortage. Nurses hiring is quite costly an analysis done shows that replacement of registered nurses for like 13 hospitals would cost a range between $ 14,225 and the US $ 60,102 and the average cost of replacing a full-time registered nurse being, $  36,657. The cost of equipment replacement in any health facility is very high since the cost of the required hospital assets appreciates each year. However, considering the purpose that it will serve in the hospital is worth buying the equipment even at a high price (Velez, & Strom, 2012). Considering the concepts of inflation, depreciation, maintenance, repair which are integral to replacement analysis, making the manager of a health facility to make proper replacement analysis of reasonable equipment.

Staff training is always essential for purposes that are related to an organization. Poor training of employees may lead them to quit the job after a short time thus it is necessary to give proper training for a longer stay and better productivity of the organization. It might cost much to invest in training new staff in nursing for a health organization, but in return it is worth. Staff education must include cross-functional training, coaching, career development and a formal orientation program. The return to investment in training the nursing staff include;

Staff morale: the staff gets motivated, and the training fosters education by creating a positive mood to the staff, and they have a committed workforce (Cimiotti, Aiken, Sloane, & Wu, 2012). Through that, they work for the organization efficiently providing quality care for the patients.

Employee retention: the members of staff develop loyalty to their practice as they feel the organization cares for them since they have benefited professionally. That would reduce another cost of staff replacement or new employment due to retention of the older ones (Velez, & Strom, 2012).

Competence in a job: the nurses who receive training for their positions are confident and more productive. That reduces hospital infections thus reducing the cost of treatment of patients who get infected in the hospital due to the incompetence of nurses.

Practice efficiency: that leads to patients’ satisfaction by the services they get. Cross training is essential for smooth running of a hospital, and the employees do better work after they feel that they are making a difference in their mission (Cimiotti, Aiken, Sloane, & Wu, 2012).

Health care reimbursement when it comes to employee and employer

Employers evaluate different strategies that thy can offer to pay their employee’s health insurance. Health insurance aid by the employer is the most appreciated fringe benefit, and it is very important as a tool for retaining of employee that is at the top and recruiting new employees. Moreover, there are several approaches that can be used for health benefits that are employer-provided. There are several strategies that an employer considers on disbursement of employees health insurance these are; budget, employer size, health benefit goals, personnel resources and information of diverse options (Velez, & Strom, 2012). The most popular strategies are; first, purchase of a plan or group health insurance which are a form of health insurance paid by the employer where the employer selects the insurance plan and purchases it through an insurance agent. Second, sitting up an arrangement for reimbursement where the employer uses the HRAs through a broker or a health insurance agent and the employer allocates a fixed amount for each employee thus no need of minimum contributions. Employees are then reimbursed in their payroll (Claxton et al,,. 2013). Third, the employer gives the employees bonuses for health insurance although that is not recommended.

Increased risk for the organization due to shortage of nurses

There is increased risk in health organizations of hospitals due to a shortage of nurses in the hospitals. There are more burnout and exhaustion of the available nurses thus work less efficient. That leads to an increase in infections and reinfections of the patients they are serving. Thus if an organization maintains a good number of nurses thus reducing the burnout the level of infections will reduce. There are also increased death with reduced nursing staff. The ratio of nurses has to match with that of patients. More nursing staff equals to fewer deaths. The organization with short nurse staffing risk high rates of a low patient outcome like cardiac arrest, UTI, pneumonia, and shock (Cimiotti, Aiken, Sloane, & Wu, 2012). The organization with nurse short-staffing risks increased the cost of treating patients who get infected in the hospital and losing the existing nurses due to burn out which would cost them more in new staffing or replacements.



Cimiotti, J. P., Aiken, L. H., Sloane, D. M., & Wu, E. S. (2012). Nurse staffing, burnout, and health care–associated infection. American journal of infection control, 40(6), 486-490.

Claxton, G., Rae, M., Panchal, N., Damico, A., Whitmore, H., Bostick, N., & Kenward, K. (2013). Health benefits in 2013: moderate premium increases in employer-sponsored plans. Health Affairs, 32(9), 1667-1676.

Velez, P., & Strom, T. (2012). Effects of organizational trust. Organization Development Journal, 30(2), 39.