Nurse Shortage and Impact on Patient Care Quality


The nursing shortage has become a global concern; though many students continue to graduate and join the profession, the high nurse turnover makes it impossible to have enough nurses at any given time. It imbalances the nurse-patient ratio, which leads available nurses overworked (McKechnie, 2016). The work overload results in poor service delivery and consequently inadequate patient care. The latter is because nurses do not have enough time to concentrate on one patient because they are rushing from one patient to another with limited time (Haddad et al., 2020). Moreover, less nurse staffing leads to poor patient care and can increase patient mortality, and infection rates error can upsurge. Though hospital administrators and nursing boards worldwide work day and night to solve these issues, there is still no found lasting solution to the nursing shortage.

In the United States, the current nurse turnover rate ranges from 8.8% to 37%, dependent on the jurisdiction and nursing specialization (Shaffer, 2020). Furthermore, the national average for registered nurse (RN) turnover is 17.1% year over year. With the increasing rate of nurses leaving the profession, it becomes hard for healthcare leaders to ensure nurse-patient ratios and maintain quality service delivery (Shaffer, 2020). Additionally, according to Shaffer (2020), healthcare facilities spend between $4.4 million and $6.9 million managing turnover each year.

The Articles

Because of the criticality and the effects of nursing turnover, many researchers have investigated various aspects of this issue, intending to find a lasting solution to the menace. Buerhaus et al. (2005) examined the Hospital RNs’ and CNOs’ perceptions of the impact of the nursing shortage on the quality of care among healthcare facilities in the United States. The study engaged current practicing Registered Nurses and Chief Nursing Officers. The main objective of this study was to find out how Registered Nurses perceive the impact of a shortage of nurses on the quality of care. This study is significant in nursing because it explores the feelings of those who have firsthand experience on how fewer employees affect nursing practice and patient care. The results of this study are an important informant to medical decision-makers, be it in hospitals or on healthcare boards.

Ashghaly et al. (2016) surveyed factors affecting nurse turnover in Iran. The main purpose of this research was to investigate reasons nurses in Iran are leaving the profession early after beginning the career. The participant incorporated 20 nurses working in general educational hospitals and ten nurses who had resigned. This study was encouraged by the researchers’ observation that nurses with less than three years of experience left the profession, leading to a shortage which contributed to high workloads, nurse less morale, and reduced patient care. This study is relevant in nursing because it brings out the factors that lead to the nursing shortage. Understanding the causing elements is vital for the hospital managers and policymakers during the intervention process.

Methods of Study

Buerhaus et al. (2005) utilized quantitative study methods because the researchers gathered numeric data, which was presented in tables and percentages. A quantitative approach is used to quantify an issue by generating numerical data that can be transformed into usable statistics. The method quantifies attitudes, opinions, behaviors, and other defined variables and generalizes results from a larger sample population. This model employs measurable data to formulate facts and uncover patterns in research.

Ashghaly et al. (2016) employed qualitative research methods because the study gathered non-numeric data through; field notes, face-to-face and semi-structured interviews. Qualitative research is exploratory research; it is utilized to gain insight into underlying reasons, opinions, and motivations. It is also used to uncover trends in thoughts and opinions and dive deeper into the problem. Its data collection methods vary using unstructured or semi-structured techniques (Cadena-Iñiguez et al., 2017). The popular approaches include focus groups (group discussions), face-to-face interviews, and participation/observations.

Benefits and Limitations of Each Methodology

As utilized by Buerhaus et al. (2005), the quantitative approach gathers more accurate data because of its numerical characteristics. It also saves time and the data collected is easy to analyze. However, this method might limit the respondents in their responses because most participants are given choices to tick. The qualitative method employed by Ashghaly et al. (2016) is an appropriate method when collecting opinions and views of respondents; information gathered through this model is quite informative. However, it takes time to gather non-numeric data, and analyzing it might be challenging and requires high expertise.

Key Result of the Study

Buerhaus et al. (2005) found out that the shortage of nurse personnel in hospitals was a big problem for the overall quality of patient care in health facilities. The findings indicated that nurse turnover was causing a high workload on the available nurses hence reducing their attention on patients. As per the findings, the study recommended that for the goals of healthcare institutions to be achieved, then the current nurse shortage should be addressed and resolved completely. Ashghaly et al. (2016) revealed that factors affecting nurse turnover included: staffing policies, the rule for promoting customer satisfaction, and challenges related to implementing excellence models. According to the findings, the researcher recommended that the study’s findings be used to deal with the important issue of nurse turnover.

Comparison of the study results

To address the effects of the nursing shortage on patient care quality, the administrators have to deal with the problem from its roots which are the causes of the nurse shortage. Ashghaly et al. (2016) highlight the cause as the high rates of turnover caused by several aspects as the researchers’ document. It is also important to understand to what extend nurse shortages affect the patient care quality, which is what Buerhaus et al. (2005) addressed. Though these two studies addressed different aspects of the PICOT Question, they are informative on the issues. The results of the two studies can be useful in implementing intervention for nursing shortage and its effects on patient quality. Though the studies are done in two different regional places, they all reflect the situation in the nursing profession across the globe, and the findings can be applied in different places to find a solution for the nurse-patient ratio.


The two articles reviewed in this paper have revealed that high nurse turnover rates are causing nurse shortages in healthcare facilities on a rolling basis. Policymakers and health boards should make this concern of uttermost importance. This problem should be reviewed regularly, and interventions occasionally changed to address arising issues. Both articles have recommended swift action by managers to handle the menace to ensure that patients get the care they deserve and quality services just as intended by health ministries.


Ashghaly Farahani, M., Oskouie, F., & Ghaffari, F. (2016). Factors affecting nurse turnover in Iran: A qualitative study. Medical journal of the Islamic Republic of Iran, 30, 356. Web.

Buerhaus, P. I., Donelan, K., Ulrich, B. T., & Norman, L. (2005). Hospital RNs’ and CNOs’ perceptions of the impact of the nursing shortage on the quality of care. Nursing Economics, 23(5), 214. Web.

Cadena-Iñiguez, P., Rendón-Medel, R., Aguilar-Ávila, J., Salinas-Cruz, E., Cruz-Morales, F. D. R. D. L., & Sangerman-Jarquín, D. M. (2017). Quantitative methods, qualitative methods or combination of research: an approach in the social sciences. Revista mexicana de ciencias agrícolas, 8(7), 1603-1617.

Haddad, L. M., Annamaraju, P., & Toney-Butler, T. J. (2020). Nursing shortage. StatPearls [Internet].

McKechnie, T. (2016). Call for nurses: The multi-dimensional manifestation of nursing shortage on patient care. QIHI Journal of Healthcare Improvement and Patient Safety, (2).

Shaffer, F. A. (2020). Nurse turnover: Understand it, reduce it. American Nurse Journal. 15(8), 57-59. Web.

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