Desirable Nurse Staffing Ratio for Optimal Patient Care

The effectiveness of the nursing fraternity within any healthcare system depends on the number of practicing caregivers present and the number of patients receiving the services (Van den Heede et al., 2013). Accordingly, the nurse staffing ratio describes the relationship between the registered nurses and the patients being attended to. At times, the number of registered nurses taking care of the patients in a health facility would be insignificant, hence affecting the quality of health services. Similarly, without the proper staffing procedures, the number of practicing nurses in a facility would be more than the number of patients. As such, the nurse leaders and managers face the challenge of balancing the ratio of the practicing nurses and the patients who are being attended to for obtaining optimum results. Hospitals with few nursing professionals often record high rates of poor patient outcomes (Van den Heede et al., 2013). Therefore, by analyzing the approaches used by the nurse leaders and managers when solving the issue of nurse staffing ratios, possible appealing factors would be paramount in enhancing the nurse/patient ratios.

Although research would confirm that healthcare facilities with few nurses record poor patient outcomes, the discussion suggests that meeting the optimum staffing levels for the practitioners is demanding for managers and leaders. Nevertheless, the responsibility of accepting the needs of patients through the staff remains the main task for nurse leaders and administrators. Consequently, the nurse leaders agree that staffing issues within the health sector have been predominantly demanding (Tubbs-Cooley, Cimiotti, Silber, Sloane, & Aiken, 2013). Hence, the leaders recognize that the rising patient acuity and the shortened hospital stay contribute to the challenge. In essence, the leaders and managers must realize the common role in ensuring that the healthcare system gets the optimal nurse-to-patient ratio to deliver appropriate patient care.

For the leaders, the challenge of optimizing the staffing ratio becomes more elaborate because they do not have organizational support as the managers who hold defined positions in the organization’s hierarchy. Therefore, the philosophy of everyone being a leader in his or her capacity would be applied in nursing leadership (Tubbs-Cooley et al., 2013). Accordingly, the leaders would only utilize the opportunity to create collaborations and innovative strategies to address the challenge of nurse-staffing ratios. Firstly, the approach would create a safe environment for both the practicing nurses and the patients. Secondly, the leaders would require support and recognition from fellow colleagues and managers to ensure the organization realizes the appropriate combination of skills by the registered nurses for optimal service delivery (Dellefield, Castle, McGilton, & Spilsbury, 2015). Thirdly, the leaders are expected to consider the element of patient acuity, unlicensed assistive personnel, and the necessary skills, education, and training for the different working environments. Moreover, the intervention by the leaders should be focused on providing a long-term solution to the challenge of nurse staffing ratios. Specifically, the interventionist approach to the staffing ratio issue should also require nurse leaders to respond proactively to the issues of shortage or excess nurses when they occur (Dellefield et al., 2015). For example, the nurse leaders would consider calling to duty the nurses on vacation whenever there is an emergency or a shortage in the nursing personnel, but summoning the caregivers would act as a short-term intervention mechanism. Similarly, the leaders would be better placed to plan on the staffing schedules and the rotation schemes to ensure that all the departments are adequately staffed on any occasion.

By taking a democratic approach, a leader would ensure that the opinions of fellow caregivers are well represented for the right nurse staffing ratios. In other instances, the leaders would be required to exercise the free-rein and transformational leadership model, which emphasizes on mentoring and motivating the team members (Madison et al., 2016). As such, unlike the authoritarian leadership systems, which emphasize on commanding the nursing staff, involving the practicing nurses in decision-making would work towards overcoming the issue of nurse staffing ratios (Lockwood, 2015). In fact, leaders can be expected to play a critical role in the nurse staffing ratio by empowering, inspiring, and motivating the nursing staff toward making the right decisions.

Healthcare managers take a fundamental position on the issue of nurse staffing because of the administrative responsibilities they hold in the organization. Particularly, a nurse manager is involved in the daily running of the healthcare system and plays a critical role in the decision-making process within the hospital hierarchy. Accordingly, the managers would be expected to keep a clear and updated record of the nurse staffing ratios to utilize the information in decision-making. Moreover, the managers must balance the number of patients and practicing nurses for optimum staffing ratios. Therefore, the nursing managers are responsible for making recommendations to the hiring authority to increase or reduce the nursing staff for the best results (Van den Heede et al., 2013). However, it is worth appreciating that critical thinking is an indispensable attribute for nurse managers to facilitate decision-making (Van den Heede et al., 2013). As such, when nurse managers are empowered through resources, critical thinking, and the power to make decisions, they can address the issue of nurse staffing with precision and accuracy.

Notably, by following and utilizing the principle of evidence-based management, nurse managers would be more efficient in staffing the healthcare organization. Besides increasing or reducing the staffing ratios, the nurse administrators would undertake qualitative research to confirm the intended outcomes (Tubbs-Cooley et al., 2013). Furthermore, the managers would ensure the collaboration of different departments that are involved in human resource management, including personnel management, human relations, and labor relations (Tubbs-Cooley et al., 2013). By enhancing teamwork in the administration of caregivers, the manager would ensure that qualified and competent nursing professionals are recruited for the best nurse staffing ratios.

On the other hand, the leaders and managers alike do not demonstrate institutional powers, which are expected to deal with the underlying challenges of the nurse staffing ratio. Nevertheless, the elements of critical thinking and the professional commitment of the leaders and managers toward improving nurse staffing ratios indicate mutual responsibilities. Besides, all nurse managers must be leaders before they assume management responsibilities. Therefore, the managers’ work in making staffing decisions would be influenced by the attributes of good leaders and the definite leadership theories ascribed. Moreover, a subjective opinion in this discussion holds that the issue of nurse staffing lies in the different areas of leadership and management; hence, a collaborative approach would be highly recommended. In addition, the effectiveness in tackling the issue of nurse staffing would require more emphasis, particularly on the strategic approach and involving the instruments of scientific research by both the leaders and managers. In essence, the analysis would advocate for the mutual involvement of the nurse leaders and managers while solving the issue of nurse ratios. As a result, the individual commitment of the nurse leaders and the nurse managers toward ensuring that the optimal levels of nurse staffing ratios will only be realized through collaborative efforts.



Dellefield, M. E., Castle, N. G., McGilton, K. S., & Spilsbury, K. (2015). The relationship between registered nurses and nursing home quality: An integrative review (2008-2014). Nursing Economics, 33 (2), 95.

Lockwood, W. (2015). Clinical Supervision: Leadership Styles. Rn. 1-12

Madison, R. D., Sampayo, J., Maranga, D., & Kennedy, M. (2016). A model for leadership and management using a S.I.M.P.L.E. approach. Retrieved from

Tubbs-Cooley, H. L., Cimiotti, J. P., Silber, J. H., Sloane, D. M., & Aiken, L. H. (2013). An observational study of nurse staffing ratios and hospital readmission among children admitted for common conditions. BMJ Qual Saf, 22,735-742

Van den Heede, K., Florquin, M., Bruyneel, L., Aiken, L., Diya, L., Lesaffre, E., & Sermeus, W. (2013). Effective strategies for nurse retention in acute hospitals: a mixed method study. International Journal of Nursing Studies, 50(2), 185-194.    

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