The Situation
In a time of cutbacks, layoffs and widespread concerns about the quality of patient care, a group of
registered nurses at a mid-size hospital decided to take matters into their own hands. They had worked
for months with inadequate staffing levels and in addition to their own exhaustion they were worried
about the increasing probability of putting patients at risk. They knew they had to do something, but what?
The surgical unit has 44 beds which are located down a long hallway. The nursing unit is divided into two sections, one at either end of the corridor and staff work in either one section or the other.
Over the course of a few years, while budgets were being cut, the staff ratios were changed and registered nurses were replaced with licensed practical nurses. Staff expressed their concerns about the changes that were taking place.
At the time, the unit occupancy was 98%, patient turnover was frequent and acuity increased. Plans for opening another operating room were underway. The base staffing level was one RN and one LPN to eleven patients.
All staff were becoming disillusioned with the situation. Anxiety levels were rising and communication was at times difficult. Staff worried about what would happen if something unpredictable occurred.
Over time the situation became more demanding, people worked without breaks to ensure that patients received the required care. Many worked extra hours and people were experiencing burnout. Under these stressful circumstances, staff were worried about their own health and everyone believed that the quality of patient care was not what it used to be.
ReflectionBased on the information presented in this case: