The Issue Of Nursing Shortage And Its Consequences University Essay Example


Proper nursing care is extremely important as it allows us to address the issues that can significantly decrease the quality of life of patients. Nevertheless, there are many important problems connected to the field that can hurt the quality of care and patients’ experiences. Speaking about these problems, it is necessary to mention understaffing that occurs in many hospitals all over the world. As for a specific location studied in this paper, Palmetto Hospital also faces some problems related to the discussed sphere. This is why it is necessary to conduct research that would help to understand how inpatients with the need for acute care perceive the effects of understaffing in nursing while being provided with acute care by nurses. What is more, it is important to take into consideration the poor knowledge base of many healthcare professionals working there. To better understand the effects that can be produced on inpatients in such a situation, it is necessary to review the studies that have already been conducted and can be regarded as relevant for the present research.

Understand the problem of staff shortages and its impact on patients

Speaking about the studies in the field that can help to understand the problem of understaffing and its effects on patients, it is necessary, to begin with, a range of research questions that were identified by the researchers who have analyzed a lot of data to present the results possessing certain practical relevance. The authors of the articles seem to have regarding the topic from different points of view establishing the links between understaffing and other negative phenomena that may occur in healthcare professionals’ practice. Thus, Ball, Murrells, Rafferty, Morrow, and Griffiths (2013) studied the relationship between staffing levels and missed nursing care whereas Kalisch, Tschannen, and Lee (2012) focused on its possible connection with patient falls. Glance et al. (2012) researched to study the connection between nurse staffing levels and negative health outcomes in the same manner as Zhu et al. (2012) who studied the situation in China. A similar study was also conducted by Park, Blegen, Spetz, Chapman, and de Groot (2012) who were focusing on nurse staffing levels and patient outcomes. The effects of staffing regulations in California on patients’ health were assessed by Cook, Gaynor, Stephens, and Taylor (2012).

Also, many researchers focused on safety and mortality rates in connection with staffing levels; for instance, Spetz, Harless, Herrera, and Mark (2013) analyzed possible changes in patient safety caused by staffing changes whereas Liang, Tsay, and Chen (2012) studied cases in Taiwan to establish the connection between nurse staffing levels and mortality rates. What is also important, many authors studied the factors that could influence patients’ satisfaction levels. For example, Stimpfel, Sloane, and Aiken (2012) focused on exploring the effects of extended shifts on patient satisfaction. Another research connected to patient satisfaction levels was conducted in Turkey by Tekindal, Pinar, Ozturk, and Alan (2012) who studied its connection with the level of burnout in nurses. Having analyzed the articles mentioned and the research questions formulated by their authors, it is possible to conclude that the topic of staffing levels and its positive and negative effects seem to be quite popular among the researchers. Therefore, the results of these studies may help to analyze the data collected within the frame of the present research. Nevertheless, not all the studies were conducted in connection with acute care. As it is clear, the authors conducted their studies in different locations; due to that, the conclusions made by the authors from other countries may be different from the ones connected to Palmetto Hospital.

Analyzing the relevance of the discussed studies for the present research, it is also important to speak about the sample populations that were used by the researchers. To begin with, authors of all studies have managed to analyze large amounts of data as it is clear from the sections where the processes of data collection and sampling are described. Due to that, it can be stated that all the studies are credible as they are based on data reported by great numbers of participants. The studies were conducted in different countries including the United States, China, Taiwan, Turkey, and the United Kingdom, and the participants whose interviews were used to answer the research questions were of different nationalities. Speaking about the size of the samples used by the researchers, it is necessary to say that all of the studies involved at least 448 participants as in the research by Tekindal and his colleagues. As for the research that involved the largest number of participants, it was conducted by Park and other researchers. The importance of the conclusions made by these researchers should not be underestimated as the total number of participants whose cases and personal details were used was around one million. Moreover, the samples used by the authors usually included both nurses and patients (some studies focusing on patients’ perceptions also involved patients’ relatives).

As for the limitations of the discussed studies, it is necessary to realize that they were closely interconnected with the research methods chosen by the authors. For instance, those studies that were conducted with the focus on qualitative data allowed the researchers to make conclusions that could be called less precise. On the other hand, quantitative data cannot be always useful to reflect participants’ opinion and the main ideas related to their personal experience. Speaking about the limitations that were the most common for the discussed studies, it is important to remember about subjective perception. Thus, an important limitation for many groups of researchers including Ball and her colleagues was connected to the inability to significantly reduce the influence of patients’ and nurses’ subjective experiences on the results of the studies. Thus, it was important for the researchers to take into consideration that some participants could understand certain notions related to the research topics in their way.


In the end, the discussed studies can be called extremely significant for the field as they allow to better understand the effects of different staffing levels on nurses’ work performance and various factors that may influence patient satisfaction levels in different countries. About the recommendations that can be made based on the analysis of previous studies, it is necessary to clearly define all the terms that can be used during interviewing patients to find out how they perceive the effects of understaffing in nursing while being provided with acute care in Palmetto Hospital. Due to that, it will be possible to secure uniformity of the evaluations and develop the most effective solutions that will help to ameliorate the situation and incorporate new staffing strategies.


Ball, J. E., Murrells, T., Rafferty, A. M., Morrow, E., & Griffiths, P. (2013). ‘Care left undone’ during nursing shifts: Associations with workload and perceived quality of care. BMJ Quality & Safety, 1(1), 1-10.

Cook, A., Gaynor, M., Stephens Jr, M., & Taylor, L. (2012). The effect of a hospital nurse staffing mandate on patient health outcomes: Evidence from California’s minimum staffing regulation. Journal of Health Economics, 31(2), 340-348.

Glance, L. G., Dick, A. W., Osler, T. M., Mukamel, D. B., Li, Y., & Stone, P. W. (2012). The association between nurse staffing and hospital outcomes in injured patients. BMC Health Services Research, 12(1), 247.

Kalisch, B. J., Tschannen, D., & Lee, K. H. (2012). Missed nursing care, staffing, and patient falls. Journal of nursing care quality, 27(1), 6-12.

Liang, Y. W., Tsay, S. F., & Chen, W. Y. (2012). Effects of nurse staffing ratios on patient mortality in Taiwan acute care hospitals: A longitudinal study. Journal of Nursing Research, 20(1), 1-8.

Park, S. H., Blegen, M. A., Spetz, J., Chapman, S. A., & De Groot, H. (2012). Patient turnover and the relationship between nurse staffing and patient outcomes. Research in nursing & health, 35(3), 277-288.

Spetz, J., Harless, D. W., Herrera, C. N., & Mark, B. A. (2013). Using minimum nurse staffing regulations to measure the relationship between nursing and hospital quality of care. Medical Care Research and Review, 70(4), 380-399.

Stimpfel, A. W., Sloane, D. M., & Aiken, L. H. (2012). The longer the shifts for hospital nurses, the higher the levels of burnout and patient dissatisfaction. Health Affairs, 31(11), 2501-2509.

Tekindal, B., Pinar, G., Ozturk, F., & Alan, S. (2012). Nurses’ burnout and unmet nursing care needs of patients’ relatives in a Turkish State Hospital. International journal of nursing practice, 18(1), 68-76.

Zhu, X. W., You, L. M., Zheng, J., Liu, K., Fang, J. B., Hou, S. X.,… & Wu, Z. J. (2012). Nurse staffing levels make a difference on patient outcomes: A multisite study in Chinese hospitals. Journal of Nursing Scholarship, 44(3), 266-273.

Philosophy Of Social Science And Education Research


In this section of the book, Nel Noddings (1998) discusses the main philosophical assumptions underlying education research as well as social science. This question is of great importance to scholars who examine the nature of scientific knowledge. The main purpose of this chapter is to show how theoretical views on epistemology can affect the activities of social or educational researchers. This paper will be aimed at examining various issues such as the concept of falsifiability and the use of various research paradigms.

The understanding of these topics is important for designing empirical studies. This is why readers should not overlook these issues. On the whole, it is possible to argue that education research and social science cannot be judged according to the standards that are traditionally applied to naturalistic sciences like physics. It should be kept in mind that these areas of study incorporate questions that cannot be examined with the help of naturalistic research techniques.

Summary and the main arguments

Overall, Nel Noddings’ main point is that researchers should remember that theories and models, which are incorporated in social sciences or educational research, do not always enable scholars to make accurate predictions. In some cases, they should help scholars gain a deeper understanding of various behavioral social, or educational phenomena. The following bullet points give a brief over view of the chapter

  1. Karl Popper’s views on scientific knowledge;
  2. The notion of progress in science;
  3. Qualitative and quantitative methodologies;
  4. The complexities of narrative research.

At first, the author focuses on Karl Popper’s concept falsifiability. This notion implies that a hypothesis or a theory can be called scientific only if it can be confirmed or refuted in an empirical way (Noddings). As a rule, this requirement is critical for social sciences. Nevertheless, this standard is not always applicable to social sciences or psychology. For instance, one can mention Freudian views on the development of personality. Similarly, Piaget’s model of developmental stages cannot always be falsified. Nevertheless, they have been critical for the development of psychology as a science.

Additionally, the writer discusses the peculiarities of qualitative and quantitative methods. Overall, quantitative methods are primarily aimed at testing a specific hypothesis or a theory. This approach is helpful when it is necessary to make generalizations. In contrast, qualitative approach is more useful when one has to explore the opinions of people and understand their major concerns. Under such circumstances, one often has to adopt a narrative approach. Still, it is not consistent with the principles of fallibility. Furthermore, this approach is not suitable for testing a scientific claim.

Finally, it is critical to remember that the data generated in the course of a social or educational research may give rise to various interpretations. In many cases, this interpretation can depend on the personality of the researcher, especially his/her values and attitudes. In contrast, natural sciences include more objective criteria which prevent a person from the misinterpretation of data.


Overall, this discussion indicates that social and educational sciences differ significantly from other areas of knowledge. In many cases, conventional standards of validity may not be applied to various studies are supposed to explore the experiences and attitudes of respondents. This reading has enabled me to understand the difficulties that educational and social researches have to encounter. These are the main details that can be singled out.

Reference List

Noddings, N. (1998). Philosophy of Education. New York, NY: Westview Press.

Nursing Shared Governance And Ethics

Ethics in Shared Governance

Shared governance is a system that allows nurses to participate in operations and activities connected not only to individual patients’ well-being but also to the hospital’s structure. In this type of governing structure, nurses have a chance to obtain more information to care for their patients, make decisions connected to the staffing of hospitals, and participate in policy-making and advocacy (Hess, 2004).

Thus, shared governance gives nursing professionals a chance to influence the course of the medical development, the establishment, in which they work, and the state of their local community. The ethical approach of this concept can be seen from both formal and informal sides. The notion of nurses being able to contribute to the patient’s care is moral in the sense that it aligns with the central principle of nursing ethics. By giving nurses more information and allowing them to influence the structure of the hospital, establishments help professional nurses to do their job in delivering the best patient care possible.

By utilizing shared governance, hospitals allow nurses to advocate not only for themselves but also for patients. Sharing some responsibilities with nursing staff gives organizations a chance to change policies connected to health care and nursing. Thus, nursing professionals can apply their deep knowledge and understanding of the profession in the policy-making process. A nursing administration that can influence the hospital’s decisions can significantly affect the moral vision of the organization.

Moreover, the concept of nurses concentrating on their professional skills and continuous learning also goes together with the principles of shared governance. Wilson, Speroni, Jones, and Daniel (2014) write that working nurses and managing nurses can work together in the conditions of shared governance. This type of governance often relies on the most experienced nurses as well as on the ideas of new nursing professionals, which brings the ethical considerations of collaborative care to everyone’s attention.

A Nurse Executive Response: Discussion

The response of Herrin (2004) to the proposition made about shared governance by other authors brings attention to several topics that can be discussed further. First of all, the idea that all administration leaders should participate in shared governance because nurses are constrained by various nursing and health care issues is understandable. According to Hess (2017), a new structure of governance moves away from nurses sharing their duties to all professionals contributing their knowledge and experience in some way.

Thus, current professional shared governance includes various individuals that work in hospitals and other organizations acting together to improve the state of health care. Moreover, Herrin (2004) notes that nursing practice involves many types of responsibility, and preparing a nurse to have even more duties may prove to be rather hard. Thus, nursing professionals should be ready to take on these responsibilities after they finish their education. It is important to integrate the concepts of shared governance into the learning process of medical students.

The author also highlights the importance of empowering nurses (Herrin, 2004). The process of empowerment may become one of the most significant steps towards creating nursing managers and leaders, who are ready to participate in governing activities. It is necessary to teach nursing professionals the value of their knowledge and experience. However, the problems of implementing shared governance should not be overlooked. Herrin (2004) outlines such issues as legal limitations, imposed by outer structures, financial restriction of hospitals, and the requirement of creating a solid foundation for nurses to implement the practices of shared governance. Thus, these concerns should be considered not only by nursing professionals but also by hospital management and legal organizations.


Herrin, D. M. (2004). Shared governance: A nurse executive response. Online Journal of Issues in Nursing, 9(1), 3.

Hess Jr, R. G. (2004). From bedside to boardroom-nursing shared governance. Online Journal of Issues in Nursing, 9(1), 10.

Hess Jr, R. G. (2017). Professional governance: Another new concept? Journal of Nursing Administration, 47(1), 1-2.

Wilson, J., Speroni, K. G., Jones, R. A., & Daniel, M. G. (2014). Exploring how nurses and managers perceive shared governance. Nursing, 44(7), 19-22.

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