Introduction
In nursing homes, where vulnerable populations rely heavily on the care provided by healthcare professionals, the question of whether inadequate staffing and mandatory overtime compromise the quality of patient care is of paramount importance. The debate surrounding this issue is multifaceted, involving patient safety, staff well-being, and organizational efficiency considerations. While some argue that understaffing and mandatory overtime lead to decreased quality of care due to fatigue, increased stress, and reduced attention to patient needs, others contend that these challenges may contribute to staff resilience and adaptability, ultimately enhancing patient outcomes. This essay explores both sides of the argument, examining the evidence and perspectives presented in recent research and scholarly articles. By critically analyzing the implications of inadequate staffing and mandatory overtime in nursing homes, we can better understand the complexities involved in ensuring quality care for residents.
Pros and Cons of Inadequate Staffing
Inadequate nursing home staffing leads to many challenges that compromise patient care and staff well-being. The Nursing Home Abuse Center’s article on understaffing elucidates the pervasive nature of this issue, highlighting its impact on resident care and well-being. Understaffing delays assistance, compromised quality of care, and increased risks for residents. On the other hand, proponents of inadequate staffing argue that reducing staffing levels could cut costs for nursing homes, thereby improving their financial viability. However, Lewis’s article on nursing home fraud debunks this notion, emphasizing that cost-cutting measures often lead to unethical practices and fraudulent behavior, ultimately undermining patient care.
Supporting paragraphs
A fact is a mandatory consequence of improper staffing, and the requirement of overtime in nursing homes compromises quality care most of the time. Armenteros (2022) emphasizes the not-very-good results due to the absence of nurses or doctors in treatment quality and the COVID-19 pandemic. The increased demands brought about by working in a facility where nurses are in short supply put them under too much pressure, which can adversely affect the quality of care provided. This has serious consequences because the nurses have to work longer hours thanks to mandatory overtime policies, as is the case with the research conducted by Luan and Lucy(2017). The study’s research team concluded that the overtime law commanding more hours of work for the employees in an instance was designed to fix the problem of shortage of staff in nursing homes, but just the opposite was witnessed. The workload, which is then increased due to prolonged shifts, may result in fatigue and burnout of nursing workers, using the username and attention to patient needs. Also, as illustrated by Slyngstad and Helgheim (2022), more time is given to documentation and report writing than would be the case if automated documentation tools were in use. This might be made worse by improper staff allotments, thereby adding to the nurses’ work and resource difficulties (Slyngstad & Helgheim, 2022). Finally, these staffing deficiencies and difficulty with overtime can impair healthy nursing staff’s ability to do all responsible assignments they may be required to do.
On the other hand, working extra duty and short staffing can also be the causes of patient safety and health being neglected. Lewis(2018) emphasizes that the economic challenges often faced by nursing homes sometimes require using cost-saving measures such as mandatory overtime. Still, these may end up being a trade-off to the level of patient care. If a facility is understaffed, it must rely on temporary and contract nurses, which can ultimately disrupt continuous relationships between the treated and the staff. Therefore, the importance of relationships between persons treated and staff members becomes very low, as Lu and Lu (2017) observed. On the other side, Lobo et al. (2018) pointed out the negative impact of shifts on nurses’ well-being; noticeable examples are fatigue and exhaustion, which are some of the reasons they don’t do long shifts. Under too much fatigue and pressure, the nurses are bound to commit mistakes and miss important details, eventually compromising the patients’ safety and causing the residents to have bad conditions. Consequently, personnel shortages in combination with mandatory overtime pose a severe threat to the quality of patient care and compromise safety standards in nursing homes, which are inconsistent with the significant postulates of healthcare in medical institutions.
Healthcare safety is hindered by hospitals employing nurses on shortage and mandatory overtime, thus giving another cycle of burnout and turnover. According to Armenteros (2022), the lack of nurses largely undermines workforce retention initiatives, especially in areas that have experienced severe cases of the COVID-19 outbreak. Overworked nurses, as well as highly stressed ones, may be the ones that leave their jobs earlier, which, consequently, causes a rise in turnover levels and aggravates the staff shortages. Above this, Lu and Lu (2017) stated that regulations on overtime hours in the healthcare sector would probably lead to choosing contract nurses who need to become moreamiliar with the facility or the residents more often. Thereby, residents may experience the detrimental effect of staffing turnover or have to work with temporary ones that may, in the end, hinder their quality care and interactions. In a way, Lobo et al. (2018) indicate the negative effects of overtime on nurses’ wellbeing with wordiness and tiredness as reasons for admitting them not to)> This is where we have a cycle that goes like this: understaffing brings overtime that means burnout and turnover that is a cause of a poor quality care.
Legal and ethical ramifications of the insufficient staffing and the fact that the nurses work when they are duty bound, as well as their consequence on the quality of the patientcare are crucial elements for the assessment of salience of the topic. From the legal standpoint, residential homes must comply with the imposed regulations and standards that set the bar for the adequate staffing of the institutes to provide patient safety and care (Slyngstad & Helgheim, 2022). Non conformity to this standards demands a legal consequence and this can vary from a license suspension, a fine or even license revocation. Besides providing protection for healthcare workers’ rights to safe and reasonable working hours through the support of mandatory overtime policies, there would come into existence a situation of no exploitation and hence, the provision of sufficient rest will be in accordance with the labor laws and regulations, too. Ethically, the nursing homes are supposed to be able to guarantee high quality care for the residents, and the extended working hours increase the probability of decreased quality of care that may have adverse effect on the residents, therefore, may pose ethical struggles and troubles for the health care providers (Stimpfe et al., 2019). Add to these the ethical principle of beneficence which mandates healthcare providers to act in the best interest of patients and which as well cut across the financial interests of nursing homes aimed at lessening the costs through the shortage of the needed staffs and substituting overtime. Consequently, navigating the legal and ethical obstacles of the inadequate staffing and mandatory overtime is critically important to secure the quality of patient care and the health entirety system of the professional healthcare.
Counter arguments
While legal and ethical aspects play critical roles in evaluating the effect of medicine shortage and obligatory overtime in nursing homes, there are in addition many counterarguments to be taken into account in the process. One the biggest sides of the argument is that many believe that having less staff and have to work overtime during the incredibly busy days is something that is inevitable. Reasons such as lowering budget rate, low number of the workforce and unpredictable sickness can worsen certain situations (Stimpfe et al., 2019). Nursing homes are at risk of struggling to recruit and retain the required staff, which would then drive their quest for staff more aggressive in spite of the initiatives to comply with the regulations. This situation might, however, entail reduction in quality of patient care. However, such decline in quality of health care service might sometimes be seen as a trade-off as it is sometimes the only way to maintain the hospital’s viability and achieve the facility’s continued operation. As well, advocates may make this argument that overtime be on compulsion is flexible enough for staffing arrangements in order to enable care homes to be readily responsive to unexpected demand in patient acuity or on unexpected cases of staff absences (Armenteros, 2022). Whilst mandatory overtime may have a negative impact on health care personnel through fatigue, it could as well be argued that the positive effect of keeping the appropriate number of workers on staff during acute patient numbers outweighs the possible risks to patient care quality.
If the staffing levels are not enough or if the healthcare providers must work some mandatory overtime shifts, then the quality of patient care in nursing homes would be compromised. On the other hand, if there is a greater workload that they have to manage, it could also exercise their skills and enable them to adapt to more diverse tasks. The critics may say that overall status, of healthcare will improve by facing problems in everyday work, such as staffing shortage, and long working hours that will help healthcare workers develop their skills. Nurses may gain these efficiencies, abilities and skills by distributing extra care needs and solve difficult cases (Armenteros, 2022). As well, enforced OT might allow the employees to write their names on the additional experience they will gain by exposed to different patients and care cases. With that said, although a sort-term strain may be experienced by health care workers due to inadequate staffing and compulsory overtime, in the long run, these challenges can instill and develop staff who are more skilled and resilient, and hence can provide higher-quality care under unmerciful conditions.
Conclusion
As a conclusion, although there were some reasons brought up in the arguments which implied that there might be certain positive aspects or challenges in dealing with the issue of staffing shortages or in the process of compulsory overtime in nursing homes, but still, all the findings point to the negative effect on the quality of patients’ care provided by nurses. Insufficient staffing levels, paramountly relevant issues, over time and pressures influence patient safety, quality of care, healthcare workers’ burnouts and inexperienced resource allocation. A disadvantage of this kind of growth spurt is that the consequences in the long term outstrip the benefits people may have expected in the short term. Consequently, as politics, administrators and all relevant stakeholders are concerned to provide staffing levels enough and not having overtime as much as can be, efforts for the quality of care and residents and employees wellbeing in nursing homes would be therefore upheld.
References
Armenteros, N. (2022). A Mixed Methods Approach to Exploring Nurses’ COVID-19 Experiences and Identifying Effective Coping Strategies for Common Nurse Job Strains. FIU Electronic Theses and Dissertations.
Lewis, R. (2018). Nursing Home Fraud: Responsible Ways to Increase Profits in Nursing Homes. Emory Corp. Governance & Accountability Rev. Perspectives, 5, 121.
Lu, S. F., & Lu, L. X. (2017). Do Mandatory Overtime Laws Improve Quality? Staffing Decisions and Operational Flexibility of Nursing Homes. Management Science, 63(11).
Slyngstad, L., & Helgheim, B. I. (2022). How Do Different Health Record Systems Affect Home Health Care? A Cross-Sectional Study of Electronic- versus Manual Documentation System. International Journal of General Medicine, Volume 15, 1945–1956.
Stimpfe, A. W., Fletcher, J., & Kovner, C. T. (2019). A comparison of scheduling, work hours, overtime and work preferences across four cohorts of newly licensed registered nurses. Journal of Advanced Nursing, 75(9).
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