As hospitals continue to struggle with staffing shortages, over 90% of nurses say that heavy patient loads have negatively impacted patient safety and quality of care, according to a new survey from the Michigan Nurses Association (MNA).

Is understaffing affecting patient safety?

According to the Michigan Health and Hospital Association (MHA), Michigan has lost 1,700 hospital beds since 2020 due to staffing shortages.

"This creates a cascade of problems, from longer wait times in the emergency department, reduced services, particularly in rural areas, and more difficulty transferring patients to the appropriate care setting," MHA said. "Communities and families across our state could lose access to the high-quality health care they have now if we don't address these challenges."

In January, MNA surveyed 400 nurses to assess how these staffing shortages were affecting them and the quality of care they are able to provide patients.

Overall, 71% of RNs surveyed said they are often assigned too many patients at once due to staffing shortages, and a similar number say that they are assigned an unsafe patient load for at least half or more of their shifts. A quarter of nurses said their patient load is almost always unsafe, more than triple the 7% who said the same in 2016.

Most nurses (58%) cited staffing shortages and patient ratios as the biggest obstacles they face to doing their job and providing quality care to patients. Among nurses working in direct patient care, 70% said they do not have enough time to provide their patients with the care and attention they need.

Almost all respondents (94%) said high patient loads have negatively impacted the quality of their patient care. Some of the negative patient outcomes reported by nurses include lacking time to properly comfort and assist patients, lacking time to educate patients and provide adequate discharge planning, and medication errors.

Over 60% of nurses said high patient loads had led to an injury to a patient or a longer hospital stay, and 42% said a patient had died. Compared to 2016, nurses reported significantly more negative patient outcomes due to understaffing.

How staffing shortages are affecting nurse retention

According to MNA, staffing shortages, along with high patient loads, may be pushing nurses out of their jobs entirely. In the survey, only 47% of nurses said they planned to stay in their current job over the next two years.

When asked about potential actions that could help retain nurses, 76% said retention pay for direct care nurses would make "a great deal of difference," and 74% said placing limits on nurse-to-patient ratios in hospitals would do the same. Half of nurses also said eliminating mandatory overtime would help retain nurses.

Over 80% of nurses planning to leave direct care within two years said limiting nurse-to-patient ratios would improve care, while over 50% said the same about eliminating mandatory overtime. (Adams, MedCity News, 2/2; Wells, Michigan Radio, 2/1; Twenter, Becker's Hospital Review, 2/2; Michigan Nurses Association survey, accessed 2/3)