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The Effects of Staffing on Nursing Roles


Nurses play integral roles in the healthcare sector. They are caregivers, teachers, communicators, decision-makers, and patient advocates. However, the success of various nursing roles depends on staffing. The staffing in hospitals is either centralized or decentralized. The essay provides insight into the effects of staffing on nursing roles.

Advantages and Disadvantages of Centralized Nurse Staffing

The ANA Scope and Standards of Practice can be a source of guidance since it explains how the centralized nurse staffing relies majorly on the top decision-maker in a hospital. The centralized staffing system requires that only one department in the hospital does recruitment of the call-in, call-off, or float staff (Wright & Mahar, 2013). This strategy also guarantees the advantage of sharing information when nurses are clustered together in a centralized design of work. Other advantages exhibited in the centralized nursing role are the quick decision-making processes by the top executive, reduced work conflicts, and improved accountability (American Nurses Association, 2010a).

On the other hand, the disadvantages range from time consumption and delays in healthcare delivery. This situation creates a barrier to the creation of patient privacy. The code of ethics as stipulated under the ANA requires that nurse staffing should ensure a proper staff-patient ratio in a given unit. The nurse at the central design must put into account the needs of individual patients (Weston, Brewer, & Peterson, 2012).

Advantages and Disadvantages of Decentralized Nurse Staffing

The continued improvement in technology has led to the embracement of the decentralization of nursing roles in hospitals. This situation has ensured the reduction of space in medical facilities. As a result, there has been improved patient care in individual units (Koren, 2010). The decentralized staffing also ensures that the charge nurses ensure the required number of medical attendants before and after shifts, or in cases of emergency. The decentralization of services has proved beneficial because it improves the visibility of patients (Mensik, 2013).

A major disadvantage is the feeling of isolation amongst the nurses because the sense of teamwork is reduced. In addition, the knowledge about the delivery of care to the patients is shared unequally among the nurses. Most nurses share information when they are together in a centralized station. However, the decentralized designs limit them from such practices (American Nurses Association, 2010c).

Answers to the Scenario Presented

Professional obligations are well stipulated in the ANA code of ethics. In the beginning, Susan, as a manager, knew that she was held responsible for the staffing roles in the unit. She sees herself as a good leader. As a result, she performed staffing besides delegating duties to nurses on night shifts (Marquis & Huston, 2015). Her moral sensitivity enabled her to use a nurse-patient ratio staffing technique to ensure the alleviation of the oncoming problems. Instead, Susan was supposed to show ethical competency by applying both the nurse-patient ratio and acuity techniques to staffing the shifts. However, this objective was not realized due to moral insensitivity.

Upon realizing various problems, she was supposed to communicate them to the board meeting instead of talking to the hospital licensing organization and the local newspaper. The staffing and night shift duties were to be conducted by the registered nurse who made plans in the daytime. The nurse should have ensured that the staff assigned duties at night were competent to handle diverse medical conditions (American Nurses Association, 2010b). Susan, being the one who conducted such activities, was responsible for the incidences that happened. Furthermore, the staff nurse who anonymously reported her to the management did not have the moral courage to face Susan to tell her the problem. Instead, she reported to the State Board of Nursing. She should not have been fired in the first place if she had presented the problem to the board. However, her unprofessional conduct and poor communication skills led to her dismissal. She should have presented such information to the board.

Reference List

American Nurses Association (2010a). Nursing Guide to the Code of Ethics for Nurses. Silver Springs, MD:

American Nurses Association (2010b). Nursing: Scope and Standards of Practice. Silver Springs, MD:

American Nurses Association. (2010c). Nursing’s Social Policy Statement: The Essence of the Profession. Silver Springs, MD:

Koren, M. (2010). Person-Centered Care for Nursing Home Residents: The Culture-Change Movement. Health Affairs, 29(2), 312-317.

Marquis, B., & Huston, C. (2015). Leadership Roles and Management Functions in Nursing: Theory and Application. Philadelphia, PA: Wolters Kluwer Health.

Mensik, J. (2013). The Nurse Manager’s Guide to Innovative Staffing. Indianapolis, IN: Sigma Theta Tau.

Weston, M., Brewer, K., & Peterson, C. (2012). ANA Principles: The Framework for Nurse Staffing to Positively Impact Outcomes. Nursing Economics, 30(5), 247.

Wright, P., & Mahar, S. (2013). Centralized Nurse Scheduling to simultaneously improve Schedule Cost and Nurse Satisfaction. Omega, 41(6), 1042-1052.

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