Off-Peak Nurse Staffing

The risk of mortality increases for hospitalized patients at night and on the weekend. Nurses, who are on duty in hospitals 24/7, are excellent sources of information about what happens on a unit during off-peak times.

Following up on a primary study of nurses in three southwestern hospitals, these researchers reviewed the literature on nurse staffing published subsequently in 132 articles. They sought to determine whether the nurse statements echoed the literature. They identified three main categories of issues, which they describe, interspersing with nurse interview quotations:

  1. Antecedents and consequents of staffing levels: Nursing shortage, rationing of nursing care, and planning for nursing staffing.
  2. Institutional factors affecting nurse staffing: Policy/legislation, practice environment/organizational attributes/hospital characteristics, nursing economics and technology informatics.
  3. Methodological considerations for studying nurse staffing and its effect on outcomes: International application/sharing of nurse staffing research findings, measurement/instrumentation challenges.

The critical care nurses interviewed provided information beyond the recent literature, informing a better understanding of off-peak staffing issues.

A typical nurse quoted: "I think that people need to understand, patients don't just go on autopilot, you know, on the night shift and weekends. They're still just as sick then as they are during the day. And you need to have that same, same standard, same level of care, same level of service, 24/7."