Effects of Nursing Staff Shortage and Quality of Care for Patients


The shortage of nurses is a common criterion in vast medical fields globally. An article by Haddad et al. (2020) states that there is no hope of an end to the shortage of nurses despite numerous attempts of addressing the issue. The nurse shortage issue is extensively linked to countless incidents of nurses leaving the nursing profession. As a result, Zhu et al., (2015) and Liang et al., (2012) articles highlight the necessity to investigate the decision-making process and the widespread problem prevalent in the medical field across the globe. The articles project that there exists a global challenge in establishing an effective way of communication within the nursing workforce mobility globally. A comparative study of developed countries around the world including China has proven a significant shortage of nurses (Qin et al., 2016). Nurses in many developed countries are continuously volunteering to leave their nursing careers.

Qualitative Study

Qualitative data analysis includes the process of identifying, examining, and interpolating non-numeric data patterns and themes in textual data. Akinyode and Khan (2018) define qualitative analysis as a research methodology that constitutes the collection and analysis of non-numerical data such as texts to discern distinctive opinions, various concepts, and opinions. It defines how the respective data patterns and themes assist with finding answers to the research questions at hand. This method, therefore, is mainly associated with collecting and analyzing non-numerical data (Creswell, 2020: Douglas, 2017), an aspect that makes it the most appropriate methodology for assessing nursing discrepancies. Through this model, various methods can be used, including random sampling, administering questionnaires, or conducting interviews.

Summary of Zhu et al. (2015) and Liang et al. (2012) Articles

In the first article Zhu et al. (2015) used the interview model to assess nineteen nurses who had quit their respective jobs in one provincial hospital in China’s capital between August 2009 and March 2010. The results indicated leaver’s departure reports saw a rise to the core category “Mismatching Expectations.” Furthermore, four distinct patterns of behavior affiliated with nursing were identified, indicating that the interaction between the core and main categories on “individuals impression of power.”

The Liang et al. (2012) article used random sampling criteria and evaluated 108 wards from 32 Taiwanese hospitals. They used the mixed effect logic model to analyze the relationship between nurse staffing and high patient mortality. The research findings found that the direct-nursing hours were long. The findings also have implications for nursing curricula, nurse staffing, and hospital-based quality-related nursing.

How the Two Articles Support the Nursing Practice

The articles by Zhu et al. (2015) and Liang et al. (2012) cordially support the nursing practices as they mutually aim at addressing the problems faced by the nurses while exploring the environment in which the nurses work. The first article seeks to identify the reason behind the tendency to voluntary quitting of the nursing practices by nurses. It establishes the nurse’s experiences from the joining point of their field to the procedures of leaving the course. Liang et al. (2012) article seek to evaluate the working conditions of the nursing by assessing their working hours and nurse manpower. Its objective is to identify the connection between the prevalent nurse staffing and patient mortality rate and find a possible solution to this problem.

How the Two Articles will be Used to Answer the PICOT Question: The Effects of Nursing Staff Shortage on Patients’ Quality of Care

Zhu et al. (2015) suggest that there is an interrelationship that exists between “Mismatched expectations.” The study verified that the greater the degree of mismatch between individuals and organizational versus the nursing expectations recognized by nurses made them develop a resistive force. Also, the extent of power imbalance perceived by individual nurses made them feel the urge of raising to higher grounds than they were. This made it more likely that the nurses developed the intention to leave the vulnerable position of the clinical nurse in the respective organizations which was insisted by the difficulty of nurses to meet their personal goals through exercising autonomy in their careers. Sasso et al. (2019) article also suppose that their shortage attributes to errors and poor quality care in their fields since they are assigned heavy workloads.

Method of Study

The two methodologies used in this study are the conduction of interviews and satisfying sampling. They are the most appropriate methodologies for the qualitative research analysis to evaluate the shortage of nurses.

Benefits and Limitations of Each Methodology

The benefit of conducting interviews is that the researcher is able to acquire firsthand information and attain real-time results. However, the major drawback of the methodology is that it is susceptible to biased information. It is also time-consuming as the formulation of the questions and conduction of the interviews consume much time.

On the other hand, satisfying sampling is advantageous as it presents the researcher with an opportunity to perform an analysis of the results and make patterns and decisive conclusions on the problem. However, its major disadvantage is that it is time-consuming. The collection and analysis of the problem often consume much time.

Key Result of the Study

When accounting for hospital-level factors, nursing is often linked to high patient mortality rates. After the severity of disease and hospital characteristics were taken into consideration, the probability of death in the long direct-nursing hours or care groups was shown to be significantly lower than in the short direct-nursing hours or care groups. However, according to the Liang et al. (2012) article, the average direct hours of nursing care were just 4.95 percent on daily basis or about 21% of a full patient care day. As a result, there is substantial information based on the positive relationship between direct nursing care hours and patient mortality. Nursing care has an impact on hospitalized patient outcomes, but other disciplines, the severity and complexity of the patient’s diseases, and the surroundings all play a role in creating a favorable atmosphere for both patients and their caregivers. In the study, the following things were discovered to be the root of the problem: individual views of majesty and false expectations when it comes to giving care to patients. The findings of this study show a direct link between nurse staffing and patient mortality, which it supposes is attributed to negligence by the nurses and or incompetency of the nurses.


In conclusion, the rate of nurses leaving their profession may greatly increase if policymakers continue to implement organizational control with no interventions. In addition, the nurse shortage issue needs to be dealt with carefully and funds also need to be provided to hospitals to increase the staffing of nurses. This paper has studied two articles addressing the issue of the nursing shortage and has concluded that the issue exists and has affected quality health care for the patients.


Akinyode, B. F., & Khan, T. H. (2018). Step by step approach for qualitative data analysis. International Journal of Built Environment and Sustainability. Web.

Douglas, E. P. (2017). Beyond the interpretive: Finding meaning in qualitative data. In Proceedings of the 124th Annual Conference and Exposition: American Society for Engineering Education, Columbus, OH, USA, (Vol. 28). Web.

Haddad, L. M., Annamaraju, P., & Toney-Butler, T. J. (2020). Nursing shortage. StatPearls. Web.

Liang, Y. W., Chen, W. Y., Lee, J. L., & Huang, L. C. (2012). Nurse staffing, direct nursing care hours and patient mortality in Taiwan: The longitudinal analysis of hospital nurse staffing and patient outcome study. BMC Health Services Research, 12(1), 44. Web.

Qin, Z., Zhong, X., Ma, J., & Lin, H. (2016). Stressors affecting nurses in China. Contemporary Nurse, 52(4), 447-453. Web.

Sasso, L., Bagnasco, A., Catania, G., Zanini, M., Aleo, G., Watson, R., & RN4CAST@ IT Working Group. (2019). Push and pull factors of nurses’ intention to leave. Journal of Nursing Management, 27(5), 946-954. Web.

Zhu, J., Rodgers, S., & Melia, K. M. (2015). A qualitative exploration of nurses leaving nursing practice in China. Nursing Open, 2(1), 3-13. Web.

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