A prominent nursing center in the mid-size East South Central city in the South has come under the fire due to a major challenge of shortage in the nursing staff. An increase in the health care expenses led to a temporary reduction in the staff’s earning that led them to decrease in the number of nurses. Decreasing the nursing staff is the only logical way to combat the increased health costs, however, it partly kills the working enthusiasm of the staff. But, the decreased staff is birthing more problems, as there is an array of patients that come to this center for care and cure and the decreased number of nurses cannot put up with all of them.

1. Running head: IMPACT REPORT TO SENIOR LEADERSHIP 1
Impact Report to Senior Leadership
Student Name
Institutional Affiliation

2. IMPACT REPORT TO SENIOR LEADERSHIP 2
The Nursing Challenge
A prominent nursing center in the mid-size East South Central city in the South has
come under the fire due to a major challenge of shortage in the nursing staff. An increase in
the health care expenses led to a temporary reduction in the staff’s earning that led them to
decrease in the number of nurses. Decreasing the nursing staff is the only logical way to
combat the increased health costs, however, it partly kills the working enthusiasm of the staff.
But, the decreased staff is birthing more problems, as there is an array of patients that come
to this center for care and cure and the decreased number of nurses cannot put up with all of
them.
From the prospect of the nurses, the decreased staff is only burdening the available
nurses with more patients. Dealing with more patients, burdens an individual nurse with more
work load that leads to stress. Also, working more shifts can lead to fatigue and sleep
deprivation. Fatigue and sleepiness often compromises with patient safety. According to Jha,
Duncan and Bates (2010) Fatigue, Sleepiness, and Medical Errors nurses need to give
thorough attention to patients, make sound judgments, and sometimes quick reactions and
decisions need to be made in emergency cases. (July 2001) All this is affected when nurses
do not get proper sleep and work more hours.
The Organization
The center facing the staff shortage nursing challenge is a teaching hospital. The
hospital envisions enhancing the lives of people by serving them with patient-centered care.
Innovation, tradition, experiences, and optimism are some of its key areas of growth, based
on which the hospital stands proud. The mission statement is dedicated to excellence and
innovation in teaching, patient care, research and delivery of services. The hospital holds dear
the values of integrity, respect, accountability, compassion, and primary concentration on
patients. It aims to deliver excellence in teaching, patient care, research and innovation.

3. IMPACT REPORT TO SENIOR LEADERSHIP 3
The shortage of staff leaves a negative impact on each of the key features along with
the mission, vision, and values of the teaching staff.
Firstly, the vision is disrupted as quality care in patient service is hindered with the
lack of staff. At times, some patients may be neglected as all the available nurses could be
engaged with other patients. With a higher nurse-to-patient ratio, more patients are prone to
neglect leading to infections, injuries and inadequate knowledge regarding how to look after
and take care of their injury or illness. ("What happens to patients when nurses are short-
staffed?", 2017) Lives are not enhanced as patients return often sicker than before.
Secondly, the key features that led to the growth of the organization are also not
honored. With over burden, there is little for a nurse to learn and gain experience from.
Nurses in training would also only get confused as they receive poor training and less
instructions from their senior nurses who would also be occupied with increased work flow.
Furthermore, according to Carayon and Gurses (2008) Patient Safety and Quality: An
Evidence-Based Handbook for Nurses, an increased workload will result in increased job
dissatisfaction and burnout contributing to high nurse turnover. Excellence would also not be
delivered, as with the decreased staff the nurses would also be expected to do unprofessional
works such as picking up food trays for instance. Innovation cannot be achieved with
inexperienced and occupied staff. Thirdly, and ultimately it would be difficult to maintain the
tradition and mission of quality care for patients and imparting skill in teaching and training
nurses as well as research. Lastly, the challenge arising due to nursing staff shortage will also
leave an impact on the hospital’s values as well. Firstly, integrity centers around doing the
right thing but a shortage of staff will not do so. This is because it does lead to more burden
to the working nurses. Respect is another value that is interconnected and the respect of all
the nurses, patients, and the organization is at stake here. Similarly, the value of
accountability of the action also lies on the hospital. With less nurses, patient care gets poor

4. IMPACT REPORT TO SENIOR LEADERSHIP 4
so any accidents or unawareness regarding any individual patients can occur. Accountability
as a value is, therefore, questioned. Tired nurses will, as an effect of the workload, not be
able to practice with compassion, another value of the hospital that will not be honored.
Since the organization is a teaching hospital, it sets an example for the younger,
learning generation who will pick each and everything from the situation and the impact of
the nurse shortage will also have an impact on the students. Since the hospital embeds
teaching as in its mission statement, calling themselves educators. Therefore, this nursing
challenge creates a gap in accomplishing the mission of the hospital, fulfilling its vision, and
outlining its values.
SWOT Analysis
A Strength, Weakness, Operation, and Threat (SWOT) analysis on the understaffed
nurses reveals a better picture of the whole situation. Below is a table that explains the
analysis.
Strengths
• Higher quality care
• Better treatments leading to
improved patient health outcomes
and decreased mortality
• Thorough patient assessments
• Support from the American Nurses
Association
• Recent research and innovation
• Latest medical technology with
skilled and fully trained staff.
Weaknesses
• Understaffed nurses
• Recent budget cuts to promote further
research and meet increased health
care costs.
• Patient care at risk
• Training levels go down

5. IMPACT REPORT TO SENIOR LEADERSHIP 5
Opportunities
• Encourage more research about
effective nursing methods
• Grant scholarship programs for
student nurses
• More intensive to experienced nurses
• Request for a budget increase.
Threats
• Cost of legistion
• Fixing shortage of nurses and aging
workforce
• Opposition from cooperate bodies
• Conflicting research related to nurse
to patient ratio
• Hospital reputation at risk
The Position
A nurse leader is the need of the hour. The position would call for an individual who
can deal with the current challenge. Evidence shows that nurse leaders have a positive impact
on the work environment, improved patient outcomes, and organizational performance.
(Sherman, Edwards, Giovengo, & Hilton, 2009). An experienced, well- trained leader is one
whom its staff looks up to and follows the targets set by him. He chalks out a plan to combat
the challenge and the steps towards the achievement of that goal are encouraged, regulated,
and inspected by him. Nurses with different education and competences yield varying skills
to patient care. A lead nurse ensures that all the nurses must be able to practice to the
optimum of their individual capabilities. To that end, the nurse leader promotes a professional
environment, recognizes and rewards these differences by assigning nurses’ roles.
("Strategies to Reverse The New Nursing Shortage", 2017) The nurse leader can plan
strategies to eliminate the threat emanating from the understaff nurses challenge such as
recruiting students and appointing healthy nurses over aging nurses who cannot meet the

6. IMPACT REPORT TO SENIOR LEADERSHIP 6
demand of the agile profession of nursing. Patients outcome is great as studies have shown
transformational leadership was associated with reduced medicinal errors. ("How Nursing
Leadership Styles Can Impact Patient Outcomes and Organizational Performance | Bradley
University Online", 2017). Effective nurse leaders assign appropriate staffing and resources
to achieve care and optimal patient outcomes. Moreover, at the organizational level they
sketch strategic direction by participation in the decision-making tier and with their ability to
effect nursing practices and values. Good qualities of a nurse leader include dedication, clear
vision, strategic focus, empathy, and commitment to develop the staff. Overall, the position
of the nurse leader will align strategies and achieve goals to face the challenge and maintain
the strengths of the organization.

7. IMPACT REPORT TO SENIOR LEADERSHIP 7
References
Carayon, P., & Gurses, A. (2017). Nursing Workload and Patient Safety—A Human Factors
Engineering Perspective. Ncbi.nlm.nih.gov. Retrieved 12 April 2017, from
https://www.ncbi.nlm.nih.gov/books/NBK2657/#_ch30_rl1_
How Nursing Leadership Styles Can Impact Patient Outcomes and Organizational
Performance | Bradley University Online. (2017). Onlinedegrees.bradley.edu.
Retrieved 12 April 2017, from
http://onlinedegrees.bradley.edu/resources/infographics/how-nursing-leadership-
styles-can-impact-patient-outcomes-and-organizational-performance/
Jha, A., Duncan, B., & Bates, W. (2017). Chapter 46. Fatigue, Sleepiness, and Medical
Errors | AHRQ Archive. Archive.ahrq.gov. Retrieved 12 April 2017, from
https://archive.ahrq.gov/research/findings/evidence-based-
reports/services/quality/er43/ptsafety/chapter46a.html
Sherman, R., Edwards, B., Giovengo, K., & Hilton, N. (2009). The Role of the Clinical Nurse
Leader in Promoting a Healthy Work Environment at the Unit Level. Critical Care
Nursing Quarterly, 32(4), 264-271. http://dx.doi.org/10.1097/cnq.0b013e3181bad5a8
Strategies to Reverse The New Nursing Shortage. (2017). Nursingworld.org. Retrieved 12
April 2017, from
http://nursingworld.org/MainMenuCategories/ThePracticeofProfessionalNursing/wor
kforce/NursingShortage/LegislationStrategies/NursingShortage.html
What happens to patients when nurses are short-staffed? (2017). Truthaboutnursing.org.
Retrieved 12 April 2017, from http://www.truthaboutnursing.org/faq/short-
staffed.html