Skip Navigation Archive: U.S. Department of Health and Human Services www.hhs.gov
Archive: Agency for Healthcare Research Quality www.ahrq.gov
Archive print banner

This information is for reference purposes only. It was current when produced and may now be outdated. Archive material is no longer maintained, and some links may not work. Persons with disabilities having difficulty accessing this information should contact us at: https://info.ahrq.gov. Let us know the nature of the problem, the Web address of what you want, and your contact information.

Please go to www.ahrq.gov for current information.

The Nursing Crisis: Improving Job Satisfaction and Quality of Care

Slide Presentation by Linda Searle Leach, Ph.D., R.N., C.N.A.A.


On April 23, 2003, Linda Searle Leach, Ph.D., R.N., C.N.A.A., made a presentation in the Web-Assisted Audioconference entitled The Nursing Crisis: Improving Job Satisfaction and Quality of Care.

This is the text version of Dr. Leach's slide presentation. Select to access the PowerPoint® slides (194 KB).


The Nursing Crisis: Improving Job Satisfaction and Quality of Care

Linda Searle Leach, Ph.D., R.N., C.N.A.A.
Assistant Professor
California State University, Fullerton

Slide 1

The Nursing Crisis: Improving Job Satisfaction and Quality of Care

Linda Searle Leach, Ph.D., R.N., C.N.A.A.
Assistant Professor
California State University, Fullerton

Slide contains a picture of Linda Searle Leach.

Slide 2

Current Conditions

Slide contains a diagram of a repetitive cycle.

  • Higher Census.
  • Aging Patient Population.
  • Shorter Lengths of Stay.
  • Increased Patient Load.
  • Lack of Collaboration.
  • Increase Overtime.
  • Stressful Work Environment.

Leads to . . .

  • Turnover.
  • Unstable Workforce.
  • Few Incentives for Experienced RNs.
  • Increased Cost of RN staff.
  • Declining Morale.
  • Quality Concerns.
  • Unionizing/Labor Activity.

Leads to . . .

  • Aggressive Recruitment.
  • Image Campaigns.
  • Registry/Traveler Staffing.
  • Hiring Bonuses.
  • Higher Wage Rates.
  • Salary Compression.

Leads back to . . .

  • Higher Census, etc.

Slide 3

Increase the Supply of RNs

  • Expand educational capacity and opportunity.
    • Increase state and federal support for nursing education.
    • Do not cut budgets that currently fund nursing education.
    • Provide incentives for and access to degree-granting education programs.
  • Fund workforce data collection and planning.
    • Systematically compile workforce data.
    • Forecasting models of supply and demand.
  • Promote partnerships between service and education.
  • More effective recruitment.
    • Recruit future generations.
    • Enhance diversity.

Source: American Organization of Nurse Executives(AONE) Legislative Priorities 2003. Health Care's Human Crisis: The American Nursing Shortage. The Robert Wood Johnson Foundation. 2002.

Slide 4

Increase Retention

  • View RNs as strategic assets.
    • Satisfying work relationships.
    • Improve compensation.
  • Make positive changes in work environments.
    • Support integration and development of new nurses.
    • Labor saving technology.
    • Ergonomic technology.
    • Adopt characteristics of Magnet hospitals.

Source: Health Care's Human Crisis: The American Nursing Shortage. The Robert Wood Johnson Foundation. 2002.

Slide 5

Increase Retention

  • Expand career options.
    • Paid opportunities.
  • Strengthen nursing leadership.
    • Support education for managers and administrators.
    • Nurse executives must be key decision-makers.
    • Nurse involvement in decisions.
  • Increase visibility of RNs contributions to quality of health care.
    • Decrease individual workloads.

Source: Health Care's Human Crisis: The American Nursing Shortage. The Robert Wood Johnson Foundation. 2002.

Slide 6

State Strategies to Address Workforce Issues

  • Increase Supply.
    • Registered Nurses.
    • Master's Prepared Nurses.
    • Faculty.
  • Protect Workforce, Ensure Safety.
  • Obtain Data for Workforce Planning.

Slide 7

California's Nurse Staffing Legislation

  • Assembly Bill 394 (2002).
    • Directs the California Department of Health Services (CDHS) to establish "minimum, specific, and numerical licensed nurse-to-patient ratios by licensed nurse classification and by hospital unit."
    • Little data to drive decision-making process, even less agreement.
    • Increased costs.
    • Expected implementation date: July 2003.
    • Enforcement challenges.

Slide 8

CDHS Nurse Staffing Ratios

Slide contains a table of Nurse to Patient Ratios by Hospital Unit. Nurse means licensed nurse, including RN, LVN, and LPT. For example, General Medical-Surgical unit needs 1:6 nurse to patient ratios; Labor & Delivery needs 1:2; Operating Room needs 1:1, by current law/registration.

Current as of July 2003


Internet Citation

The Nursing Crisis: Improving Job Satisfaction and Quality of Care. Text Version of a Slide Presentation at a Web-assisted Audioconference. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/ulp/workforctel/sess1/leachtxt.htm


Return to Audioconference

The information on this page is archived and provided for reference purposes only.

AHRQ Advancing Excellence in Health Care