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Journal Club
Open Access Article

Healthcare Team Members' Perception of Staffing Adequacy in a Comprehensive Cancer Center

Beverly A. Nelson
ONF 2011, 38(1), 52-59 DOI: 10.1188/11.ONF.52-59

Purpose/Objectives: To describe the perceptions of staffing adequacy of healthcare team members working together on units in a comprehensive cancer center.

Research Approach: A descriptive, phenomenologic design was used. Semistructured interviews were conducted with participants.

Setting: An urban, Magnet®-designated comprehensive cancer center in the southwestern United States.

Participants: A purposive sample of 10 RNs, 5 nursing assistants, and 5 associate directors.

Methodologic Approach: Data analysis was guided by Streubert's procedural interpretation of the phenomenologic method.

Findings: Themes emerged, including alterations to care; challenges to an already challenging shift; the right mix; effects on patients, safety, and quality; mitigating factors; and the aftermath.

Conclusions: Perceived inadequate staffing affects healthcare staff both personally and professionally, triggering responses that influence approaches to patient care, unit operations, and relationships.

Interpretation: The unique and sometimes varied perspectives and experiences of frontline staff are critical to understanding factors that influence and affect willingness to work and remain in hospital settings, and may serve as a basis for shaping interventions and strategies to ensure adequate numbers of caregivers at the bedside.


Adams, A., & Bond, S. (2000). Hospital nurses' job satisfaction, individual and organizational characteristics. <i>Journal of Advanced Nursing, 32</i>, 536-543. doi: 10.1046/j.1365-2648.2000.01513.x

Aiken, L. H., Clarke, S. P., & Sloane, D. M. (2002). Hospital staffing, organization and quality of care: Cross national findings. <i>International Journal for Quality in Healthcare, 14</i>(1), 5-13. doi: 10.1093/intqhc/14.1.5

Aiken, L. H., Clarke, S. P., Sloane, D. M., Lake, E. T., & Cheney, T. (2008). Effects of hospital care environment on patient mortality and nurse outcomes. <i>Journal of Nursing Administration, 38</i>(5), 223-229. doi: 10.1097/01.NNA.0000312773.42352.d7

Aiken, L. H., Clarke, S. P., Sloane, D. M., Sochalski, J., & Silber, J. H. (2002). Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction. <i>JAMA, 288</i>, 1987-1993.

Aiken, L. H., Hue, X., Clarke, S. P., & Sloane, D. M. (2007). Supplemental nurse staffing in hospitals and quality of care. <i>Journal of Nursing Administration</i>, 37(7-8), 335-342. doi: 10.1097/01.NNA.0000 285119.53066.ae

Blegen, M. A., & Vaughn, T. E. (1998). A multisite study of nurse staffing and patient occurrences. <i>Nursing Economic, 16</i>(4), 196-203.

Bowers, B. J., Esmond, S., & Jacobson, N. (2000). The relationship between staffing and quality in long-term care facilities: Exploring the views of nurse aides. <i>Journal of Nursing Care Quality, 14</i>(4), 55-64.

Buerhaus, P., Donelan, K., DesRoches, C., Lamkin, L., & Mallory, G. (2001). State of the oncology nursing workforce: Problems and implications for strengthening the future. <i>Nursing Economic, 19</i>(5), 198-208.

Burke, R. J. (2003). Hospital restructuring, workload, and nursing staff satisfaction and work experiences. <i>Health Care Manager, 22</i>, 99-107.

Cho, S., Ketefian, S., Barkauskas, V., & Smith, D. G. (2003). The effects of nurse staffing on adverse events, morbidity, mortality, and medical costs. <i>Nursing Research, 52</i>, 71-79. doi: 10.1097/00006199-200303000-00003

Cline, D., Reilly, C., & Moore, J. F. (2003). What's behind RN turnover? <i>Nursing Management, 34</i>(10), 50-53. doi: 10.1097/00006247-2003100 00-00016

Dang, D., Johantgen, M. E., Pronovost, P. J., Jenckes, M. W., & Bass, E. B. (2002). Postoperative complications: Does intensive care unit staff nursing make a difference? <i>Heart and Lung: The Journal of Acute and Critical Care, 31</i>, 219-228. doi: 10.1067/mhl.2002.122838

Eberhardt, B. J., Pooyan, A., & Moser, S. B. (1995). Moderators of the relationship between job satisfaction and nurses' intention to quit. <i>International Journal of Organizational Analysis, 3</i>, 394-406. doi: 10.1108/eb028838

Friese, C. R. (2005). Nurse practice environments and outcomes: Implications for oncology nursing. <i>Oncology Nursing Forum, 32</i>, 765-772. doi: 10.1188/05.ONF.765-772

Friese, C. R., Lake, E. T., Aiken, L. H., Silber, J. H., & Sochalski, J. (2007). Hospital nurse practice environments and outcomes for surgical oncology patients. <i>BMC Health Services Research, 43</i>, 1145-1163.

Goodin, H. J. (2003). The nursing shortage in the United States of America: An integrative review of the literature. <i>Journal of Advanced Nursing, 43</i>, 335-350. doi: 10.1046/j.1365-2648.2003.02722_1.x

Hall, D. S. (2004). Work-related stress of registered nurses in a hospital setting. <i>Journal for Nurses in Staff Development, 20</i>, 6-14. doi: 10.1097/00124645-200401000-00002

Hayhurst, A., Saylor, C., & Stuenkel, D. (2005). Work environmental factors and retention of nurses. <i>Journal of Nursing Care Quality, 20</i>, 283-288.

Hegney, D., Plank, A., & Parker, V. (2003). Nursing workloads: The results of a study of Queensland nurses. <i>Journal of Nursing Management, 11</i>, 307-314. doi: 10.1046/j.1365-2834.2003.00376.x

Heinz, D. (2004). Nurse staffing and patient outcomes: A review of the current literature. <i>Dimensions of Critical Care Nursing, 23</i>, 44-50. doi: 10.1097/00003465-200401000-00011

Hogston, R. (1995). Quality nursing care: A qualitative inquiry. <i>Journal of Advanced Nursing, 21</i>, 116-124. doi: 10.1046/j.1365-2648.1995 .21010116.x

Husserl, E. (1962). <i>Ideas: General introduction to pure phenomenology.</i> New York, NY: MacMillan.

Idvall, E., & Rooke, L. (1998). Important aspects of nursing care in surgical wards as expressed by nurses. <i>Journal of Clinical Nursing, 7</i>, 512-524. doi: 10.1046/j.1365-2702.1998.00180.x

Kane, R. L., Shamliyan, T. A., Mueller, C., Duval, S., & Wilt, T. J. (2007). The association of registered nurse staffing levels and patient outcomes. <i>Medical Care, 45</i>, 1195-1204. doi: 10.1097/MLR.0b013e318 1468ca3

Koch, T. (1995). Interpretive approaches in nursing research: The influence of Husserl and Heidegger. <i>Journal of Advanced Nursing, 21</i>, 827-836. doi: 10.1046/j.1365-2648.1995.21050827.x

Kovner, C., & Gergen, P. J. (1998). Nurse staffing levels and adverse events following surgery in U. S. hospitals. <i>Journal of Nursing Scholarship, 30</i>, 315-321. doi: 10.1111/j.1547-5069.1998.tb01326.x

Lamkin, L., Rosiak, J., Buerhaus, P., Mallory, G., & Williams, M. (2001). Oncology Nursing Society workforce survey part I: Perceptions of nurse staffing in outpatient and inpatient oncology settings. <i>Oncology Nursing Forum, 28</i>, 1545-1552.

Lamkin, L., Rosiak, J., Buerhaus, P., Mallory, G., & Williams, M. (2002). Oncology Nursing Society workforce survey part II: Perceptions of the nursing workforce environment and adequacy of nurse staffing in outpatient and inpatient oncology settings. <i>Oncology Nursing Forum, 29</i>, 93-100. doi: 10.1188/ONF.93-100

Larrabee, J. H., Janney, M. A., Ostrow, C. L., Withrow, M. L., Hobbs, G. R., & Burant, C. (2003). Predicting registered nurse job satisfaction and intent to leave. <i>Journal of Nursing Administration, 33</i>(5), 271-283. doi: 10.1097/00005110-200305000-00003

Lopez, K. A., & Willis, D. G. (2004). Descriptive versus interpretive phenomenology: Their contributions to nursing knowledge. <i>Qualitative Health Research, 14</i>, 726-735. doi: 10.1177/104973230426 3638

Mark, B. A., Salyer, J., & Harless, D. (2002). What explains nurses' perceptions of staffing adequacy? <i>Journal of Nursing Administration, 32</i>(5), 234-242. doi: 10.1097/00005110-200205000-00003

McNeese-Smith, D. K. (1999). A content analysis of staff nurse descriptions of job satisfaction and dissatisfaction. <i>Journal of Advanced Nursing, 29</i>, 1332-1341. doi: 10.1046/j.1365-2648.1999.010 18.x

Muncer, S., Taylor, S., Green, D. W., & McManus, I. C. (2001). Nurses' perceptions of the perceived causes of work-related stress: A network drawing approach. <i>Work and Stress, 15</i>, 40-52. doi: 10.1080/02 678370110063402

Needleman, J., Buerhaus, P., Mattke, S., Stewart, M., & Zelevinsky, K. (2002). Nurse-staffing levels and the quality of care in hospitals. <i>New England Journal of Medicine</i>, 346, 1715-1722. doi: 10.1056/NEJMsa012247

Parsons, M. L., & Stonestreet, J. (2003). Factors that contribute to nurse manager retention. <i>Nursing Econonmic, 21</i>(3), 120-126. Retrieved from http://findarticles.com/p/articles/mi_m0FSW/is_3_21/ai_n18615828/ <a target="_blank" href='http://findarticles.com/p/articles/mi_m0FSW/is_3_21/ai_n18615828/'>http:...

Polit, D. F., & Hungler, B. P. (1999). <i>Nursing research: Principles and methods</i> (6th ed.). Philadelphia, PA: Lippincott Williams and Wilkins.

Pronovost, P., Dang, D., Dorman, T., Lipsett, P., Garrett, E., & Jenckes, M. (2001). Intensive care unit nurse staffing and the risk for complications after abdominal aortic surgery. <i>Effective Clinical Practice, 4</i>, 223-225.

Shader, K., Broome, M. E., Broome, C. D., West, M. E., & Nash, M. (2001). Factors influencing satisfaction and anticipated turnover for nurses in an academic center. <i>Journal of Nursing Administration, 31</i>(4), 210-216. doi: 10.1097/00005110-200104000-00010

Shaver, K. H., & Lacey, L. M. (2003). Job and career satisfaction among staff nurses: Effects of job setting and environment. <i>Journal of Nursing Administration, 33</i>(3), 166-172. doi: 10.1097/00005110-2003 03000-00008

Sovie, M. D., & Jawad, A. F. (2001). Hospital restructuring and its impact on outcomes: Nursing staff regulations are premature. <i>Journal of Nursing Administration, 31</i>(12), 588-600. doi: 10.1097/00005110-20 0112000-00010

Speziale, H. J., & Carpenter, D. R. (2003). <i>Qualitative research in nursing: Advancing the humanistic imperative</i> (3rd ed.). Philadelphia, PA: Lippincott Williams and Wilkins.

Strachota, E., Normandin, P., O'Brien, N., Clary, M., & Krukow, B. (2003). Reasons registered nurses leave or change employment status. <i>Journal of Nursing Administration, 33</i>(2), 111-117.

Taylor, S., White, B., & Muncer, S. (1999). Nurses' cognitive structural models of work-based stress. <i>Journal of Advanced Nursing, 29</i>, 974-983. doi: 10.1046/j.1365-2648.1999.00980.x

Ulrich, B. T., Buerhaus, P. I., Donelan, K., Norman, L., & Dittus, R. (2005). How RNs view the work environment: Results of a national survey of registered nurses. <i>Journal of Nursing Administration, 35</i>(9), 389-396.