By Marcia Faller, RN, MSN, executive vice president and chief clinical officer, AMN Healthcare

In their quest to recruit nurses, healthcare facilities highlight features such as shared governance, reduced overtime and increased efficiencies. Yet there is one area that perhaps should be more heavily promoted in the recruitment efforts: safe staffing levels.

According to a recent poll conducted by the American Nurses Association (ANA) of nearly 15,000 nurses, 71 percent of nurses feel that the staffing levels at their facility are inadequate. Perhaps of singular interest to hospitals is that 52 percent of respondents said they were considering leaving their current position with 42 percent listing insufficient staffing as the primary reason for their job search. Approximately half of the nurses polled felt that their facility was so inadequately staffed that they would not feel comfortable having a friend or family member treated at their facility.

Results of the poll—which was conducted from March 2008 through June 2009—are published on the ANA sponsored Web site www.SafeStaffingSavesLives.org.

A similar survey recently conducted by The International Council of Nurses and Pfizer Inc. External Medical Affairs found that 92 percent of respondents felt they didn't have enough time to spend with individual patients. In addition, 96 percent of the nurses polled said that if they had more time to spend with patients, it would have a significant impact on patient health.

These results, while disturbing, offer insight into what nurses are experiencing from the frontlines of care. Utilizing this knowledge to create a better work environment can not only improve the work environment for nurses, it could also improve patient outcomes and reimbursement rates.

Currently, 12 U.S. states and the District of Columbia have passed some form of legislation that regulates nurse-to-patient ratios. Legislation varies from requiring a documented staffing plan to public posting of staffing ratios and to state-regulated minimum unit based staffing ratios (only California has actually passed this type of legislation to date). However, based on the results of the ANA's recent survey, these efforts do not seem to be enough. Clearly something more is needed to offer nurses the support they need to effectively care for patients and to improve retention of U.S. nursing professionals.

So what can be done? For starters, sell stronger staffing levels to your key executive decision makers by clearly quantifing the financial outcomes that nurses contribute to. Some of the critical financial outcomes to examine include:
1. Cost of turnover (keep your nurses satisfied and this cost drops)
2. Reduced lengths of stay
3. More satisfied patients
4. Reduced malpractice liability

Safe staffing will produce results both in terms of quality patient outcomes and nurse satisfaction. With improved job satisfaction comes lower turnover and longer retention; and perhaps even keeps a nurse committed to the nursing profession longer. In the end, we need to focus on the things that nurses care about. Being able to deliver quality patient care in an environment that is safe and productive matters to nurses. The bottom line: give nurses the time they need to care for patients by ensuring staffing levels are sufficient at all times.