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Student: Kathryn Whitehead
Supervisor: Dr Suzanne Gower
Sponsor: Canterbury Medical Research Foundation

The quality of care that patients receive in hospital has been consistently related in the literature to nurse staffing and the skillmix of nurses. Patient outcomes, such as length of stay in hospital and even mortality, are connected to the ability of hospitals to retain nursing staff. Staffing and skillmix affect the job satisfaction of nurses and their intentions to leave nursing. Comments made in an open field by nurses who responded to the Survey of New Zealand Hospital Nurses were analysed using qualitative methods.

These methods aim to express the perspectives of nurses, as they describe them. Three major themes emerged to do with staffing and skillmix. First, nurses feeling frightened and frustrated by being stuck between a desire to give care, and cost restrictions imposed by management. Second, nurses identified the compromising of patient care due to short-staffing. Finally, nurses perceived that a vicious cycle existed, whereby nurses left the profession because of their dissatisfaction, resulting in more problems for those who stayed, as well as poor quality of care for patients. Results are discussed in the context of current nursing theory and are applied to the concept of Magnet Hospitals, hospitals that are able to retain nursing staff and have good patient outcomes. This analysis gives a nursing perspective to the issues of staff shortages, and to nurse and patient outcomes associated with these. It is compared with quantitative analysis of results from the Survey of New Zealand Hospital Nurses 2001, adding validity and life to these findings.

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