Understaffing in the Psychiatric Unit


Patient safety is very vital and crucial in the Psychiatric unit in any hospital. Due to its intense commitment and urgency, the psychiatric unit often requires adequate professional staff. In my work setting, the most pressing patient safety problem is understaffing. This comes with a lot of challenges within the psychiatric unit. For instance, 

Workload and Lack of Time

The high workload in nursing is unquestionably affects the timing allocated by nurses to perform the various task. In extreme condition of heavy workload, the health care attendants might not have enough time to perform his or her tasks in ensuring patient safety. The workload might have impacted the nurses’ decision to carry out various actions. The high amount of work may also lessen the time that is spent by nurses teaming up as well as speaking with physicians, accordingly influencing the cooperation between the nurse and the physician. It also prompts poor nurse-patient correspondence.

Nursing Workload and Worsened Motivation

Various research studies have indicated the relationship between working conditions of nurses, for instance, the high workload and occupation discontent. Employment discontent among cases can lead to absenteeism, poor work execution, low morale as well as turnover. This undermines patient care value as well as hierarchical efficiency. Many scholars have discovered positive relations between work contentment and employment performance as well as patient satisfaction and nature of care.

Effects of High Workload on Stress and Burnout

The great workload is a critical occupation stressor factor for nurses in several of care setup. A substantial workload may lead to distress, for instance, emotional exhaustion, cynicism and outrage, and emotional exhaustion. Nurses encountering stress as well as burnout will most likely be unable to carry out their work proficiently and viable due to the decreased resources both their physical and cognitive. The medical attendant at the psychiatric unit will lose morale and the motivation leading to stress cases. This situation is perilous, especially when handling patients in this unit. The suboptimal performance will influence patient safety and care as well.

Medication Errors

The high workload may also lead to medical errors. Errors are often classified as slips and lapses and mistakes or information errors. High workload as time pressure might decrease the consideration committed by a nurse to safety-basic tasks, therefore making conditions for errors which are not safe for patient care. Making errors related to medication in the psychiatric unit can be very costly. This can often lead to death cases of the patient. Therefore, to uphold patient safety, it is very vital or imperative to have the adequate and professional personnel. The medication errors can, therefore, be significantly reduced when understaffing problem is rectified.


In a psychiatric setting, seclusion is a reality. It causes worry to the staff as well as patients. In the recent past, it has been seen as a special concern in patients’ discernments of the seclusion encounter, and their attitudes are fundamentally negative. It is regularly associated with disempowering, negative, dependable impact of being secluded. The association between staff and patient is a unique source of discontent, and patients felt they needed data earlier and amid the seclusion. The need for questioning after seclusion, comprising of the preventive tactics. Actualizing such ideas is probable in any setting as well as would enhance patients’ emotional state of strengthening and trust. Late research has been engrossed on interventions, for instance, staff planning which might prompt a decrease in seclusion custom or time span in seclusion. 


A current review observational examination likewise found that throughput, or patient flow, affects staffing adequacy; there was an expansion in patients mortality when attendants dealt with many admission, transfers, and discharges in the midst of their day of work (Needleman et al., 2011). A similar research additionally exhibited that medical attendants’ ability to securely screen patients diminished as a result of high workload and low staffing levels; the resultant diminishment in observation compared with an expansion in death rates (Needleman et al., 2011). Additionally, high attendant workloads increment the hazard and number of given a record of the work wounds (back wounds, needle sticks, and stress-related handicap), possibly bringing about high measures of medical caretaker burnout and expanded staff turnover (Clarke and Donaldson, 2008). Balancing nursing ability, experience, and preparing with various patient needs also confounds characterizing acuity balanced staffing.

Systemic, Organizational Effects of Nursing Workload

The last component of the connection between nursing workload and patient safety depends on the systemic, progressive impact of nursing workload: an overwhelming workload faced by a  nurse trickles down to affects other nurses, as well as different influence nurses and therapeutic services workers in the nurse’s work system. Short-staffing might diminish time nurses need to help different nurses. The absence of time might also lead to deficient preparing as well new nurses supervision.

Managing Understaffing In Psychiatric Unit

Involving workers in decision making about work design and work flow. To certify the provision of safe as well as excellent care, direct care nurses and nurse leaders must work together on the improvement of a staffing plan. Studies show that to diminish the recurrence of negative events and moreover patient mortality; these arrangements must be both extensive and versatile in setting staffing levels at the bedside (Mark and Harless, 2011; Needleman et al., 2011). When nurse leaders are developing their staffing model, they should deliberately take a gander at various variables to connect at the correct staffing levels for their unit.These aspects incorporate variables in patients such as homogeneity of the populace, severity of illness, comorbidity, throughput, staff variables, for instance, instructive level, involvement, skill blend as well as hospital factors such as innovation, unit design, and unit age. Additionally, the attendant architect of the arrangement must fuse shift to shift elements, for example, a few admissions, transfers and discharges. Adjusting these factors in a staffing arrangement with known quality measures makes building up any standard staffing extent troublesome. A medical attendant staffing arrangement is utilized as the foundation for choosing staffing needs. This is often made yearly levels, y, fitting with the affiliation’s spending arranging process. Staff to patient proportions have for quite a while been utilized to set up staffing plans at the authoritative level. “Attendant staffing productivity” is often measured in nursing hours per patient day. Hours per persistent day (HPPD) can’t speedily be utilized to accurately choose nurture to-tolerant proportions as this measure, by and large, reflects the general staffing over a 24-hour time span. Utilizing HPPD formulae is defective, on account of components, for example, staff mix, staff capacity, mix over time versus regular hours, and changes in the patient registration are rejected in the computations of this number. 

Besides, not all nursing hours are usually spent offering direct care. Medical attendants may be possessed with exercises, for example, direction, organization, and quality assurance. Measuring HPPD will most likely lead to overestimation of the precise estimation of bedside care. What is thought about attendant staffing arranging originates from investigations of therapeutic, surgical, medical caretakers as rules of hospitals? These research demonstrate that variables are affecting attendant staffing levels to fuse patient acuity, diagnosis, and age. Additionally, the ability blend of various nurses and nurse’s helpers, the amount of attendants’ guideline, and experience level of medical attendants are enticing. Additional effort that influences staffing viability in psychiatric settings fuses the idea of support by the organization for the demonstration of nursing and certain sorts of hospital attributes, for example, educating, a development utilized, and a few beds.Research on the remedial surgical, medical caretaker to patients staffing proportions shows that better attendant staffing yields better patient results, including fewer deaths. Scientists have perceived, regardless, that these are much of the time troublesome data to interpret on the level of a staff extent framework. There is no exploration on nursing staffing levels for psychiatric units. Specialists who have examined the connection between staffing numbers and viability/patient results on inpatient psychiatric units have contemplated that the various factors affect any relationship of the staffing-persistent outcome.

Deadlines from 1 hour
Get A+ help
with any paper


In conclusion, patient safety is an essential aspect that should be put into consideration in unit or department in the hospital. In managing understaffing problems in the psychiatric unit, the needs for involvement workers in decision making process to design workflow is a pretty good idea. This strategy will ensure all factors regarding staffing are well taken care of with an aim resolving the stalemate. 

Did you like this sample?
  1. Coleman, J. C., & Paul, G. L. (2001). Relationship between staffing ratios and effectiveness of inpatient psychiatric units. Psychiatric Services, 52(10), 1374-1379.
  2. Mark, B. A., & Harless, D. W. (2011). Adjusting for patient acuity in the measurement of nurse staffing: Two approaches. Nursing Research, 60(2), 107-114.
  3. Needleman, J., Buerhaus, P., Pankratz, V. S., Leibson, C. L., Stevens, S. R., & Harris, M. (2011). Nurse staffing and inpatient hospital mortality. New England Journal of Medicine, 364(11), 1037-1045.
  4. Clarke, S. P., & Donaldson, N. E. (2008). Nurse staffing and patient care quality and safety.
Related topics
More samples
Related Essays