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The Continuing Saga of Nurse Staffing

Historical and Emerging Challenges

Blouin, Ann Scott, PhD, RN, FACHE; Podjasek, Kara, BSN, RN, RNC-NIC, CBC

JONA: The Journal of Nursing Administration: April 2019 - Volume 49 - Issue 4 - p 221–227
doi: 10.1097/NNA.0000000000000741

Registered nurses are the backbone of America's health systems, providing care and support to patients across the lifespan. Appropriate nurse staffing is critical to ensure safe and effective care for patients. Nurse staffing is a complex topic; nurse administrators find themselves facing escalating challenges to meet staffing needs. These challenges can be attributed to a variety of factors, both historical and new. This article examines the current factors contributing to nursing shortages, nurse staffing challenges, and the implications of inappropriate staffing on both financial and patient outcomes.

Author Affiliations: President (Dr Blouin), PSQ Advisory, Ltd, LaGrange, Illinois; Former Executive Vice President (Dr Blouin), Customer Relations, The Joint Commission; Nurse Clinician (Ms Podjasek), Prentice Women's Hospital and Maternity Center, Northwestern Memorial Hospital, Chicago, Illinois; and Former Nurse Intern (Ms Podjasek), The Joint Commission, Oakbrook Terrace, Illinois.

The authors declare no conflicts of interest.

Correspondence: Dr Blouin, PSQ Advisory, Ltd, 110 N Madison Ave, LaGrange, IL 60525 (

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