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Decision Making for Nurse Staffing: Canadian Perspectives

Faculty of Nursing & new investigator, Canadian Institutes of Health Research, University of Toronto, Ontario

Leah Pink, MN, RN

Michelle Lalonde, MN, RN

Faculty of Nursing, University of Toronto, Ontario

Gail Tomblin Murphy, PhD, RN

School of Nursing and Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia

Linda O'Brien-Pallas, PhD, RN

Nursing Services Research Unit, Canadian Institutes of Health Research/Canadian Health Services Research Foundation (CIHR/CHSRF) Chair, Nursing Health Human Resources, Faculty of Nursing, University of Toronto, Ontario

Heather K. Spence Laschinger, PhD, RN

School of Nursing, Faculty of Health Sciences, University of Western Ontario, London, Ontario

Ann Tourangeau, PhD, RN

Faculty of Nursing and Career Scientist, Ontario Ministry of Health and Long-Term Care, University of Toronto, Ontario

Jeanne Besner, PhD, RN

Nursing and Health, Calgary Health Region, Calgary, Alberta

Debbie White, PhD, RN

University of Calgary, Alberta

Deborah Tregunno, PhD, RN

School of Nursing, York University, Toronto, Ontario

Donna Thomson, MBA, RN

St. Peter's Hospital, Hamilton, Ontario

Jessica Peterson, RN

Lisa Seto, MN, RN

Jennifer Akeroyd, MIR, RN

The effectiveness of methods for determining nurse staffing is unknown. Despite a great deal of interest in Canada, efforts conducted to date indicate that there is a lack of consensus on nurse staffing decision-making processes. This study explored nurse staffing decision-making processes, supports in place for nurses, nursing workload being experienced, and perceptions of nursing care and outcomes in Canada. Substantial information was provided from participants about the nurse staffing decision-making methods currently employed in Canada including frameworks for nurse staffing, nurse-to-patient ratios, workload measurement systems, and "gut" instinct. A number of key themes emerged from the study that can form the basis for policy and practice changes related to determining appropriate workload for nursing in Canada. These include the use of (a) staffing principles and frameworks, (b) nursing workload measurement systems, (c) nurse-to-patient ratios, and (d) the need for uptake of evidence related to nurse staffing.

Key Words: nurse staffing • nursing workload • nurse-to-patient ratios

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