The Impact of Emergency Department RN Staffing on ED Patient Experience.

INTRODUCTION: Patient experience ratings are important to health care organizations from both a clinical and financial perspective. Studies examining the relationship between patient experience and nurse staffing are prevalent in the inpatient setting, but not as much is known about how staffing affects these ratings in the emergency department. METHODS: Using responses from 3,120 adult patients who visited the emergency department of a large academic medical center in the southeastern United States between March 1, 2015, and November 30, 2015, this study examined the relationships between ED RN staffing and patient experience ratings. Ordinal logistic regression models were used to examine the relationship between 2 nurse staffing variables and patient ratings of care. RESULTS: Overall, higher levels of RN staffing in the emergency department were associated with better patient ratings of their care experiences, but the strength and significance of this relationship varied as a function of different factors (eg, how staffing is measured, discharge status of the patient). DISCUSSION: Higher levels of ED RNs may enable nurses to better meet the expectations of patients presenting to the emergency department, highlighting a number of opportunities for allocating nursing resources.

Using a mentorship program to recruit and retain student nurses.

The authors present a student nurse mentorship program designed to provide an experience that assists nursing students to transition more easily into competent nursing professionals. The outcomes to date have been encouraging, showing a decrease in turnover among mentorship participants. At little cost and with great benefit to the student, the mentor, and the hospital, the mentorship program is presented as a successful way to recruit and retain the brightest graduate nurses.

A clinical ladder program based on Carper's Fundamental Patterns of Knowing in Nursing.

Clinical and career ladder programs were popular adjuncts to recruitment and retention during the nursing shortage of the 1980s. Programs commonly used Benner's work as an organizing framework and typically used activities such as continuing education credit, committee participation, work experience, certifications, academic degrees, community service, and performance appraisal scores as criteria for advancement. The authors present a unique clinical ladder program based on Carper's Fundamental Patterns of Knowing in Nursing. This philosophical work has been debated in the literature for many years, yet to the authors' knowledge, this work has never been used as the conceptual basis for program development. The four patterns of knowing in nursing were found to be consistent with the definition of professional nursing, and provided a meaningful organizing framework that was well received by staff registered nurses. An overall history of clinical ladders is presented, followed by the organization's prior experience with these programs, and finally the details of development and implementation of the program with plans for evaluation.