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Nursing Home Understaffing

One underlying cause of elder abuse and neglect that affects nursing homes all across the country is the issue of understaffing. When nursing facilities do not have enough staff to give each patient adequate attention, it leads to mistakes and neglect. At the same time, when staff is extremely overworked and stressed, there is a greater risk that they will commit abusive acts out of frustration.

Understaffing is a serious issue that has plagued nursing homes for decades, and more than 90% of nursing homes are currently understaffed. Studies have proven that residents who live in understaffed nursing homes are at a greater risk of malnutrition, weight loss, bedsores, dehydration, infections, and pneumonia. Families of elderly patients are increasingly noticing this problem and are starting to hold nursing homes responsible for the abuses that occur as a result.

Why Are Nursing Homes Understaffed?

There are few different reasons why more and more nursing homes are being understaffed. One of those reasons is cost. The labor costs for nursing homes are very high compared to other costs. Some nursing homes cannot afford to have as many registered nurses and certified nursing assistants as they need. Instead they just try to stretch their existing staff as much as they can.

There are also situations were nursing facilities struggle to find and hold on to qualified medical professionals. Nursing home facilities are a difficult and high stress environment, and some nurses and nurse’s aides prefer to work in hospitals and other facilities. It is also very difficult for nursing homes in small towns and rural areas to find enough qualified people to fill all of their positions.

Overtime and Exhaustion

Because nursing homes lack the necessary amount of staff, the existing staff is pushed to work as quickly and as long as they can. Some nurses and staff members view overtime and long hours as beneficial because they will make more money, but many feel overworked and underpaid even with overtime. The exhaustion after working several hours can cause a nurse to make mistakes and miss changes in a patient’s condition.

Understaffing Effects on Care

The negative effects of understaffing are obvious. Without enough nurses and nursing assistants, a facility is unable to provide a high level of care that is personalized for each patient. In a survey, 46% of the nurses said that they have missed changes in a patient’s condition because their excessive workload. Nurses in understaffed facilities do not have time to pay attention to detail, and that can lead to mistakes, injuries, and death of nursing home residents.

Patients who need the most medical attention and who are immobile are at greatest risk when a facility is understaffed. Nursing assistants must help these patients eat, drink, and go to the bathroom. They must also make sure that they turn and move these patients and change their clothes often in order to prevent bedsores and other dangerous infections.

These high workloads make it impossible for nursing staff to provide individualized care. One of the most common causes of injury in nursing homes is falling. Staff is supposed to supervise patients and make sure their basic needs such as eating and going to the bathroom are met, so that patients will not wander or try to do too much on their own. Unfortunately, this is impossible in some nursing homes where there is not enough staff.

When staff members are overworked and exhausted it leads to stress and frustration. These staff members are more likely to commit abuse, whether intentional or not. These acts of abuse can be very harmful to the patients.


Hefner, David. “Understaffed Nursing Homes Affecting Patients.” Journal of the National Medical Association. 94(5).May (2002): 283. Web. 23 Feb. 2014. <http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2594332/?page=1>.

“The 2013 Florida Statutes.” Online Sunshine. The Florida Legislature, 23 Feb 2014. Web. 23 Feb 2014. <http://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&Search_String=&URL=0400-0499/0400/Sections/0400.23.html>.


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