Nurse-to-patient ratios and staffing issues: a qualitative investigation of nurses' perceived work environments in Quebec's integrated healthcare centers
Bibliographic record
Abstract
Nurse-to-patient ratios (N/P) are designed to ensure acceptable levels of patient load as well as enough nurses to properly care for patients. Representatives of the nursing profession and unions have been urging government to implement regulation to ensure the respect of mini-mum established N/P ratios at all times in Quebec healthcare organizations. This paper aims to examine N/P ratios, in the context of demands of many organizations for a law enforcing mandatory staffing ratios in Quebec healthcare organizations. A qualitative exploration was conducted using 42 semi-directive interviews with unionized nurses throughout the province of Quebec. A thematic analysis was carried out using NVivo. Using the Nursing job de-mands-resource model, which gives importance to the broader organizational climate, we assessed nurses' perceptions of their working environment. Four main themes emerged: 1) intensifying workload, 2) inadequate skill mix, 3) cost-effective management, 4) adverse outcomes. Our findings suggest that reducing the number of patients per nurse will not neces-sarily result in better working conditions if other lean strategies are adopted to compensate for the higher staffing costs, nor will it make the work environment fundamentally more attractive. While higher staffing levels are needed, seriously caution should be paid to the ways in which ratios are implemented. Alternative models of healthcare institutions, such as Magnet hospitals or other models, should be examined.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".