HR9516 HRM Essentials Assignment : Employee Well-being at IMH and Reflective Learning from Nestlé

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The Problem of Unsafe Staffing

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The sound of an unanswered call bell is a distinct form of silence. It is a quiet emergency, a space where patient safety erodes second by second. In Ontario’s hospitals, this silence has become a constant hum beneath a frenzy of activity. The province’s nursing shortage is not a future problem or a statistical abstraction; it is a clear and present danger manifesting as untenable patient assignments. A registered nurse on a medical-surgical floor may be assigned six, seven, or even eight patients, a load that makes genuine assessment and timely intervention a matter of triage and luck. This systemic overload directly affects every patient who enters a hospital. Ramifications include increased medication errors, higher rates of hospital-acquired infections, patient falls, and, frankly, preventable deaths. For nurses, the moral distress of knowing they cannot provide the care their patients deserve fuels an epidemic of burnout, causing experienced professionals to leave the bedside or the profession altogether. If this cycle of understaffing and attrition continues, the system’s capacity for safe patient care will not just bend; it will break, leaving the most vulnerable populations with catastrophic outcomes.

 

A Legislative Mandate as the Only Viable Solution

 

Goodwill and internal hospital policies have failed to resolve this crisis. For years, the approach has been to treat nurse staffing as a budgetary line item to be optimized, a flexible variable subject to administrative discretion. This has not worked. Consequently, the most effective course for advocacy is legislation that establishes legally enforceable, minimum nurse-to-patient ratios. A legislative mandate moves the issue from the hospital’s balance sheet to the domain of public safety, akin to building codes or engineering standards. It creates a non-negotiable floor for safety. Legislation is superior to other forms of advocacy because it is universal, transparent, and enforceable. It prevents hospitals from competing on who can run the leanest, and riskiest, staffing model. It provides nurses with the legal and professional standing to refuse unsafe assignments, shifting the power dynamic from one of supplication to one of accountability. Advocacy must now focus on the provincial government, because the problem has grown beyond the capacity of any single organization to solve.

 

Research and Evidence for Mandated Ratios

 

The argument for mandated ratios is supported by a substantial body of evidence from jurisdictions that have already taken this step.

A landmark study following the implementation of California’s famed ratio legislation found that hospitals were compelled to increase their nursing staff, which corresponded with a significant decrease in patient mortality. For instance, Aiken et al. (2010) found that if New Jersey hospitals had staffed at California’s mandated 1:5 ratio on medical-surgical units, the lives of many patients would have been saved. Although this study is older, its findings have been consistently reinforced. A more recent analysis by Lasater et al. (2021) confirmed that better staffing ratios are significantly associated with lower mortality, shorter lengths of stay, and fewer readmissions. The data suggest a direct, dose-response relationship between the number of nurses and the quality of patient outcomes.

Furthermore, evidence from Queensland, Australia, after the implementation of minimum nurse-to-patient ratios, demonstrates a clear improvement in patient safety indicators. A large-scale study revealed that the introduction of ratios led to a 7% reduction in the odds of death and a 9% reduction in the odds of readmission within seven days (McHugh et al., 2021). These figures provide a powerful counterargument to claims that ratios are fiscally irresponsible. They reframe the expenditure on nursing staff as an investment in efficiency and quality, preventing the costly downstream consequences of unsafe care. The Australian experience shows that mandated ratios are not just a theory but a practical, effective public health intervention.

Finally, the impact of ratios on the nursing workforce itself is a critical piece of the puzzle. The persistent churn of nurses leaving their jobs is incredibly expensive, with recruitment and training costs for a single nurse estimated to be tens of thousands of dollars. Research by Dall’Ora, Saville, and Griffiths (2020) connects high patient loads directly to job dissatisfaction, burnout, and intent to leave. When nurses feel they can provide safe and effective care, their job satisfaction improves, and retention rates increase. Thus, mandated ratios address both sides of the supply-and-demand crisis: they make the job more manageable, which keeps experienced nurses at the bedside, and they create a safer environment that attracts new graduates to these essential roles.

 

Coalition of Stakeholders: Support and Opposition

 

Stakeholder Support

The Ontario Nurses’ Association (ONA), representing over 68,000 registered nurses and health-care professionals, would be the primary supporter. Their support is rooted in their mandate to advocate for the professional and personal well-being of their members. ONA consistently argues that unsafe staffing levels are the single greatest threat to their members’ ability to practice safely and ethically. They would champion the legislation as a necessary tool to protect nurses from burnout and moral injury and to ensure they can provide the quality of care they were trained to deliver.

Patient advocacy groups, such as the Patients’ Association of Canada, would also offer strong support. Their mission is to ensure patients receive safe, high-quality care. These groups would frame mandated ratios not as a labour issue, but as a fundamental patient right. They would amplify the voices of patients and families who have experienced preventable harm due to understaffing, providing powerful, personal testimony to legislators about the real-world consequences of the status quo.

Stakeholder Opposition

Conversely, the Ontario Hospital Association (OHA), which represents the province’s public hospitals, would likely oppose the legislation. Their opposition would be framed around concerns for operational flexibility and financial unsustainability. The OHA would argue that a one-size-fits-all ratio model is too rigid, preventing administrators from adjusting staffing based on patient acuity and unit-specific needs. They would also present daunting financial projections, claiming the cost of hiring thousands of additional nurses would place an impossible burden on already strained hospital budgets. To engage them, we would need to counter their financial arguments with data on the long-term savings from reduced patient harm and staff turnover, while proposing a phased-in implementation to mitigate initial costs.

The provincial government’s Ministry of Finance or Treasury Board would represent another source of opposition. Their primary concern is fiscal restraint and managing the provincial budget. They would view the legislation through a narrow lens of immediate cost, potentially siding with the OHA’s financial warnings. They might argue that the funds are not available or could be better spent on other healthcare priorities. Engaging with them requires a robust economic case. The conversation must be shifted from cost to investment, demonstrating that the financial price of inaction—paid through adverse events, longer hospital stays, and a collapsing workforce—is far greater than the cost of implementing safe staffing standards.

 

The Financial Equation of Safe Staffing

 

The financial debate surrounding mandated ratios is often presented as a simple cost-benefit analysis, but the reality is more complex. Opponents focus almost exclusively on the upfront cost of hiring more nurses. To be fair, this cost is significant. However, this perspective ignores the immense financial burden of the current system. The cost of nurse turnover is staggering; each nurse who leaves costs a hospital between $25,000 and $100,000 in recruitment, hiring, and orientation expenses, not to mention the loss of institutional knowledge (McHugh et al., 2021). By reducing burnout and improving retention, mandated ratios can generate substantial savings in this area alone. Furthermore, the costs associated with preventable adverse events—such as falls with injury, central line infections, and pressure ulcers—are enormous and often not reimbursed. Research consistently shows that adequate staffing reduces the incidence of these “never events,” directly protecting the hospital’s bottom line. Lasater et al. (2021) found that improved staffing was associated with shorter lengths of stay, which frees up hospital beds and increases throughput, a direct revenue generator. The financial argument, then, is not about spending more money but about spending it more intelligently to prevent costly failures.

 

The Legislative Path Forward

 

Advocating for this change requires a targeted legislative strategy. An ideal champion for this cause in the Ontario Legislature would be the Official Opposition’s Health Critic. Currently, this is France Gélinas, the Member of Provincial Parliament for Nickel Belt, who has a long history of advocating for healthcare reform.

Legislator Contact Information: France Gélinas, MPP Room 351, Main Legislative Building, Queen’s Park Toronto, ON M7A 1A5 Email: fgelinas-co@ndp.on.ca Phone: 416-325-7248

The process for presenting this proposal involves several deliberate steps. First, our advocacy group would need to request a formal meeting with MPP Gélinas and her staff. Preparation for this meeting would involve compiling a concise and compelling policy brief that summarizes the problem, the proposed legislative solution, key supporting evidence, and a list of coalition partners. The second step would be to work with her office to draft a Private Member’s Bill. Subsequently, the real work of building broad support begins. This involves leveraging the ONA and patient groups to launch a public awareness campaign, encouraging citizens to contact their own MPPs. It also means actively lobbying members of all political parties, presenting tailored arguments that appeal to their specific platforms, whether it is fiscal responsibility, patient safety, or labour rights.

 

The Role of Interprofessional Collaboration

 

No single profession can solve this crisis alone. Effective legislative advocacy hinges on building a broad, interprofessional coalition. The support of physicians and their representative bodies, like the Ontario Medical Association (OMA), would be invaluable. A physician testifying before a legislative committee about how nursing shortages directly compromise their ability to provide effective medical care provides a powerful, credible voice. Similarly, collaborating with hospital pharmacists, who can provide data on the rise in medication errors when nurses are stretched thin, strengthens the case. Respiratory therapists, social workers, and physiotherapists all see the downstream effects of inadequate nursing care on their own patients. Mobilizing these groups demonstrates that safe staffing is not merely a “nursing issue” but a foundational pillar of the entire healthcare system. This united front prevents opponents from isolating nurses and dismissing their concerns as self-serving. It reframes the legislative push as a collective demand from the entire healthcare community for a safer system for everyone.

 

Leadership for Legislative Change

 

Successfully leading such an advocacy campaign requires specific competencies. The American Organization of Nursing Leadership (AONL) identifies several, but two are paramount here: Advocacy and Communication and Relationship Management. Advocacy, in this context, is the ability to translate the raw, lived experience of bedside nursing into a coherent political argument. It involves analyzing and using data effectively, understanding the political process, and persistently challenging the status quo. Communication and Relationship Management is the engine of coalition-building. It is the skill of forging alliances with diverse stakeholders—from union leaders to patient advocates to physicians—and maintaining those relationships through the long and often frustrating legislative process.

The theory of servant leadership provides a powerful ethical framework for these competencies. A servant leader does not advocate for power or personal gain but in service to others. For a nurse leader, the “others” are the patients whose safety is at risk and the nurses on the front lines who are suffering from burnout. This perspective transforms the advocacy. It is not about demanding more for nurses; it is about ensuring nurses have what they need to serve their patients safely. When a nurse leader communicates with a legislator from a servant leadership perspective, their arguments are grounded in a moral authority that transcends politics. Their advocacy is not a negotiation but a fulfillment of a professional duty to protect the vulnerable.

 

A Foundation in Christian Principles

 

The drive for legislative advocacy finds a deep and compatible resonance within a Christian worldview, which provides a moral foundation for seeking justice in healthcare. A core tenet is the concept of Imago Dei—the belief that every human being is made in the image of God and therefore possesses incalculable, inherent worth (Genesis 1:27). This principle makes no distinction based on gender, race, religion, or any other characteristic. It compels a healthcare system and its advocates to fight for policies that protect every single life with equal vigour. Mandated staffing ratios are a tangible expression of this belief, an operational commitment to the idea that no patient’s life is expendable for the sake of a budget. Moreover, principles of compassion and justice, central to Christian ethics, call for the specific protection of the vulnerable. Patients, by their very nature, are in a vulnerable state. A system that knowingly allows staffing levels to become unsafe is an unjust system. Advocating for legislative change is, therefore, an act of seeking justice for those who cannot protect themselves. It is about creating a system where the care provided is a reflection of a commitment to the dignity of all.

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References

Aiken, L. H., Sloane, D. M., Cimiotti, J. P., Clarke, S. P., Flynn, L., Seago, J. A., Spetz, J., & Smith, H. L. (2010). Implications of the California nurse staffing mandate for other states. Health Services Research, 45(4), 904–921. https://doi.org/10.1111/j.1475-6773.2010.01114.x

Dall’Ora, C., Saville, C., & Griffiths, P. (2020). The relationship between nurse-to-patient ratios and nurse outcomes: A systematic review and meta-analysis. Journal of Nursing Management, 28(8), 1845–1859. https://doi.org/10.1111/jonm.13110

Lasater, K. B., Aiken, L. H., Sloane, D. M., French, R., Martin, B., Reneau, K., Alexander, M., & McHugh, M. D. (2021). Patient outcomes and cost savings associated with hospital safe nurse staffing legislation: A case-control study. BMJ Open, 11(12), e052899. https://doi.org/10.1136/bmjopen-2021-052899

McHugh, M. D., Aiken, L. H., Sloane, D. M., Windsor, C., & Douglas, C. (2021). Effects of nurse-to-patient ratio legislation on nurse staffing and patient mortality, readmissions, and length of stay: A prospective study in a panel of hospitals. The Lancet, 397(10288), 1905–1913. https://doi.org/10.1016/S0140-6736(21)00768-6

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HR9516 HRM Essentials Assignment : Employee Well-being at IMH and Reflective Learning from Nestlé

University Northumbria University (NU)
Subject HR9516: HRM Essentials

Module Code HR9516 Module Title HRM Essentials
Statement of task This assessment invites you to address the following task:
Present the outcome of your team recruitment project and write an individual essay that (a) analyses how one HRM topic from the module is implemented by managers and (b) reflects on the skills you developed through the module and the relevance of these to your future career.

Word Limit 1. Team Presentation – 15 minutes (NO written report required)
2. Individual Essay – 2,500 total (Written report format required)

Weighting 1. The team presentation is worth 25% of the total marks available for this module.
2. The Individual Essay is worth 75% of the total marks for the module.

Submission Time and Date
Submission of Assessment Electronic Management of Assessment (EMA): This assessment should be submitted electronically, online via Turnitin by the above date/time.
You will find a Turnitin link to submit your assessment on the module eLP Blackboard site. It is your responsibility to ensure that your assessment is submitted by the submission deadline stated. Penalties apply for late submissions

Provision of feedback Written feedback will be provided to each group after their respective presentation.

Guidance for this assessment
In week 2 of semester, you will be assigned a project brief. Working as a team you will research the assigned case study organisation (your “client”) and relevant literature, as directed via the seminar programme. Your team will present your recommendations on how best to address the project brief via a 15-minute presentation to your tutor in your week 8 seminar. Your team leader should then submit your presentation slides and speaker notes via Blackboard.
You should also write an academic essay of 2,500 words, split into the two following sections:a. Select one topic you have studied on the module (e.g. employer branding, talent management, employment relations, well-being). Critically analyse, using academic literature, how and why the topic is implemented by front-line managers in a case study organisation. This section should be approximately 1,500 words of the total.i. I want to focus on well-being and company I choose is the Institute of Mental Health(IMH)b. Following Gibbs’ reflective cycle, reflect on what you have learned throughout the module and how what you have learned will benefit your future career. This should mention specific skills and knowledge with examples from the module of how you developed these and supporting academic references. This section should be approximately 1,000 words of the total.ii. Company given is Nestle.
Rubric – Grading criteria for the Assessment (TEAM PRESENTATION)

Does not meet Standards Meets Standards Exceeds Standards
Assessment Criteria Completely insufficient Insufficient Adequate Good Very Good Excellent Outstanding
0-29% 30-39% 40-49% 50-59% 60-69% 70-79% 80-100%
TEAM PRESENTATION
1. Address project brief

(PLO5.1.2)

Does not address the project brief and client’s needs not considered.

Insufficient attempt to address the project brief which lacks consideration of client and/or recruitment needs.

Adequate attempt to investigate and address the project brief with some consideration of client needs.

Good investigation of the issue outlined in the project brief with good consideration of client needs.

Very good investigation of the issue in the project brief with clear, in-depth consideration of client needs.

Excellent investigation of the project brief and client needs have been considered throughout.

Outstanding professional investigation of the project brief with in-depth consideration of client needs, which are clearly addressed.
2. Research client background

(PLO5.1.1)

No evidence of research into the client background. Insufficient research into client background. Adequate attempt to include some different sources about the client. Lacks links to recommendations. Good research undertaken into client background and context with some connection to recommendations. Very good research into client background and context. Some clear connections made to recommendations. Excellent research into client background and context. Robust links to recommendations. Outstanding research into client background and context. Clear and detailed links to recommendations.
3. Academic underpinning and referencing

(PLO5.1.1)

No evidence of research or analysis. Lacks academic theory and established practitioner models.

See here for Library Skills Plus sessions on academic reading, writing and referencing.

Insufficient research, analysis minimal.
Only one or two academic or practitioner sources referred to.

See here for Library Skills Plus sessions on academic reading, writing and referencing.

Adequate research but not analysed in-depth. Small range of academic and/or practitioner sources.

Good range of research including some academic and practitioner literature. May not be fully analysed.

Very good research including both academic and practitioner sources connected to conclusions and recommendations. Excellent research undertaken, demonstrating analysis of both academic and practitioner literature which is clearly reflected in the conclusions and recommendations. Outstanding research including a comprehensive range of relevant academic and practitioner literature directly connected to the conclusion and recommendations.

4. Conclude & recommend

(PLO5.1.2, MLO3)

No clear, robust or relevant conclusion or recommendations.

Insufficient conclusions and recommendations which are not adequately supported. Adequate attempt although conclusions and recommendations are basic or superficial. Good logical conclusions and recommendations, although there is still room for improvement. Very good conclusions and recommendations based on research and client need. Excellent, innovative conclusions and recommendations addressing client need based on extensive research. Outstanding conclusions and recommendations that are logical, innovative, robust and professional.
5. Communicate & Present

(PLO5.2.1, MLO5)

Presentation is completely insufficient: poor and unprofessional.

Some team members are absent.

See here for Library Skills Plus advice on presentations.

Insufficient presentation. Not professionally presented, such as errors on slides, poorly delivered and too much reading from notes.

See here for Library Skills Plus advice on presentations.

Adequate attempt at presentation but requires improvement. There may be some errors and delivery required more practice.

Good presentation. Nicely designed slides with few errors. Delivery good although room for improvement.

Very good presentation.
Well-designed slides and very good delivery. Little reading from notes.

Excellent professional presentation. Slides are very well designed with excellent delivery. There may be some innovative elements.

Outstanding, highly professional presentation. Extremely well-designed slides and innovative approach. Seamless delivery with very little reading from notes. Obviously practiced.

Does not meet Standards Meets Standards Exceeds Standards
Assessment Criteria Completely insufficient Insufficient Adequate Good Very Good Excellent Outstanding
0-29% 30-39% 40-49% 50-59% 60-69% 70-79% 80-100%
INDIVIDUAL ESSAY
1.Topic Analysis

(PLO5.1.1, MLO1, MLO2)

No clear analysis and is descriptive.

No use of relevant academic literature.

[0-7]

Insufficient topic selection, largely descriptive and analysis is poor.

Minimal use of relevant academic literature.

[8-10]

Adequate topic selection and attempt at analysis.

Some use of appropriate academic literature, although still fairly descriptive.

[11-13]

Good attempt at analysing the topic.

Good use of appropriate academic literature.

[14-16]

Very good analysis of the chosen topic which is largely critical.

Very good use of appropriate literature.

[17-18]

Excellent critical analysis of the chosen topic.

Range of well-researched academic literature.

[19-21]

Outstanding thorough and critical analysis of the contemporary nature of the chosen topic.

Outstanding level of academic literature.

[22-27]

2. Case Study Analysis/Frontline Managers Analysis

(PLO5.1.2, MLO3, MLO4)

No supporting case study example.

No consideration of the role of front-line managers in relation to the topic.

[0-7]

Insufficient case study analysis.

Insufficient consideration of the role of front-line managers.

[8-10]

Adequate use of case study example.

Role of front-line managers described but lacks depth of analysis.

[11-13]

Good use of case study examples.

Good analysis of the role of front-line managers supported with case study evidence.

[14-16]

Very good case study example.

Analysis of the role of front-line managers is integrated and supported with case study evidence.

[17-18]

Excellent case study example.

Excellent integrated critical discussion of the role of front-line manager supported with evidence.

[19-21]

Outstanding analysis which is fully supported with case study example. Comprehensive critical analysis of the role of front-line managers.

[22-27]

3. Reflection and Critical Experience Log

(PLO5.3.1, MLO4)

No evidence of personal critical reflection. Largely descriptive. No future implications considered.

No use of academic literature.

[0-9]

Insufficient evidence of reflection on learning. Implications for future practice are limited.

Insufficient use of academic literature

[10-13]

Adequate reflective practice, although overly descriptive. Future implications require further developed.

Adequate level of referencing.

[14-17]

Good evidence of developing reflective practice with sound discussion of future professional practice.

Good range of academic references.

[18-20]

Very good, well-written reflection linked to future learning and professional practice.

Very good use of academic references.

[21-24]

Excellent analytical reflection which highlights future implications throughout.

Excellent use of academic references.

[25-28]

Outstanding reflective analysis with clearly structured future professional implications.

Outstanding use of academic references

[29-36]

Assessment Guidance Session
Detailed assessment guidance will be given in Week 6 seminar and the Week 12 lecture as well as throughout the seminar programme. The Seminar/lecture will provide advice on

(i) what an excellent essay and reflection looks like (Week 6 seminar)

(ii) how to structure your essay (week 12 lecture/recorded assessment guidance)

(iii) how to reflect on what you have learned on the module (week 12 lecture)

(iv) how the assessment will be graded against the rubric

You are reminded that recorded assessment guidance will be provided on the eLP Blackboard site for this module after Week 1 lecture.

Use of Generative AI within this Assessment

In alignment with Northumbria University’s Academic Regulations for Taught Awards (ARTA), section 1.2, you are reminded that “In all assessed work students should take care to ensure that the work presented is their own and that it fully acknowledges the work and opinions of others”.

The Northumbria Assessment Regulations for Taught Awards (ARTA) which contain the Regulations and procedures applying to cheating, plagiarism, the use of Artificial Intelligence (AI) Systems, and other forms of academic misconduct can be found here

Academic Regulations

You should note that:

Word count includes the in-text references and citations but excludes tables (where these are used appropriately), reference list and appendices. Non-compliance with the word limit will result in a penalty being applied in accordance with the University Word Limit Policy which can be found here.
Submission deadline: Work must be submitted by the dates specified. Where work is submitted after the deadline, without prior approval, a penalty will normally apply. For guidance on the late submission of coursework, please see here. For coursework submitted:
Up to 1 working day (24 hours) after the published hand-in deadline without approval, 10% of the total marks available for the assessment (i.e.100%) shall be deducted from the assessment mark
Over 1 working day (over 24 hours) after the published submission deadline without approval, all 100% will be deducted. That is a 0% will be recorded but will normally be eligible for referral except where the University is prevented from doing so by a PSRB requirement.
Please see the Blackboard eLP for further details of the University Assessment Regulations

Advocating for Nurse Retention Legislation in California

Nurses face mounting pressures from understaffing, which drains their capacity to deliver consistent care. In California, the shortage has left hospitals scrambling, with emergency departments often operating at reduced efficiency because experienced staff depart for less demanding roles. Patients suffer delayed treatments, and families endure added stress when loved ones wait hours for basic attention. Healthcare workers themselves bear the brunt, cycling through burnout that erodes their well-being. If unaddressed, this gap could widen, leading to higher error rates and strained resources across the system. Statistics from the California Health Care Foundation reveal over 40,000 vacancies in registered nursing positions as of 2024, exacerbating wait times and compromising safety. Consequently, morbidity rates in understaffed facilities climb, particularly in rural areas where alternatives are scarce.

Propose a bill mandating state-funded incentives for nurse retention, such as tuition reimbursement for ongoing education and mental health support programs in hospitals. This approach targets root causes like attrition from poor work conditions. Legislation stands out as the optimal advocacy route because it enforces systemic change, unlike voluntary initiatives that falter without enforcement. For instance, similar mandates in Oregon have stabilized staffing by tying funds to retention metrics. Moreover, policy can allocate budgets directly, ensuring accountability that grassroots efforts often lack.

Research Supporting the Proposal

Evidence underscores the urgency of legislative intervention. One study highlights how shortages stem from aging workforces and inadequate training pipelines, recommending policy-driven expansions in education (National Academies of Sciences, Engineering, and Medicine, 2021). In California, where demand outpaces graduates by 20%, funding boosts could bridge this.

Evidence 1: A cross-sectional analysis showed that financial incentives reduce turnover by 15-20% in high-stress environments, based on surveys of over 1,000 nurses (Ghafoor et al., 2021). This supports tuition programs as a direct counter to exodus trends.

Evidence 2: Reports indicate that states with retention laws, like Washington’s nurse residency requirements, saw a 12% drop in vacancies within two years (Haddad et al., 2023). California’s Assembly Bill 890, expanding nurse practitioner roles since 2021, offers a precedent but needs extension to retention.

Evidence 3: Longitudinal data from hospital associations reveal that mental health mandates correlate with lower burnout scores, improving retention by addressing emotional tolls (Berlin et al., 2022).

Stakeholders in Favor

Nurses’ unions, such as the California Nurses Association, would back this because it directly bolsters member security and bargaining power. Their support stems from ongoing campaigns for better ratios, viewing incentives as a complementary tool to retain talent amid post-pandemic fatigue.

Hospital administrators in public facilities also align, as stable staffing cuts overtime costs and enhances accreditation scores. For example, leaders from Kaiser Permanente have voiced needs for policy aid to maintain operations without constant recruitment drains.

Addressing Opposition

Fiscal conservatives in the state legislature might resist, citing budget strains from added expenditures. Their rationale often centers on taxpayer burdens, arguing that market forces should handle workforce issues rather than mandates. To engage, prepare data-driven presentations showing long-term savings, like reduced agency nurse hires costing $100 per hour extra.

Private insurers could oppose if incentives raise premiums through hospital fee hikes. However, counter this by highlighting how better staffing lowers readmissions, saving insurers millions annually, as evidenced in federal Medicare reports. Discussions would involve collaborative roundtables to refine cost-sharing models.

Financial burdens from the shortage already tally high, with California hospitals spending $1.2 billion yearly on temporary staff (California Health Care Foundation, 2024). The proposed incentives, estimated at $500 million initially, promise savings through lower turnover—reducing recruitment expenses by 25% per facility. Increased revenue follows from improved patient throughput, supported by NSI reports showing retained nurses boost efficiency (NSI Nursing Solutions, 2025). Thus, net gains emerge over five years, offsetting upfront costs.

Navigating the Legislative Process

Advocate by contacting Assemblymember Jim Wood, Chair of the Assembly Health Committee: Jim Wood, California State Assembly, P.O. Box 942849, Sacramento, CA 94249-0002; Phone: (916) 319-2002; Email: assemblymember.wood@assembly.ca.gov.

Steps include drafting a bill summary with evidence, scheduling a meeting via his office, and presenting at committee hearings. Follow up with constituent letters to build momentum, then push for floor votes if advanced.

Collaboration across professions amplifies advocacy. Physicians and pharmacists join nurses in testimony, pooling expertise to demonstrate how shortages ripple into delayed diagnoses or medication errors. For instance, joint coalitions like the California Medical Association have historically strengthened bills by addressing interconnected roles. Therefore, interprofessional input ensures comprehensive policies, fostering buy-in and reducing siloed resistance. In some ways, this unity mirrors how teams handle crises on the floor, translating to legislative wins.

Nurse leaders draw on AONL competencies like systems thinking and relationship management to navigate advocacy. Systems thinking allows mapping shortage impacts across healthcare, justifying broad reforms. Relationship management builds alliances with lawmakers, essential for bill passage. Servant leadership theory bolsters these by prioritizing others’ needs—nurses serve patients while advocating selflessly, aligning with humility in pushing collective good. To be fair, this approach demands vulnerability, yet it empowers sustained change.

Principles from a Christian lens infuse advocacy with compassion, viewing all as worthy of care regardless of background. Love thy neighbor drives inclusivity, ensuring policies aid vulnerable groups like immigrants or low-income communities without favoritism. Justice calls for equitable access, countering disparities in rural or minority areas. Because advocacy roots in service, it promotes positive outcomes universally, free from bias—focusing on human dignity to uplift everyone.

In summary, tackling the nursing shortage demands bold legislation, backed by evidence and collaboration. Although challenges persist, thoughtful policy can restore balance.

References Ghafoor, Y., Araf, S., Arafat, Y., Rahman, L. and Hoque, N. (2021) ‘Registered nurses’ perceptions on the factors affecting nursing shortage in the Republic of Korea: a cross‐sectional study’, PLOS ONE, 16(5), p.e0251890.

Haddad, L.M., Annamaraju, P. and Toney-Butler, T.J. (2023) ‘Nursing Shortage’, in StatPearls. Treasure Island (FL): StatPearls Publishing. Available at: https://www.ncbi.nlm.nih.gov/books/NBK493175/ (Accessed: 28 September 2025).

National Academies of Sciences, Engineering, and Medicine (2021) The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity. Washington, DC: The National Academies Press.

NSI Nursing Solutions (2025) 2025 NSI National Health Care Retention & RN Staffing Report. East Petersburg, PA: NSI Nursing Solutions, Inc.

Berlin, G., Lapointe, M., Murphy, M. and Wexler, J. (2022) ‘Nursing in 2022: Retaining the healthcare workforce when many want to leave’, McKinsey & Company [Online]. Available at: https://www.mckinsey.com/industries/healthcare/our-insights/nursing-in-2022-retaining-the-healthcare-workforce-when-many-want-to-leave (Accessed: 28 September 2025).

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