The Healthcare Staffing Crisis is a Safety Crisis

Hospitals everywhere are confronting a hard truth: the global nurse staffing shortage isn’t just squeezing schedules, it’s creating unsafe conditions for patients and clinicians alike. A recent report from Global Nurses United (GNU) reveals that chronic understaffing drives medical errors, delays care, increases workplace violence, and heightens moral distress on the front lines.

A Real-World Example From Maine: When “Making Do” Isn’t Enough

In Houlton, Maine, the result of chronic understaffing became impossible to ignore when nurses at the local hospital announced a two-day strike in late 2025. According to local reporting, emergency department staff said due to understaffing, they no longer felt they could consistently provide safe care. Patients were frequently treated in hallways, acuity levels continued to rise, and staffing failed to keep pace with the growing complexity of cases.

For nurses on the front lines, “making do” had become the norm rather than the exception. The strike, they said, was not about convenience or leverage– it was about drawing attention to risks they believed were already affecting patient safety.

Last year, those pressures intensified when the hospital’s labor and delivery unit closed, forcing expectant mothers in the region to seek care elsewhere. But as local news station WAGM reported, births don’t always follow a plan. As a result, more women are now arriving at the emergency department in need of urgent maternity care.

That shift has placed additional strain on an already stretched ER staff. Michael MacArthur, a Houlton emergency room nurse, told WAGM that nurses are now expected to manage “a larger variety of patients, including patients that are going to be delivering or having issues with their pregnancies,” requiring broader training and greater responsibility without additional resources.

Situations like this illustrate how staffing shortages can push care teams beyond their intended scope. Emergency departments are built to triage and stabilize, not to replace specialized units like labor and delivery. When those boundaries blur, stress increases for clinicians– and patients may not receive the level of care they expect during some of life’s most critical moments.

While Houlton’s experience is not unique, it offers a clear picture of what understaffing looks like in practice: clinicians doing everything possible with too little support, hoping they’ll have the capacity to meet whatever emergency comes through the door next.

New York City: When Staffing Strain and Safety Risks Intersect

Similar dynamics are now playing out on a much larger scale in New York City, where thousands of nurses are currently on strike amid ongoing discussions about staffing levels and workplace safety.

In a recent New York Times op-ed, emergency room nurse Sheryl Ostroff described her personal experience with workplace violence over the course of her career– injuries and threats that underscore the risks nurses can face in high-acuity, high-volume environments. Her account reflects a growing body of data showing that workplace violence in healthcare is widespread and increasing, particularly in settings where wait times are long and patient needs are complex.

When teams are thin, workloads increase, care takes longer, and frustration can escalate. Nurses, who spend more time with patients than anyone else in the hospital, often bear the emotional and physical weight of those pressures.

Taken together, the experiences in Maine and New York illustrate a shared challenge facing hospitals nationwide. Chronic staffing strain doesn’t reflect a lack of effort or care. It reflects a system under pressure, where teams are doing everything they can within real constraints– often without the support structures needed to reduce risk when conditions escalate.

A Shift in Perspective: Staffing as a Safety Issue

When teams are stretched thin, delays compound, early warning signs are easier to miss, and situations are more likely to escalate, putting both patients and clinicians at risk.

Some states are beginning to respond. Ohio, for example, has introduced bipartisan bills HB 521 and HB 535 that would reshape how hospitals manage staffing.

“These bills represent the answer to the question we hear every day from Ohio nurses, Ohio health professionals, patients, and families: What can be done about chronic understaffing in hospitals?” said Rick Lucas, President and Executive Director of the Ohio Nurses Association.

The legislation reflects a growing acknowledgment that understaffing is not just an operational challenge, but a patient safety issue. Lawmakers and nursing leaders are increasingly framing chronic understaffing as an issue that affects not just hospital operations, but patient safety and public trust.

Why Safety Systems Matter Even When Ratios Improve

Calls for staffing reform are growing louder in the healthcare space, and decades of research show that nurse-to-patient ratios directly affect outcomes. At least one study found that each additional patient added to a nurse’s workload increases the risk of patient mortality by 7%.

Alternatively, hospitals with safer ratios are associated with lower mortality, fewer adverse events, and higher job satisfaction among nurses. These standards reduce baseline risk and create a more stable foundation for care.

Healthcare does not operate under static conditions, however. Patient acuity changes rapidly, emergencies overlap, and multiple units can be strained at once. No staffing model or law can fully prevent moments when teams are thin and risk rises.

That’s where safety and incident-response systems play a critical role. When staffing is limited, the ability to recognize incidents early, communicate clearly, and summon help quickly can reduce the likelihood of escalation and serious harm.

A modern safety and incident-response system:

• routes the right help to the right place instantly,

• supports thin teams during high-acuity surges,

• cuts through chaos with clear communication,

• allows leadership to view what’s happening in real time, and

• reassures staff that they’re not alone when things escalate.

These systems don’t replace staffing improvements, but they provide essential protection right now, while longer-term solutions continue to take shape.

Safety Infrastructure is the Foundation

Staffing ratios establish a minimum standard for care, but they don’t determine how quickly or effectively teams receive help when situations escalate. While compliance can set a baseline, it doesn’t address the risks that arise when units are strained and incidents unfold rapidly. Hospitals that pair staffing standards with intentional safety infrastructure are better equipped to protect staff and manage risk in the moments that matter most.

Effective safety infrastructure is layered and role-appropriate. It meets clinicians where they are, reflects how care is delivered across different units, and ensures help can be summoned quickly, regardless of setting or circumstance.

In practice, that means:

• Wearable panic buttons enable discreet, one-touch access to help or staff at highest risk.
• Intuitive alerting at fixed workstations such as computer-based panic buttons at nursing stations or on WOWs, so staff can escalate concerns without leaving their post.
• Blanket coverage through [wall-mounted panic buttons in common areas, hallways, and other shared spaces where incidents may occur unexpectedly.
• Mobile safety applications that extend protection beyond fixed locations, ensuring staff can call for help wherever their work takes them.
• A centralized incident management hub that gives leadership real-time visibility into active situations, response status, and emerging patterns.
• Built-in reporting and analytics that track incidents over time, surface trends, and help identify areas where additional training, staffing, or safeguards may be needed.
• A mass communication system that can be automated or customized by incident type, ensuring timely, targeted communication to the right people across the organization– so staff, responders, and leadership receive the information they need through the channel they’re most likely to see.

Just as important as the tools themselves are the workflows behind them. Effective systems allow hospitals to define custom incident types and response protocols, ensuring alerts are routed to the right people, in the right order, every time. That consistency reduces confusion during high-stress moments and shortens the path from escalation to response.

The Bottom Line: We Can’t Fix Staffing Overnight, but We Can Make it Safer

Nurses are working in increasingly strained environments, and patients are feeling the effects through delays, hallway care, and rising safety risks. While staffing reform is necessary, it will take time, and hospitals cannot wait for long-term solutions to fully materialize before acting.

Understaffing will take time to fix, but we can make care safer– starting right now. Schedule a no-pressure consultation to evaluate your current safety infrastructure and explore how tailored incident-response solutions can better support your staff today.