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In the 1996 the Institute of Medicine (IOM) raised there concern about the need of ensuring an appropriate patient nurse ratio as well as the need for skill distribution among the staff in order for quality health care to be ensured. Research that has been done on the relationship patient’s outcome and staffing level is not yet complete. For a critical analysis it’s important that we fully understand that people we are talking about and the duties that they perform at the hospital. We have three groups of nurses which include the registered nurses, licensed practical nurses as well as well as nurse aids. The last groups of nurses are not licensed by the State. The roles played by registered nurses include assessment of patient needs, development of patient care plans. Other roles that are carried out by nurses include medication and treatment administration.

Licensed practical nurses basically work under the direction of registered nurses and they specifically carry out nursing duties that they have been a located by the registered nurse. Non specialized nursing duties are implemented by nurse aids and other activities that they carry out include patient’s personal care activities. All the three groups of nurses work directly with patients. Registered nurses have three types of academic qualifications and this education is acquired by use of different roots. For example a registered nurse will get a three year diploma program, a four year baccalaureate degree on addition to a two year associate degree. Research indicates that one third of all nurses have baccalaureate degree and about 7.6 percent of all nurses have their masters or doctorate degrees (Mason, Leavitt and Chaffee 517).

On the other hand registered practical nurses receive a twelve to eighteen months training which put specific emphasis on nursing tasks that are considered technical. Nurse aids most of the times have certificates in nursing aide. This group also includes certifies nurse aides but they are only employed when the organization proves that they have some skills that are required in nursing. Measurement of staffing can only be done at two levels which include the hours that a nurse takes with a patient as well as patient to nurse ratio. Nursing hours is only applicable to registered nurses and not the other groups of nurses. The number of nurses in a given hospital is an area of many concerns since many believe that the number of house spend with a patient and the ratio between nurses and patients plays a significant role in determining the final outcome of a patient (Hospital management 50).

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