Hospital Staffing Patterns: Less Support for Nurses Today


In 2015, my son and I went to the Bay Area Science Festival at Oracle Park in San Francisco.

There were a ton of things to learn and explore, but one really stood out for my then 4-year-old son (and he still talks about it to this day).

One booth had a bunch of geometric shapes made out of balsa wood.

The booth attendants asked visitors to try to break the various shapes with their hands.

My son stepped up to the plate. The circle, broken. The square, destroyed. Then he came to the triangle.

He tried and tried, but the triangle would not break.

That is when he learned that the triangle is the strongest shape.

Think for a minute about the triangle shape … it has a wide base, which makes it the strongest at the bottom.

In fact, no matter which direction you turn it, a triangle will always have a strong foundation supporting everything above it.

(The science behind its strength, for those interested: triangles are the strongest shape because any added force is evenly spread throughout all three sides.)

Now let us think about the triangle in the context of a hospital staffing model.

Let us say you have the physician at the top. And below that physician is three nurses. Then below those three nurses are nine service staff members.


You would have a perfect, unbreakable triangle. One where any added work is spread evenly and appropriately to the right team members in the hospital.

When the hospital staffing model creates a triangle shape, it helps clinicians achieve more for the patient by operating at the top of their skills and licenses.

But that is a stark contrast to what we see in hospitals today.

According to 2017 data compiled at
Occupations by Share

When using 2017 values, we can summarize the makeup of hospital staff: 

staffing table


That is not a triangle with a strong base; that is a diamond shape that teeters.


This is the unfortunate reality clinicians and service staff face today.

Nurses already realize that they don’t get the support they need. They are both support to the physicians and substitutes for service staff.

(For more related to this topic, check out an article I wrote on nursing workarounds.) 

The economics of healthcare is how we got here.

One of the most important roles in a hospital is, of course, the nurse. And so we would expect to see the nursing role grow in hospitals across the U.S.

And it doesn’t help that when times get tough, hospitals cut non-revenue-generating roles: the service staff.

It’s likely we will not see an overnight change to this. However, we can help ourselves.

The answer is to give service staff the tools to improve their performance, so they can deliver higher quality work more efficiently.

Consider an operations framework to build high-performing hospital service teams. 

As part of that, you can implement technology solutions (like ReadyList) to ensure your efforts go farther.

Just some of the things you can expect when operations are streamlined with technology include:

  • Lean-standardized operations.
  • Real-time operating metrics.
  • Strong partnership among all hospital personnel.
  • An environment that fosters complete focus on patient care.

As hospital executives, operations professionals and nurses, we know there can be challenges with today’s hospital-wide staffing model.

One way to get around this roadblock is to work smarter with what we have. And streamlining hospital service team operations is one way to do so.

You might not achieve the triangle shape you’re after, but it will add more integrity to your diamond so it can more evenly absorb the force of your daily operations.

What do you think? Please leave a comment below.

Brian Herriot is a hospital operations leader and Co-Founder of ReadyList, Inc. ReadyList software ensures fully operational inpatient and surgical environments to help clinicians dedicate more time to their patients.

Do you agree? Leave us a comment.