The healthcare sector focuses on attending to patient needs and managing their experience. Hospitals are tasked with improving the quality of patient care, and since nurses spend most of their work time with the patients, they have a significant impact on the patient care outcome. Nurses are, therefore, expected to have a proper understanding of the patient's needs and ways of improving their experience ( Watson et al., 2016) . The nursing field faces many challenges that have affected the patient experience. Of the many problems within the healthcare sector, none has changed the patient experience more than the patient to nurse staffing ratio. With the low number of registered nurses in America, the patient to nurse ratio has been an essential area of concern that has continually hampered the patient experience within the healthcare sector (Watson et al., 2016). Meleis Middle-Range Transition in Nursing theory is offers best approach in managing the patient nurse ratio challenge in the healthcare sector.
A survey run by various chief nursing officers (CNO) on the nurse supply-demand shows a worrying trend of the continued shortage of registered nurses and the devastating effect this has had on patient care outcomes ( Buerhaus et al., 2017) . The healthcare organizations have an uphill task finding the type of nurses that they need within their facilities. The low patient to nurse staffing ratio may make the nurses feel overstretched, and as a result, the feeling of lethargy and burnout sets in ( Driscoll et al., 2018) . The inadequate number of nurses within the healthcare sector is a considerable hindrance to patient safety. The overstretched and physically drained nurses cannot adequately address the needs of the patients at personal levels ( Driscoll et al., 2018) . The nurse shortage has a devastating effect on patient satisfaction and focused patient care.
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Nursing shortages also led to medical errors that arise out of lethargy and long working hours. The medical errors have led to fatalities and, in some cases, led to the development of new health complications, not to mention the high morbidity rates ( Driscoll et al., 2018) . The challenges of replacing the high number of experienced retiring nurses have only made matters worse. During emergencies, patients have had to contend with long waiting hours for service, skipped drug administration and, in some cases, lack of nurse efforts to follow up on their progress ( Watson et al., 2016) . Some nurses have had to extend their year of service just to ensure that their families are cared for. The delayed retirement has not made matters any better since the aged nurses are not as fast as the freshly graduated nurses.
Middle range theories in the nursing profession seek to connect the various nursing theories with the nursing practice. Meleis transition theory appears to be the best middle-range nursing practice that is most meaningful in addressing the patient care concerns of low patient to nurse staffing ratio concerns. The variable and different fluctuations in the patient acuity and the registered nurse shortages in the healthcare sector have made the staffing ratio to be an uphill task ( Meleis, 2015) . The Meleis nursing transition theories set in to address the concerns that could arise from the nurse staffing within the healthcare sector. The Meleis transition theory also discusses the relevance of patient care from the onset of the admission to the point of discharge ( Brandão, 2017) . With the full understanding that the adequate patient-to-nurse ratio is the foundation of proper nursing care, the Meleis transition theory helps to focus on some of the factors that hinder the transition of the various nursing practitioners from the college to the hospitals.
A critical understanding of the transition theory gives an element of addressing the staffing concerns that will assure patient safety. The right patient to nurse staffing ration leads to enhancement of patient satisfaction, reduced medical errors, increased outcomes with lowered incidents such as falls and pressure ulcers as well as lower patient costs ( Meleis, 2015) . The transition theory recommends an increased patent to nurse staffing ratio by motivating the nurses through the issuance of per diems, having the 13-week contract nurses, incorporating various compensations such as overtime payments and other incentives to the nurses ( Meleis, 2015) . The overall benefit of these measures is to ensure that the nurses feel safe within the working environment, and as a result, they give their best.
The Meleis transition theory also recommends for the increased patient-to-nurse staffing ratio by offering extensive transition between work and life balances. The transition theory supports the change in the recruitment strategies that provide flexibility between the nurses' schedules in line with work-life balances ( Meleis, 2015) . When nurses feel that they have the freedom to practice their careers as well as attend to their social needs, they will be willing to take up the nursing roles and, as such, reduce the mortalities and morbidities that are synonymous with low nurse-patient ratio.
The Meleis transition theory also identifies retention strategies as one of the best ways to manage the low nurse-patient ratio concerns. In this case, therefore, it is vital to ensure that the experienced nurses are given growth within the healthcare instead of letting them leave ( Brandão, 2017) . Qualified nurses are the backbone of an increased patient care outcome ( Meleis, 2015) . Also, the increase in patient care outcome strategies in line with the transition theory may see the hiring of nurses with specific expertise and experiences in a particular field to address the needs of the patients within the healthcare. All these measures are sure to solve the concerns surrounding the patient to nurse ratio, which, as a result, leads to improved patient care outcomes.
Conclusion
Low patient to nurse staffing ratio impacts negatively on the patient experiences within the healthcare sector. The nurse staffing concerns have seen the rise in the cases of medical errors leading to mortalities within the healthcare sector. The middle-range Meleis transition theory recommends ways of addressing the ratio concerns as a result of increasing the patient care outcome, as discussed by the research.
References
Brandão, M. A. G., Martins, J. S. A., Peixoto, M. D. A. P., Lopes, R. O. P., & Primo, C. C. (2017). Theoretical and methodological reflections for the construction of middle-range nursing theories. Texto Contexto Enferm [Internet] , 26 (4), e1420017.
Buerhaus, P. I., Donelan, K., Ulrich, B. T., Norman, L., DesRoches, C., & Dittus, R. (2017). Impact of the nurse shortage on hospital patient care: comparative perspectives. Health affairs , 26 (3), 853-862.
Driscoll, A., Grant, M. J., Carroll, D., Dalton, S., Deaton, C., Jones, I., ... & Astin, F. (2018). The effect of nurse-to-patient ratios on nurse-sensitive patient outcomes in acute specialist units: a systematic review and meta-analysis. European Journal of Cardiovascular Nursing , 17 (1), 6-22.
Meleis, A. I. (2015). Transitions theory. Nursing theories and nursing practice , 4 , 361-380.
Watson, S. I., Arulampalam, W., Petrou, S., Marlow, N., Morgan, A. S., Draper, E. S., & Modi, N. (2016). The effects of a one-to-one nurse-to-patient ratio on the mortality rate in neonatal intensive care: a retrospective, longitudinal, population-based study. Archives of Disease in Childhood-Fetal and Neonatal Edition , 101 (3), F195-F200.
