By Carrie Mortrud, RN
MNA Policy Project Specialist
Last week there was an article, “Nurse staff levels draw hot debate” in the Times Telegram out of New York which addressed the nurse staffing issue in hospitals and nursing homes. The link for the article is provided below.
Same situation, nurses explaining how they cannot provide care to patients because they have too many assigned to them at one time. Followed by the same response of hospital management and administration stating they should make the decisions when it comes to staffing, not a law that provides a minimum standard.
One nurse executive stated that there is a lot of research that proves when there are more nurses on duty better patient outcomes are achieved. She then went on to say that she didn’t believe there was any research that said specific nurse staffing ratios guarantee safety, but we know that measurements of patient safety are included in measuring patient outcomes.
We also know that more nurses means improving patient safety. Respected researchers Linda Aiken and Jack Needleman support this conclusion. Aiken found that a patient’s mortality (within 30 days of hospital admission) increases by 7 percent for each additional patient added to the nurse’s workload. Needleman supports this as well. His research shows each time a patient is exposed to a shift that does not have enough nurses, patient mortality increases by 2 percent. Last time I checked, keeping people alive and successfully discharging them was the goal of most hospitals and healthcare workers.
Hospital administration are supposed to make staffing decisions based on patients’ needs, nurse experience, and nurse skill level, but too often they don’t. Nurses caring for the patients at the time of care know when they have too many. Nurses know a shift or hours in advance that the next shift is not going to have enough nurses. Nurses sometimes know a day in advance and (believe it or not) a month in advance when they aren’t going to have enough nurses to care for the patients. So is this some secret only nurses know and hospital administration is left in the dark? “No.”
It’s managers’ responses to those vacancies and requests for help in the form of more nurses that concern us most. “Do the best you can.” “Cross your fingers no one else comes in tonight.” Or sometimes, no response at all. Managers, and administrators simply walk away. Last year, MNA members reported 2,140 times that managers either gave an inappropriate response like those stated above or no response at all when patient care needed more staff.
Legally a nurse may not abandon their patient(s). A nurse is obligated to give report or hand off the patients to someone as qualified or more qualified than themselves. Yet these comments and behaviors, management seems to believe they can abandon the staff. This is why we a minimum standard on the books. Hospitals do not provide enough nursing staff if it negatively impacts their bottom line.
No more excuses. No more abandoning and ignoring requests. No more needless patient suffering.
Safe Patient Standard Now.