Editorial: Fixed Nurse-Patient Ratios Are Needed In More Than Just The ICU

From WGBH Boston: http://wgbhnews.org/post/fixed-nurse-patient-ratios-are-needed-more-just-icu

 

By Callie Crossley

If you have ever had a loved one in a hospital intensive care unit, you know. In that sterile scary room, the nurse can be the most important person.

She or he is a steady presence — deftly monitoring the mountain of tubes and beeping machines, while at the same time calming frightened families and friends.

I can remember what it was like being in that emotional and physical space. It’s a scene still emblazoned in my memory — my family and I standing at the draped hospital bed praying out loud that my dad would be okay. He lay there unconscious and unmoving, suffering complications from heart surgery. The intensive care nurse assigned to him focused on him alone. We were comforted that should anything happen, she could respond in an instant.

What my father and my family experienced so long ago in Tennessee was the norm — one nurse for one patient in intensive care. Until recently, it was also the model in most states, including Massachusetts. But hospital staff reductions and the national effort to control health care spending have turned one nurse/one patient into what’s been labeled as a luxury.

Several studies have demonstrated that focused nursing care reduces patient injuries and improves overall quality of care. The Massachusetts Nurses Association warned patient care would suffer if hospitals reduced nursing staff. The state’s largest nursing union gathered enough signatures to put two initiatives on this November’s ballot, one to set limits on staffing ratios, and another to require transparency about CEO salaries.

There were biting radio and TV advertisements aimed at the Massachusetts Hospital Association. The ads state, “Taxpayers have the right to know if their tax dollars are paying for patient care or million-dollar salaries for hospital CEOs.” Not surprisingly, the Mass. Hospital Association called the ads “misleading and irresponsible” and noted that fixed staff ratios would restrict the hospital’s flexibility to adjust staffing for sicker or more stable patients.

The nurses’ arguments won over the state legislature. Governor Deval Patrick quietly signed the bill last week, but only after the Nurses Association agreed to drop both ballot initiatives. Under the compromise victory, an intensive care nurse — now by law — can be assigned no more than one critically ill patient. However, ICU nurses can add another patient if they assess the first patient would not be endangered.

By the time he left the hospital, my dad knew the names of all of the nurses who cared for him. He enjoyed a full and rich life for more than a decade.

The Massachusetts Nursing Association plans to push for fixed nursing ratios in all hospital areas outside of the ICU, a law now only in California. Nurses here feel they have a strong case to pitch to the public. They can count on my support, an appreciative vote in memory of Samuel Crossley.

Callie Crossley is the host of ‘Under the Radar with Callie Crossley’.

Patient Story

arlene townsend staffing award

Unsafe staffing costs a Florida facility $1 billion

From Trial Magazine, March 2014 issue: Trial Magazine, 3/11/14 VERDICTS & SETTLEMENTS Arlene Townsend, 63 suffered a stroke and required 24-hour care. She was admitted to Auburndale Oaks Healthcare Center, a nursing home owned by Trans Healthcare, Inc. In the three years leading up to her death, Townsend suffered numerous fall resulting in broken bones and lacerations, infections, significant weight loss, chronic constipation, skin breakdowns, dehydration, and other problems. She is survived by her adult son. Townsend’s estate sued Trans Healthcare, alleging that it had understaffed the nursing home to increase profits and failed to provide adequate care, including protecting Townsend from falls, ensuring a safe environment, and documenting changes to her condition. The court entered a judgment of liability against the defendant, and the…
Read More