What if you knew about a problem that makes patients have to stay in hospitals longer, suffer more infections, and make it more likely they’ll need to come back for more treatment? That makes nurses unhappier at their work, and more likely to suffer burnout? That actually makes more patients die? What would you do? Would you take to the streets?
“Nurse-to-patient ratios” is a dry term for a big problem. When one nurse has to take care of more than four patients, one study showed, the likelihood of the patient dying within 30 days increased by 7% for each extra patient. A massive, more recent study showed that the average patient experiences three shifts where nurses are clearly understaffed, and with each of those shifts their mortality risk grew by 2%. That’s 6% in total – for an average patient. Those who stayed in hospital longer were also confronted with more understaffed shifts, and suffered the consequences.
Separately, the study also found an even steeper danger during shifts where nurses had to deal with especially high patient turnover – those increased the risk of death by 4% each!
#NursesTakeDC rally, this Thursday: what are they doing, and what do they want?
A group of active nurses is saying “Enough is enough”, and they will take their message to the U.S. Capitol Building: #NursesTakeDC! We wrote about them last year: Nurses take DC! Marching for safer nurse-to-patient ratios. But they’re going to keep hammering the message home. This Thursday, they will hold a “National Rally for Nurse: Patient Ratios Now”.
Their aim: tell Congress it should pass a bill that forces hospitals to follow minimum nurse-to-patient staffing ratios. The bill, which is stuck in both the Senate and the House right now, would regulate just how many patients can be assigned to a single nurse during a shift.
That number would depend on the kind of care the patients need, of course. For example, the bill suggests, no more than two patients per ICU Registered Nurse, four patients per med-surg nurse, or six patients per postpartum nurse. These minimal standards would also require Registered Nurses with demonstrated unit-specific competence. Beyond that, RNs, LPNs, CNAs and other additional staff could still be assigned based on patient acuity or other needs.
#NursesTakeDC wants to push for change inside as well as outside, so participants have been busy trying to make appointments with members of Congress and their staff too. They want to tell them in person how important they think it is to establish minimum standards by law.
Advocating for better laws and policies isn’t always easy – if you’re just a regular person, you’ll need all the tools and info you can get. That’s why nurses, NPs, CNAs and student nurses can also already take part in a seminar tomorrow, where they can learn how you can make more of a difference as nursing advocate.
An issue that will not go away
The issue these nurses raise are real, and they are only going to become more urgent. Today’s patients are not the same as those of a generation ago. The US population is aging. Health care facilities have been able to cut the amount of time patients stay for treatment. Both those developments mean that the average patient now is more likely to have especially complex and chronic health problems, and need more intensive nursing care. Making sure there are always enough nurses at the bedside is literally a matter of life and death!
Just like #NursesTakeDC, organisations such as National Nurses United want Congress to pass the Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act. That would make all of the US follow California’s example of imposing minimum nurse-to-patient ratios. But not everyone has been on board with this cause. The American Nurses Association (ANA) has long argued for more flexible solutions, and relying on nurse staffing plans and a greater representation of nurses on hospital committees to achieve them.
This position has upset other nurses, however, who feel safe staffing plans are inadequate. They think imposing a minimum nurse-patient ratio still leaves plenty of room for additional, flexible arrangements:
Do you want safe RN:patient ratios that are shown to save your patients' lives? Contact your senators today & inform…
Posted by Amanda Brown Conti on Thursday, June 23, 2016
Who do you think is right? Are mandatory ratios the way to go? Or are they too blunt a tool for the complexity of nursing care, and should we keep trying other strategies? What else do you think could be done?
If you agree with NursesTakeDC, check out the program for the rally and other activities. There are not just one, but two Facebook groups for nurses preparing for the event. If you can’t make it this time, but you’d like to stay up-to-date with their activities, you can follow their Facebook page or Twitter account.
Here at NurseRecruiter.com, we have been writing about safe nurse-to-patient ratios and union protests for higher staffing levels for years, and we’ll keep doing so. Let us know your take on the problem in the comments here, or on our Facebook, Twitter or LinkedIn posts!
Cat Richards
Why just hospitals? Why not nursing homes or assisted living? The documentation alone is a reason to have higher ratios. Nurses spend more time documenting than with their patients.
Joost
You’re right of course, Cat. The issue is as relevant for nursing homes and other healthcare institutions as for hospitals!
Teresa Combs
We need more nurses. Nursing home care needs a big change with patient nursing ratio.
Linda C. Proffitt
“Safe staffing” will not work. Hospitals are controlled by business people instead of medical people. They do not understand acuity. They want to make money. We need a MANDATORY patient to nurse ratio. So called “safe staffing” will be continuously abused or ignored. We need to think of the patients safety first, but we also need to think of our nurses stress levels to decrease burn out and not put them in situations where their licenses are in jeopardy.