Standing on the bottom line: Nurses and safe patient ratios
It’s the battle cry of nurses everywhere, ‘Better nurse-to-patient ratios!’
Bottom line is, they’re right. Safe staffing saves lives.
Over the last few years, nurse-to-patient ratios has become a topic of heated discussion with nurses demanding mandated legislation and healthcare institutions screaming in opposition.
When nurses have fewer patients, they can take better care of them. Safe nurse-to-patient staffing ratios allow for nurses to individualize patient care, closely monitor for changes in patient condition, and provide adequate patient education, resulting in lower health care costs, fewer patient injuries and deaths, and a better workplace for nurses. Healthcare institutions have taken a strong stand against mandated legislation, citing millions of dollars of increased labor costs that most hospitals won’t be able to absorb and exacerbating the nation’s nursing shortage, resulting in decreased access to care and increased costs to patients.
Nurses are highly trained. We are skilled and compassionate care providers who take significant pride in doing our jobs well. In the absence of mandated nurse-to-patient ratios, hospitals are at liberty to treat us as a line item on financial spreadsheets, understaffing to increase profit margins.
We work long hours, taking on sometimes dangerous patient care loads– running from one task to the next, often with no breaks. In these situations, we are forced to leave many basic care measures undone, leading to an increase in preventable patient injuries and infections; increasing length of stay and cost of patient care. All of this carries with it an untold emotional burden and overwhelming guilt knowing that for many of our patients we couldn’t do enough. Be enough.
Several years ago, during a busy shift in our neonatal ICU, I was taking care of two babies, each born several months too early, that were only a couple of days old. I was often pulled away from their bedsides to do other tasks such as helping with a new admission and administering feedings for other busy nurses, because my babies were ‘easy.’
I popped over to do their vitals, change their diapers and do a quick visual assessment every three hours when they were due to be fed. The next day, one of the babies was sent out to a tertiary medical center for complications due to a very serious infection. To this day, I carry the guilt of not catching that on my shift. I missed the fact that the isolette was compensating for a fever and that the baby was a little less ‘feisty’ than normal. We were short staffed that night.
When nurses take on too many patients, patients suffer the consequences. According to the most conservative estimates,approximately 250,000 patients die in the U.S. each year from preventable errors. That’s an eye-opening 685 patients a day.
Where then is the bottom line? Facing an already established nursing shortage across our country, nurses are leaving the profession in droves, refusing to work in situations where they are unable to provide proper care to their patients, leaving behind years of experience and expertise due to burnout and job dissatisfaction. New, inexperienced nurses are left without seasoned preceptors. This in itself is a major threat to the healthcare community and their bottom line.
The hospital industry says employing the extra nurses needed to meet ratios would be ‘impossibly expensive.’ But it turns out ratios might not be that bad for hospitals’ bottom lines. Perhaps they could actually save money. Added nurses would prevent expensive patient complications and hospital readmissions to the tune of millions of dollars and save significantly on turnover costs.
It is time to address the legislation supporting minimum nurse-to-patient ratios in hospitals and acute care settings. At the federal level, two bills, Senate Bill 1063 and House Bill 2392 have been recently re-introduced specifying unit-specific RN-to-patient ratios for acute-care hospitals, and common sense mandates allowing nurses to put patients first ‘above all other concerns’. It is imperative to support this legislation and eliminate unsafe nurse staffing practices.
Safe staffing saves lives… a win for everyone’s bottom line.
Amanda Novitski-Juedes RN is a graduate student at the University of Connecticut.
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