Healthcare workers and in particular, nurses, have been a hot topic of discussion since the beginning of the pandemic back in March of 2020. Healthcare workers endured strained working conditions, high patient volume and acuity, and were supported with dwindling supplies of PPE (personal protective equipment) with which to deliver care.
These were widespread concerns noted across hospital systems throughout the United States. What was further highlighted by this pandemic was an already overwrought hospital work force and a decreasing number at that. COVID-19 served only to emphasize an ongoing issue, the nursing shortage and safe staffing ratios.
Having the ability to call on this system for support is vital. The pandemic revealed the importance of having strong and capable hospital systems and work forces. Nurses make up a large part of that hospital work force. The Bureau of Labor Statistics estimated that nurses made up approximately 30% of the hospital employment across the United States in 2019. After the COVID-19 pandemic of 2020 there was a 1% decrease in that number.
It is true that a collaborative network of personnel exists within the hospital infrastructure, all working together to ensure the highest quality of patient care. The nurse exists separately somehow. He or she is as an ever-present fixture throughout the inpatient care stay. While other specialties and services come and go during the length of stay, the nurses remain. They remain at the bedside monitoring, assessing, collaborating with providers, and administering treatment plan of care.
Where this ability of care is diminished is seen when the nurse’s tasks and demands are too great a feat to meet. A medication is delayed or a change in patient condition goes unnoticed. The nurse has too many patients to oversee and care for. In a systematic review, medical centers across Illinois reported data that nurse to patient ratio limits could decrease patient risk and mortality, decrease length of stay and serve to reduce hospital costs.
This could mean the difference in the nurse’s availability to quickly identify changes associated with heart attack. Or have the availability to assist in getting the patient to the bathroom safely and prevent a patient fall. Patient safety and outcomes are always a highlight when considering nurse to patient ratios but moreover, there is improvement to be considered in the working conditions of the nurses themselves.
Research from Marshall University notes when nurse-to-patient ratios are too great, there is a negative impact on the psychological and physical health of the nurse that is directly associated to poor patient outcomes. The conditions under which nurses have been asked to work can continue no longer. There are times when nurses are not able to take lunch, bathroom breaks or even get a drink of water until the very end of his or her shift.
Nurses are compassionate individuals, driven to a career aimed at caring and serving others. Who is caring for the nurses? Would other professions accept this as appropriate working circumstances? The argument that nurses somehow “chose” this profession and understood its requirements is one that is outdated and flawed.
It’s failure? This myopic viewpoint, one that cries the individuals knew what they were getting into ahead of time, will not serve to persuade individuals to stay within the profession any more than it will encourage those to enter. One percent of nurses have already left and the future nursing requirement only grows, how many more will be forced into leaving?
Currently there exists no federal legislation mandating nurse to patient staffing ratios. California and Massachusetts are the only states with legislation dictating nurse staffing ratios based on unit specialty. S. 1567 is a bill introduced to the Senate in May of 2021 proposing the establishment of safe nurse-to-patient staffing regulation for hospitals. Safe staffing for nurses affects the community whether it is experienced on a day-to-day level or only in those times of emergent need.
In that time of need do you want your nurse there? Do you want him or her to be able to provide the appropriate and required attention that is deserved when you enter those hospital doors? You do. Ask your local congressmen to support the S. 1567 legislation and the nurses caring for our communities. Doing so supports patients, both current and future, and the nurses that aid them. One day you may need those nurses too.
Megan Livesey lives in Marlborough.