Response of the resilient
Creating safe and defined staffing ratios for nurses will promote better patient safety and quality of care
From an outsider’s perspective, nurses are often admired for their strength and courage. However, as a seasoned nurse, I can honestly say these same qualities have been taken advantage of. What sets the nursing role apart from others in the medical field is that its core values revolve around a strict code of ethics and holistic patient centered care. Nurses, inherently put their patients before themselves.
The responsibilities of a nurse are exponentially evolving. Today, they are a patient’s last lifeline. They are the first to recognize and report an acute change, and the last person to double check the correct dose or indication of a medication. They are a patient advocate, therapist, physical therapist, transporter, punching bag and waitress all rolled into one. Now multiply that by 10. Add seven for family members, that at times require as much time and resources as a patient.
However, it seems that the amount of responsibilities expected of a nurse are inversely related to the number of nurses staffed in a given department. Furthermore, staffing is determined by hospital cost-benefit ratio by those very far removed from the bedside. Busy emergency room nurses are responsible for seven to eight patients when a safe maximum should be around four — less if a patient is bound for an ICU admission.
Many institutions have discovered it is more financially beneficial to “mandate” a nurse to stay beyond his or her given shift to cover a staffing shortage than to hire another nurse to fix the staffing problem. The result? Nurses working 16-hour days that are mentally and physically exhausting. Is that someone you would want taking care of your loved one?
Burnout is now becoming a topic of interest, and stress and exhaustion are leading nurses to leave the bedside altogether. This revolving door creates a toxic environment composed of novice nurses and staffing holes. Creating safe and defined staffing ratios for nurses will promote better patient safety and quality of care. In addition, it would combat burnout and keep nurses at the bedside longer, which would save institutions money spent on frequently training new staff.
Efforts to enforce safe staffing ratios in the past have been met by resistance due to concerns of prolonged ED wait times and premature discharge. The thought is that if nurses are limited to only four patients at a time, people will wait longer to be seen and rushed out quicker to allow for the next patient to return. In actuality, patients will wait either way, whether in a room or waiting room, as the more patients a nurse is responsible for, the longer it will take him or her to perform necessary tasks. Hiring more staff to support a four-patient limit would increase nurse speed and productivity.
Numerous studies have shown that when nurse staffing is inadequate patients are at a significantly greater risk for medical errors, infections, longer hospital stays or re-admissions, injuries and death. In a 2015 Massachusetts survey of nurses, 85 percent of nurses said that patient care is suffering directly due to high patient to nurse ratios, 50 percent related understaffing to patient harm and 25 percent related understaffing directly to patient deaths. A 2017 study of 845 critically ill patients found that a high staffing ratio was associated with a substantial (95%) reduction in the odds of survival.
As the role of nursing continues to evolve, staffing solutions should as well. Nurses should be empowered to speak out against unsafe staffing and hold their corresponding organizations accountable. Research repeatedly proves that nurse staffing is directly tied to patient outcomes. It’s time we treat our nurses the way we want them to care for our loved ones.
Please refer to the American Nurses Association for more information on the nursing staffing crisis. The video above was filmed with real nurses, not actors, in Connecticut medical facilities.
Stephanie Fiore is a registered nurse from Cromwell.
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