Dying For Lack Of Nurses

[-jt]

Today's New York Times Editorial, based on the JAMA research article,

http://www.nytimes.com/2002/10/25/opinion/25FRI3.html?pagewanted=print&position=top

Dying for Lack of Nurses

October 25, 2002

A report in this week's Journal of the American Medical Association says that when hospital nurses are given too many patients to care for, the patients have a much greater risk of dying. That may seem self-evident, but it has been surprisingly difficult to establish that patients suffer harm when a nurse's patient load goes up.

Equally surprising is how little it takes to put patients in danger. Adding a single patient to a nurse's caseload seems to increase the risk of dying within 30 days by 7 percent. If a hospital increases the average nurse's patient load from four patients to six, the patients have a 14 percent greater chance of dying. Boost the patient load to eight, and the risk is 31 percent greater than with four patients per nurse. As the patient load goes up, nurse burnout rises and nurses leave their jobs.

These findings come from a study of 168 hospitals in Pennsylvania conducted by nursing researchers from the University of Pennsylvania under a grant from the National Institute of Nursing Research, a federal agency. While its results may seem a touch self-serving to the nursing profession, they are viewed as reliable.

The study questioned some 10,000 nurses and reviewed the outcomes for more than 232,000 patients who underwent common surgical procedures. High nursing patient loads may account for 20,000 unnecessary deaths a year, the researchers suggest.

There is no easy solution. The nursing work force is aging, and hospitals are confronting a severe shortage of nurses. Many institutions are resorting to signing bonuses, hiring from abroad, demanding overtime from their own nurses or using temporary nurses at a higher cost than for staff nurses.

One simple solution would be to make hospitals report their patient-nurse ratios so that prospective patients can decide where to take their chances.

(ed. An New York State Nurses Assoc, American Nurses Association, and United American Nurses initiative, with bills requiring facilities to publicly report their staffing ratios currently pending in the state & national legislatures)

Nurses complain of low pay, heavy workloads, lack of opportunity and a demeaning relationship with physicians. Women, traditionally the backbone of the nursing profession, have many more opportunities today. If the medical establishment can't find some way to make the profession more attractive, the exodus may turn into a stampede.

# # #

I just love how everybody keeps saying we're "aging". Ok so we all know that the majority of us are in our 40's & if the employers know it too, why are they still resisting doing anything to make the physical labor of the job easier on our "old" bodies so we can continue to work? Availability of ergonomic equipment & support staff would help keep a lot of these "aging" nurses at the bedside.

nurses are encouraged to send their comments to the NY Times:

[email protected]

[canoehead, BSN, RN]

Thank you for the article, finally a reputable study. I plan on printing it off and sharing it with TPTB at my hospital.

[l.rae]

l don't think tptb care as long as they bring home the fat pay check......LR

[Youda]

Here's an email I just sent to a reporter at our local paper:

---------------

I am writing to you because I met you once when you were working on a story.

If this subject isn't of interest to you, perhaps you will pass it on?

From time to time, the _________ has carried stories about poor patient

care in nursing homes. But, did you realize that people are dying because

of it?

http://jama.ama-assn.org/issues/v288n16/rfull/joc20547.html

There's been a lot said recently about the nursing shortage. Do you

understand why there is a shortage of nurses? Do you understand why there

is poor care in hospitals and nursing homes? When the ______ covers these

stories, why haven't you asked the nurses who have left, why they left the

particular nursing home or facility or hospital?

The simple truth is that there is NOT a shortage of nurses or staffing;

there is simply a shortage of nurses willing to work in nursing anymore.

Studies have been done which show this without doubt!

Retaliation to those who report poor care, poor working conditions, heavy

workloads, poor benefits, poor wages compared with other occupations,

mandatory overtime, burn-out, etc. all contribute to the problem.

Ironically, during this same time, large corporations are showing record

profits. Legislation and watch dog agencies have no way to enforce

standards of care because these large corporations expect to be sued and

fined, so they keep large "liability accounts" to pay off the results of the

poor care: the harm and deaths.

Profit is the ends and the means with consolidation of health care

corporations quickly causing a monopoly not unlike a Microsoft situation,

where a few very strong healthcare corporations are beginning to control the

entire industry. Studies have been done which show this!

Healthcare is one of the few "profit" industries that are consistently

allowed to produce an unsafe, inferior "product." Firestone came under great

disrepute for doing this. Enron did, too. If Chrysler manufactured an

automobile that killed people because it was manufactured so substandard

that it caused many, provable deaths, there would be such a public outcry .

. . Or what if the pharmaceutical industry produced a medication that was

causing provable deaths? Would the FDA respond? Would there be class-action

lawsuits? You bet!

But, in healthcare, the end "product" is the same: provable deaths. Yet,

Congress consistently makes great speeches (when CNN or primetime CSPAN is

there), but their sole contribution to this issue in the 107th Congress was

to pass the Nurse Reinvestment Act, a bill without clear appropriation for

it. The rest of the bills to benefit nurses that were introduced in the

107th Congress will quietly go away at the urging of the lobbyists and PACs

of the huge healthcare corporations unless a lot of people start hollering

very loudly and very persistently.

The public is blissfully unaware that their lives are in jeapordy the moment

they need health care. They trust the hospitals and nursing homes to take

care of their health needs, but these are needs that cannot be met.

The issue of the nursing shortage and the reasons for it affect the safety

of the entire population! The plight of nurses affect every man, woman, and

child in this country; yet this issue is consistently ignored in the media.

Frequently, this is because major advertizers are the very healthcare

corporations who perpetuate the problem. Why alienate your advertizers?

Because people are dying.

The public has got to be educated. At this point, they accept the deaths of

their loved ones as inevitable and do not see the root cause of these

premature deaths, nor can they understand the sequence of events that led up

to them . . . simply because they aren't nurses.

This is the biggest travesty, the biggest fraud, ever perpetrated upon the

public. It is tantamount to mass murder, or at least mass negligent

homicides. Yet, the investors of these corporations are still going to get

their quarterly dividend check, their blood money.

Something is seriously wrong here.

Where else in America is a corporation or industry allowed to cause deaths

because of a greedy run for profit, without the slightest conscious?

The studies have been done. Yet, the public remains complacent, and the

media unresponsive.

If I can help you with more data, studies, information, please email me.

[NRSKarenRN, BSN, RN]

GREAT REPLY!

[UKRNinUSA, RN]

I emailed "Dateline NBC" consumer investigative reporting with a few comments and the pdf file of the nursing shortage study and the corresponding JAMA editorial, asking them to do an investigation of the matter and to interview nurses for the real cause of the nursing shortage.

[-jt]

WOW! It looks like the Allnurses "PAC" is getting a movement started!

Karen, Great idea to start this section of the website way back when!

[jnette, ASN, EMT-I]

Ahhhhhhhh.. you guys ROCK !!!

I feel the old activist blood stirring again.... once again the pen is mightier than the sword....

Keep it coming, I'm getting hooked !