Another Newspaper Article on the Nursing Shortage

Published Oct 1, 2003

296 Posts

Nurse-to-patient ratio is key to shortage, lawmaker says

By: Chad Selweski, Macomb Daily Staff Writer September 29, 2003

A Macomb County nurse-turned-lawmaker hopes to solve the state's nursing shortage by requiring hospitals to follow strict staffing levels.

State Rep. Lisa Wojno believes that legislation mandating a smaller nurse-to-patient ratio at hospitals would improve medical care and reduce the stress and workload that causes nurses to quit the profession.

"There's a direct correlation between the nurse-to-patient ratio and the quality of health care the patient is getting," said Wojno, a Warren Democrat. "We shouldn't be looking at the financial bottom line, we should be looking at the patients' bottom line."

Wojno's bill would amend the public health code to mandate ratios that would vary from one nurse for every two patients in critical care to one nurse for every six patients in the nursery. Wojno served as registered nurse at a hospital for eight years before taking office in January.

Nursing shortages are a problem for hospitals nationwide. According to health care organizations, 45 states have nursing shortages and more than 126,000 nursing positions are unfilled in hospitals across the nation. Some say the shortages are because of stressful workloads, relatively low pay and an aging work force that's retiring at twice the rate of other occupations.

California is the only state that requires specific nursing ratios for hospitals, though legislation has been considered in Pennsylvania and Florida.

Wojno's bill could face fierce opposition from hospital administrators, who say that nursing ratios means hiring more RNs and adding considerable costs. Some facilities could resort to closing some beds to meet the standards, particularly in inner-city hospitals.

Jack Weiner, CEO of the St. Joseph Mercy of Macomb Hospitals in Clinton Township and Mount Clemens, said that Wojno's bill is an unfunded mandate that imposes expensive new rules without additional funding to pay for the added staff.

"It's a disaster. It's an attempt at a solution, but it's a problem-creator," Weiner said. "It doesn't solve the core problem."

Weiner said hospitals have substantially raised salaries, subsidized training and education for nurses, and engaged in recruiting at the junior high and high school levels.

The nursing shortage problem, he said, isn't the result of wages or workload, it's a product of the many new career opportunities in health care that don't relegate women to the nursing profession.

Many hospitals have tried to fill the gaps in the work force by increasing the number of nursing assistants -- who have less education and earn less pay -- on staffs.

Two University of Pennsylvania studies have found a link between the quantity and quality of nurses on staff and the number of patients who suffer medical setbacks or death while in a hospital.

One study released this week found that death rates among surgical patients at 168 Pennsylvania hospitals were nearly twice as high when the percentage of nurses with bachelor's degrees is low.

An earlier study by the University of Pennsylvania found that with each critical care patient added to a nurse's workload there was a corresponding increase in medical care errors and a 7 percent higher chance of patient death within 30 days.

The Michigan Nurses Association, the state's largest nurses union, has negotiated mandatory nursing ratios in several labor contracts. But only 24 percent of RNs in Michigan are unionized.

"Staffing levels are a huge concern," said Carol Feuss, an MNA spokeswoman. "Raising this issue in the Legislature is of great value."

The MNA has also negotiated wage hikes with employers concerned about the keen competition for nurses. At Macomb County's Martha T. Berry Medical Care Facility, the contract reached between the county and the MNA in July calls for a 10.75 percent wage increase for nurses. The county has had difficulty recruiting and retaining nurses.

The Wojno bill is part of a legislative package that includes two other Democratic bills designed to increase unionization in nursing and make it easier to negotiate major raises for nurses.

Wojno said she is willing to compromise on her bill, perhaps by setting up state guidelines for nursing ratios without imposing requirements on hospitals.

"I'm not demanding a mandate, but this is a good place to start," she said. "Obviously, as a nurse, I think this is a very important issue."

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