smoke coming out of my ears!!!

  1. alright everybody....i came across this in the paper and the last 2 paragraphs have me fuming....:angryfire as usual, i was turning to you guys to find out your thoughts on this.

    for those of you who don't want to read the whole is what has me so angry!!!

    "Andrew Snyder, spokesman for Porter Memorial Health System, said an adequate number of nurses can never replace the comforting opinion of a patient's doctor or word of mouth.

    "Both of those carry a heck of a lot more weight than a bunch of numbers," Snyder said."


    Study shows more RNs make for healthier hospitals
    PHOTO CAPTION: Donna Lewis-Allen, a registered nurse at St. Anthony Medical Center, checks on patient Edward Teffeau of Lowell during his stay at the Crown Point hospital. (John Luke / The Times)

    BY JERRY DAVICH Times Staff Writer
    Posted on Monday, July 8, 2002

    A higher percentage of registered nurses in a hospital equates to healthier patients, shorter stays and lives saved from deadly complications, a new study confirmed.

    However, local hospitals will not reveal their true patient-nurse ratios. In fact, except for St. Anthony Medical Center in Crown Point, local hospitals will not even discuss how many nurses they employ compared to the number of patients they treat.

    The study, conducted by Jack Needleman, with the Harvard School of Public Health, found hospital stays are 3 percent to 5 percent shorter when nursing levels are high, and the best-staffed hospitals in the study averaged 2.7 patients per nurse, while the lower ones averaged 3.8.

    Needleman estimates that hundreds, if not thousands, of deaths each year stem directly from low nursing levels.

    And it's registered nurses -- the most highly skilled -- who can curb this trend and who can be the best advertising for hospitals. This is especially true in a region like ours, which has more open hospital beds than it does patients in need.

    The study found no health benefits from more care by either licensed practical nurses or aides, but Carol Schuster from St. Anthony Medical Center doesn't agree.

    "We firmly believe that these important health providers do make a difference," even if it's not in identifying serious complications, said Schuster, associate vice president of patient care services.

    But, she noted, St. Anthony does not use LPNs or aides in its intensive care or critical care units.

    Unlike other hospitals in the area, Schuster freely offered St. Anthony's nursing numbers: Overall, the hospital employs 433 RNs, 31 LPNs and 63 patient care assistants, with a daily average of 108 patients.

    But Schuster pointed out that any comparison to the Harvard study would be "misleading" because the study corrected for differences in patients and their diagnoses.

    St. Anthony encourages patients and their families to call with staffing questions. "And some people do," she said.

    Needleman said nurses are the eyes and ears of the hospital. But observation requires time at the bedside. "Low nurse staffing is a serious problem at many hospitals. It can have severe consequences for patients."

    The study showed those consequences to include hospital-acquired pneumonia, shock and cardiac arrest, gastrointestinal bleeding, urinary tract infections and deep venous thrombosis (blood clots).

    The death rate also was nearly 3 percent higher for "failure to rescue," a term used to describe a patient's death from these complications.

    The results were culled from 1997 data involving 799 hospitals in 11 states (covering more than 6 million patient discharges). It was analyzed to determine how staffing levels of RNs, LPNs and nursing aides compared with patient complications during their hospital stay.

    The study, the most comprehensive to date, came as no surprise to nursing groups.

    "These findings reinforce what we already know," said Mary E. Foley of the American Nurses Association.

    Because of this, the ANA currently is lobbying Congress for passage of the Nurse Reinvestment Act, which will provide scholarships for nursing students and fund stronger recruitment programs. The bill is expected to pass any day now, according to Erin McKeon, from the ANA's government affairs office.

    No local numbers available

    Do patients ask about nursing numbers? It appears not to be a priority -- yet.

    "Most of the time, in this acute care setting, people are concerned with what is happening directly to them, such as procedures, medications and consultations with doctors," said Donna Lewis-Allen, a St. Anthony RN.

    However, as a patient's length of stay stretches out, they begin to feel better and develop a relationship with the nurses. "It's then they begin to inquire about our work environment," she said.

    Lewis-Allen, who works in cardiac care, has been a nurse at St. Anthony for five years. But some RNs have been there since the hospital opened in 1974, she said.

    "There is a family atmosphere here, and many of my patients say they wouldn't go to any other hospital. To me, that is the best advertising."

    Local hospitals defend their refusal to discuss nurse-patient ratios by noting that many factors besides nursing come into play when choosing a hospital, including emergency admissions, specific equipment needed and physician referrals.

    "Rather than across-the-board nursing ratios, patient care is a process depending on the needs of the patient," said Mary Vidaurri, senior vice president at Ingalls Memorial Hospital in Harvey, Ill.

    RNs at Community Healthcare System hospitals are responsible for all aspects of direct patient care, while LPNs provide some care under the supervision of an RN, and nursing aides assist with daily activities like feeding and bathing patients, spokeswoman Mylinda Cane said.

    "The staffing levels of the hospitals of the Community Healthcare System are well within regional and national benchmarks," Cane said. "Also, turnover rates at all three Community hospitals are below national averages."

    The Methodist Hospitals have a "patient concern" program that offers a 24-hour help line to patients. That number is (219) 886-4290.

    "Concerns are forwarded to appropriate managers, who then contact the patient," spokeswoman Carole Biancardi said.

    St. Margaret Mercy Healthcare Centers President Gene Diamond did his own analysis of the Harvard study, finding that RNs composed an average of 68 percent of the nursing staff in the 799 hospitals surveyed in 1997.

    But this 5-year-old data was "equalized," he noted, taking into account variations in patient population.

    "Those variations, however, may not be comparable to the patient population we care for at St. Margaret Mercy," Diamond said.

    Regardless, St. Margaret Mercy's two local hospitals both exceed the 68 percent average, he said, "with at least 72 percent of our nursing staff comprised of RNs."

    St. Anthony's Schuster said nurse-patient ratios do not underscore the importance of patient care outcomes. These outcomes, which include having a proficient, competent nursing staff, "go well beyond the numbers," she said.

    Controversy may grow

    In short, local hospitals say shopping for nursing numbers shouldn't be the lone criteria. Even Needleman admitted nurse staffing is an "incomplete measure" of judging hospitals.

    "I would not try to get ratio numbers and interpret them. That can be confusing," he said. "I would have a family member or close friend stay in the hospital as a patient advocate.

    "The idea of fixed minimum staffing numbers remains controversial," he said. "Better we press for all hospitals to have adequate nurse staffing than think consumer pressure is going to protect our families when we need to be hospitalized.

    "Patient empowerment is great, but sometimes empowerment must be directed toward collective action, not individual behavior."

    The study is expected to raise concerns over the country's growing nursing shortage. Needleman hopes it prompts action from hospitals, hospital accreditation agencies, public and private payers and public policy makers.

    "Patients and citizens should be pressing these organizations and agencies to assure adequate staffing."

    But, the study also is expected to intensify pressure on hospitals in disclosing nursing staff numbers to the public, offering choosy consumers a new way to "kick the tires" of a hospital.

    In at least one state, Pennsylvania, hospitals must report staffing levels to the state's health department, and the information also is available to the public under freedom of information laws.

    Andrew Snyder, spokesman for Porter Memorial Health System, said an adequate number of nurses can never replace the comforting opinion of a patient's doctor or word of mouth.

    "Both of those carry a heck of a lot more weight than a bunch of numbers," Snyder said.

    Jerry Davich can be reached at or (219) 933-3243.
  2. Visit shannonRN profile page

    About shannonRN

    Joined: Oct '01; Posts: 523; Likes: 37
    onc/heme rn


  3. by   Qwiigley
    Just plain ignorance. What, was that guy a new resident? He'll learn. Don't get too upset, he'll get his. When one of his patients goes south and he doesn't have a bed in the ICU 'cuz there aren't enough nurses to care for them. ETC.... Don't get your blood pressure up. Eventually they all learn.
  4. by   MollyJ
    I'd say Andrew is tap dancing around the issue because it is obvious he doesn't want to talk about their nurse patient ratios.

    But maybe Andrew is right. Maybe all we really need to do is tape record doctors saying comforting things (like, maybe, the "Our Father") AND when the too few nurses for the job can't make it to the patient's bedside--to assist them in getting up, to answer their complaint of pain, to evaluate their increased post-procedure bleeding--they can play the tape recording of their doctor.

  5. by   Gomer
    Might I suggest that anyone reading ShannonRN's message take note that at the bottom of the article is the writer's e-mail address -- maybe everyone responding here could "cut & paste" their response and e-mail it to Jerry Davich.

    I plan to, as soon as I calm down a little. I doubt if he will publish what I'm thinking right now -- #@!&*%!?"!(!!
  6. by   RNPD
    OK maybe I am dense here, but what the heck does it mean? I get the "comforting opinion of a patient's doctor" (like when he or she delivers a devastating dx and then runs on to the next payor-er, I mean patient, leaving the "numbers" (read nurses) to deal with the fallout). But what the heck does "word of mouth" mean in this context?
  7. by   fedupnurse
    Gomer you took the words right out of my mouth! Clearly this "spokesperson" is a six figure exec!!!!
    We can't get the docs to go in the room let alone offer encouraging words!!!!! PHUUULLEEEEEEZZZE!!!!!!
  8. by   fedupnurse
    I would think word of mouth advertising.
  9. by   Amy ER Nurse
    I would think word of mouth is the experiences of patients related to others. " I was a patient in hosp. X, and you can't ever get a nurse in there to help you!"
  10. by   shannonRN
    so far i haven't sent a copy of the letter with my thoughts to the ANA. i intend to write to both the hospital and the newspaper by the end of the week. MollyJ, i couldn't have said it better myself. I quoted you in my article to the ANA!!! :wink2:
  11. by   nell
    Once again, we and all of the comforting, caring, life-saving things we do have been reduced to just "a bunch of numbers". Yeah, we're a dime a dozen.

    Methinks the nurse-to-patient ratios at Porter Memorial Health System are likely to be much less than adequate, and probably due in part to the attitudes of suits like "Mr. Spokesman" .

    Another management guy that just doesn't get it.
  12. by   P_RN
    The results were culled from 1997 data involving 799 hospitals in 11 states (covering more than 6 million patient discharges). It was analyzed to determine how staffing levels of RNs, LPNs and nursing aides compared with patient complications during their hospital stay.
    We've all seen this study before. I think he just needed a "nursing shortage article" of 500 words or so. Shoot the study is FIVE years old. Has any one read one of these articles lately that WASN'T a re-hash of all the earlier cra* ???
  13. by   RNPD
    Thanks for all who explained "word of mouth" to me. It now seems so obvious-but then it always does when someone explains it first!

    I would think however that "word of mouth" must paint a pretty poor picture at that hospital, if the "numbers" don't add up!
  14. by   pacernurse
    Ok, of the "433 RNs, 31 LPNs, and 63 PCAs", how many are are managers and how many are actually at the bedside? Also, what happens when the "average daily" total of patients goes over 108? So many questions, so few answers.

    The problem is no matter how many studies say that RNs reduce the patient's length of stay and how they do affect long term costs, the suits will never listen because they still see nurses as a large, wasteful labor pool that they can cut to save money in the short term.

    As far as the stupid idiot saying MDs and word of mouth are more comforting than a nurse. Nothing. We shouldn't bother with people who so clearly don't get it and probably never will.