Inadequate Staffing Endangers Nurses and Patients Alike
Good nursing work environments are characterized by positive working relationships between doctors and nurses, active nurse involvement in hospital decision making, management responding to nurse patient care concerns, continuing education programs for nurses and constant quality improvement for patient care programs. While increased nurse staffing greatly improves patient outcomes in hospitals with positive nurse working conditions, it has little to no effect in hospitals that otherwise have poor nurse working conditions. In long-term care facilities, patients with more direct RN time (30 to 40 minutes daily per patient) reported fewer pressure ulcers, acute care hospitalizations, urinary tract infections, urinary catheters, and less deterioration in their ability to perform daily living activities. An earlier analysis produced similar results, showing in 2007 that an increase of one full-time registered nurse in a unit per day would result in nine percent fewer hospital-related deaths in the ICU, 16 percent fewer deaths for surgical patients and six percent fewer deaths for medical patients. These conclusions are backed up by a 2018 meta-analysis of other research, which found for every increase of one nurse, patients had a 14 percent decrease in risk for inhospital mortality. Researchers found significantly better health outcomes in California, including lower surgical mortality rates, reduced inpatient deaths within 30 days of admission and a lower likelihood of death from failing to properly respond to symptoms. The most comprehensive study of the impact of the law came out in 2010 and compared hospitals in California to hospitals in New Jersey and Pennsylvania. Since it was fully implemented in 2004, research specific to California has shown measurably improved patient outcomes, in line with the broader academic consensus about the positive impact of lowering nurse workloads. In 1999, California became the first state to pass a law setting a legal maximum patient-to-nurse staffing ratio in order to improve patient care. Safe Staffing Practices Improve Patient Care Outcomes Unfortunately, staffing problems are only set to get worse as baby boomers age and the demand for health care services grows, making staffing a growing concern for nurses and patients alike.
Adequate nurse staffing is key to improving patient care and nurse retention, while poor staffing endangers patients and drives nurses from the profession. In the face of aggressive cost-cutting, minimum staffing levels are necessary to ensure the safety of patients and nurses. But far too often, nurses are overworked and under-supported as hospital administrators seek to lower costs and boost profits. They provide acute care for patients in emergency rooms and intensive care units and administer medicine and other daily essentials throughout our country’s hospitals. Nurses play an integral role in the health care system.