The American Gazette

Commonsense political and social commentary from "Flyover Country"

Location: Rural Michigan, United States

Monday, October 11, 2004

Massachusetts State Senator Blasts Mass. Nurses attempt to institute minimum staffing guidelines

State Senator Richard Moore(D) disputes something that nurses have been saying is needed for years, that we need specific guidelines that give a patient to staff ratio. Without specific guidelines any hospital in the country can make a nurse take an unsafe patient load. The idea of specific patient to staff ratio's are based on patient safety. Believe it or not there are facilities throughout the country that have nurses taking care of three or four patients in an ICU. Having been a neuro ICU nurse I can unequivically tell any politician from either side of the aisle that is highly inappropriate. Depending on the acuity of the patient more than one may be inappropriate. Many are the nights I remember sitting in a patients room for my entire 12 hour shift because their condition was simply too unstable for me to be able to leave. And yes that meant no bathroom breaks and no dinner. In facilities throughout the country med-surg nurses are taking 8 and more patients. When my own dad was in Baptist Memorial Hospital in Memphis Tennessee in 2000 his nurse had 14 patients, on a surgical oncology floor, a patient to staff ratio that is so highly unsafe that it boggled my mind. The care my dad received was horrid. While his floor was staffed the way it was, the hospital was busy building a "state of the art cardiac center" designed to make Baptist Memorial THE place to go for cardiac care. The new area of the hospital would bring the bed count to over a 1000 beds. However what I could not and still do not understand was if the hospital was having difficulty staffing other floors appropriately then who was going to staff this wonderful state of the art cardiac care area? Or could it be that the hospital was deliberately scimping on staff in order to put money into this cardiac area? My money was on the latter.
Some hospitals have instituted internal patient to staff ratios, something my own facility has done to a degree, however it is not on all floors, and covers primarily only those areas that are considered ICU or in my case pre and post cardiac cath related to high risk of bleeding.
A study concerning patient to staff ratio's was done about a year and a half ago. It shows that for every patient on a med-surg floor that a nurse takes beyond 4 that the risk of patient mortality and morbidity increases by 7%.
Politicians need to listen to those who do the care. We know what we need in order to achieve the best patient outcomes. Running literally from room to room without opportunity for breaks or dinner does not enhance patient care, it also drives nurses out of the profession exacerabating an already severe problem. Next time your in the hospital either yourself or as a visitor ask the nurse how many patients she has, ask if she gets time to go to the bathroom, ask if she managed a lunch or a dinner. If you have a nurse who is not scared to speak out the answers you get may surprise you.



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