Tuesday, October 18, 2016
Nursing staffing levels threaten patient care
On the day that I penned this post, I rounded at our community hospital. My first patient was in the step-down unit, which houses patients who are too ill for the regular hospital floor. I spoke to the nurse in order to be briefed on my patient's status. I learned that this nurse was assigned 6 patients to care for, an absurd patient volume for a step-down unit. “Why so many patients?” I asked. She explained that some nurses called off work and the patients had to be spread around among the existing nurses.
This occurs every day in every hospital in the country. Nurses are routinely required to care for more patients than they should because there is a nursing shortage on a particular day. Why do hospital administrators allow this to happen? If any are reading this post, I invite your response. Enlighten us. When a nurse is overburdened, how do you think this affects quality of care and nursing morale?
I suppose it saves a few bucks on payroll, but this strikes me as very short term gain that risks medical and financial consequences. Providing high quality medical care can't be a rushed effort. If a nurse's job description increases by 30%, do you think the quality of care and patient/family satisfaction won't decline? Don't administrators fear the risk of medical errors from overworked nurses? Would any of them like to be patients under these circumstances?
Nurses have confided to me for years how demoralized they are that no one speaks for them. Instead of watching their backs, they often feel that they are stabbed in the back.
I do not have warm feelings for labor unions and I support right to work initiatives. But, when I see what nurses endure and the lack of support that they receive, I would support them if they moved to organize.
If a third grade teacher is ill, we expect a substitute teacher to be called in. The third graders are not simply herded into another classroom expecting 1 teacher to handle a double load.
Many of us today are asked to do more with less. Teachers, law enforcement, businessmen and government program administrators know this well. At some point, you aren't cutting fat anymore, but are slicing into bone. We are not taking proper care of those who have dedicated their lives to care for us. Who will heal the healers?
This post by Michael Kirsch, MD, FACP, appeared at MD Whistleblower. Dr. Kirsch is a full time practicing physician and writer who addresses the joys and challenges of medical practice, including controversies in the doctor-patient relationship, medical ethics and measuring medical quality. When he's not writing, he's performing colonoscopies.
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Ira S. Nash, MD, FACP, is the senior vice president and executive director of the North Shore-LIJ Medical Group, and a professor of Cardiology and Population Health at Hofstra North Shore-LIJ School of Medicine. He is Board Certified in Internal Medicine and Cardiovascular Diseases and was in the private practice of cardiology before joining the full-time faculty of Massachusetts General Hospital.
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