It seems obvious that lessening the number of patients a nurse must care for at each shift would result in improved patient care. Improving the care of the patient results in shorter hospital stays, faster recovery time, and lowers the number of patient deaths significantly. In fact, a recent study by the JAMA supports that better nursing staff saves lives. A 1:8 nurse-to-patient ratio results in five additional deaths annually over a 1:4 ratio. For each additional patient a nurse is assigned, the odds of patient death go up by 7%.
These numbers are per 1,000, and appear as just that-numbers-on reports. However, as any qualified professional caregiver knows, these numbers are people-patients, with families, and in need of the care that should be expected in a hospital or care facility. Why aren’t the staffing ratios better?
Why Lowering Nursing Staff Numbers Doesn’t Work
Typically, the care facility or corporation is concerned about that bottom line. Money is the motivator for most businesses and hospitals, clinics, nursing homes and all manner of care facilities are businesses today. Nursing staff makes up the largest clinical subgroup in medical facilities, and the corporate beancounters assume cutting nursing staff numbers will help save money.
Unfortunately, by cutting nursing staff numbers care facilities face grim results. Quality of care plummets significantly, patient outcomes are not successful, staff turnover becomes a concern, and hospitals, and the like, lose funding, have bad reviews, and become a detrimental environment instead of a life-saving one. Working a skeleton crew of nurses to the bone is not good for patients, nurses or the facility’s bottom line.
Create Better Nursing Staff
Staffing that’s more than ‘adequate’ goes hand-in-hand with the quality of care patients receive, that’s a given. How to create a nursing staff environment that is more than adequate begins with the care facility’s willingness to ensure there’s enough RN and support nurses to tend to patient care. Beyond patient care, there are additional reasons to beef up for better nursing staff.
By ensuring there is adequate coverage so that nursing staff can take breaks, vacations, and not have to work mandatory overtime, the turnover will be much lower. Sufficient staffing also promotes a safer environment for all. Accidents happen when people are tired, burned out, and distracted. When your facility is short-staffed you are running way too many risks for your patients and your employees.
In addition to being sufficiently staffed with RNs, hospitals and care facilities should also retain a fair number of support nurses such as LPNs and CNAs, along with nurse techs. There are many instances where an RN is not necessarily needed to perform certain tasks. By employing support nursing staff the facility improves patient care, and facilitates a more inviting work environment.
A better staffed hospital or care facility makes for happier nursing staff. When your employees are content you usually have a more cooperative team. That means nurses are less likely to call off, and more likely to cover each others shifts if necessary. This ripple effect certainly reinforces good results, across the board, including profits for the hospital.
Current Mandates
The type of care given as well as the number of patients will determine a hospital’s need for nursing staff. For units such as Telemetry, Postpartum, and Med-Surge less staff will be required. Trauma, OR, and ICU are obviously going to need a smaller ratio of nurse-to-patients. Currently California has a law requiring 1:1 for Trauma, OR, and ICU.
Better nurse staffing does save lives. But, for hospitals, better staffing practices also create an overall improved environment for patient care and for nurses. This positive outcome is actually much healthier for the bottom line than slashing nursing staff numbers, as explained above.
Current federal law requires that those facilities certified to take part in Medicare must maintain sufficient staffing numbers for medical support personnel. Many states are enforcing their own version of this federal mandate and requiring more optimum ratios. Patient census dictates the number of nurses a facility will need, and, so far, 17 states enforce the ratios as they are mandated. To be understaffed can cause more than just a headache for the nurses. Non-compliant medical facilities risk fines, reprimands, license revocation and even closures.
Solving Staffing Issues
Of course it can be hard to predict the number of patients any hospital or care facility will have on any given day. Pulling from the PRN pool is useful, but many more medical facilities are turning to staffing agencies when their census numbers go up. For RN’s, and all nursing staff, a staffing agency can be an essential tool for compliance with guidelines, and just plain better nursing staff.
Photo via TheShiv via VisualHunt.com
