Friday, May 4, 2007
About the Author
Maureen Caristi (e-mail: bgrnc1@roadrunner.com) is president of the Maine State Nurses Association.
You're in the hospital, you're in pain. Will someone be there for you when you need help?
Unfortunately the answer might be "nobody" for far too many Maine patients.
Patient care standards today are rapidly eroding. One major reason is the often unbearable conditions for registered nurses who are a patient's primary lifeline and advocate.
Hospitals force them to juggle too many patients at any given time, endangering patients and overwhelming caregivers.
All too often, this means that R.N.s don't have the time to assess and properly care for any of their patients, particularly since hospital patients today are much sicker and need more complex medical treatments than in the past.
LEAVING THE PROFESSION
Rather than continue to practice in conditions that are unsafe for both the patient and the caregiver, increasing numbers of nurses simply choose to leave the hospital patient's bedside as a result. That's why, when you need an R.N., there might not be one available.
That is why the Maine State Nurses Association/National Nurses Organizing Committee are working with Rep. Sean Faircloth, D-Bangor, to enact LD 1538, "An Act to Increase the Safety of Hospital Patients," which will significantly improve patient safety in our hospitals with enhanced standards for nurses and stronger protections for patients. Ý
A hearing on this critical legislation is scheduled today in the Joint Labor Committee.
The bill would set minimum, safe R.N.-to-patient staffing ratios and is modeled after a groundbreaking law California approved a decade ago. More nurses are staying at the bedside there, and more are entering the workforce with the promise of better conditions.
Since the law was enacted, more than 70,000 additional RNs have been licensed, a yearly average triple the number seen before the law.
Our association is told by our members that they are so overworked they are unable to answer patient call bells, have to leave some patients in need to tend to emergencies, and are forced to be late with required medications and treatments.
Are these risks we want Maine patients and families to endure?
The law would also bar hospitals from retaliating against nurses who blow the whistle on unsafe conditions like these.
Ratios are common-sense minimum safety standards, just as we have in other areas of public life, including airline pilots and licensed day care employees.
Many studies have documented the effects of hospital nursing ratios -- and what happens when they fall short. The latest, in the journal Medical Care, found that in an especially busy hospital, a 10 percent increase in the number of patients a nurse must care for led to a 28 percent increase in avoidable adverse events, such as hospital-acquired infections, accidents and medication errors.
Similarly, a five-year study by the Joint Commission on Accreditation of Hospitals found that inadequate R.N. staffing in hospitals precipitated one out of every four unexpected deaths or serious injuries.
The Journal of the American Medical Association found that each additional patient assigned to a R.N. led to a 7 percent increase in death within 30 days. Thus, when R.N.s go from having to care for four patients to having to care for eight, death rates jumped 31 percent.
And the New England Journal of Medicine reported some of the problems that safe staffing ratios can prevent include cardiac arrest, shock, pneumonia, urinary infections and gastrointestinal bleeding.
A MATTER OF SAFETY
Given these sobering numbers, how can Maine not move to protect patients by enacting safe nurse-to-patient ratios? Whose life is not worth saving?
The sad truth is that too many hospitals today act as big businesses, putting their bottom line ahead of best safety standards for Maine residents. That's why this modest reform is needed.
Registered nurses are at the heart of our medical system. It's time for Maine to take care of them-so they will be there for us and our family members.
- Special to the Press Herald
Reader comments
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However, opposing views are also valid. In my almost 50 years of nursing experience, I have found that hospitals attempt to balance staffing to meet patient care needs and safety with the very real need to function as fiscally efficient businesses. Hospitals do, after all, have to pay for all the workers they employ, the food they serve, the electricity, water, and sewer services they consume, the medical supplies they use, and the enormously expensive modern medical equipment that is the standard of care in this country.
Comparing hospitals to airlines and day care centers is ludicrous: if airlines are faced with a pilot shortage, they cancel or reschedule flights; if too many people want to travel on a particular day, the excess are denied tickets; day care centers can limit the number of children they accept if they lack workers. Hospitals must, by federal law, accept every patient who presents seeking emergency care and must provide appropriate medical screening and stablizing treatment, regardless of staffing levels or the patient's ability or desire to pay. While technically hospitals have the ability to then refuse additional care if the patient does not have a true emergency condition, I am unaware of any hospital that actually does that.
LD 1538 is undoubtedly well-intentioned, however, like most misguided governmental attempts to regulate a human service, it is cut-and-dried and much too rigid. It makes no allowances for differences in individual patient condition and care needs, or even for the obvious differences in care needs between daytime and nighttime hours. If enacted, the required ratios will make staffing hospitals, especially small hospitals with limited human resources, very difficult, and impossible for some. report abuse
If state legislators go for this baloney, they should know that it will have consequences beyond getting them support from a union that's attempting to establish a stronger toe-hold in Maine.
They should also understand that at the same time state government is blaming all the financial ills of the world on healthcare, and hospitals, in particular, this bill will drive up labor costs, which in turn will drive up healthcare costs.
LD 1538 is unnecessary.report abuse
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