Here are some appalling statements made by nurses in the UK’s Care in the Balance snapshot survey done by Unisom:
“Crisis has become the norm.”
“It’s unacceptable and upsetting to see standards of care drop because of staffing levels, or should I say lack of staffing levels.”
Also, many of the nurses reported having been forced to skip breaks and meals due to “unreasonably high workloads.” Overall, 73% of participating nurses felt that hospitals were too understaffed to provide safe, dignified, and compassionate care. 91% said they were in favor of introducing minimum nurse to patient ratios.
Are Nurses In The US Echoing This?
Closer to home, a University of Pennsylvania survey of over 13,000 hospital nurses found that only 60% were satisfied with their jobs, and over 33% felt that there were not enough RN’s to provide patients with high-quality care. That’s nearly half of our nurses begging for change.
And when nurses are dissatisfied, creating positive outcomes for patients is a nearly impossible feat. As Matthew McHugh, study leader and assistant professor at the University Of Pennsylvania School Of Nursing said, “Patients are better off in hospitals where nurses are happier doing their job.”
Job Compensation In The Nursing Industry Today
Medscape, in its annual RN/LPN Compensation report, which highlights trends in nurse compensation over the last year, surveyed 7,145 nurses—5,143 RN’s and 2,002 LPN’s—between June and August 2019.
Overall, the salary for RN’s dropped slightly, while LPN’s salary increased a bit. This also varied by level of education and location.
As with the survey conducted by the University of Pennsylvania, Medscape found that among RN’s, only 51% felt fairly compensated!
To add to the insult, this rate had been declining steadily for the past three years.
A Call For Appropriate Nurse-Patient Ratios
A nationwide effort, led by the National Campaign for Safe RN-to-Patient Staffing Ratios, is in place to ensure steps are taken to implement adequate nurse staffing levels.
Studies have continuously proven that an optimal ratio results in both medical and economic improvements in patient care, including:
- Overall improvement of patient satisfaction and HCAHPS scores
- Decrease in medication errors, patient death, hospital readmissions, and general length of stay
- Reduced incidents of falls, pressure ulcers, and healthcare-associated infections (HAIs)
- Less cost for patient care with the avoidance of unexpected readmissions
- Prevention of nurse fatigue
The Inter-Professional Approach
As the American healthcare system progresses, many healthcare experts are being asked to develop a more holistic approach to deal with the increasing complexity of today’s health needs. That puts a new strain on nurses, who are expected to acquire knowledge from several non-nursing fields in order to properly treat patients.
Truth: Higher Ratio Equals Better Care
Creating a positive work environment for nurses, including increased nurse-to-patient ratios, will result in healthier patients and fewer readmissions.
It has been established both logically and statistically that patients recover sooner when they are in the care of a properly staffed nursing team, who are happy and comfortable in their environment.
High Ratio: Low Mortality.
Linda H. Aiken, PhD, as recorded by the Journal of the American Medical Association, studied the risks associated with a low nurse-to-patient ratio in a hospital setting. Using data gathered from 232,342 patients, statistics showed that “each additional patient per nurse was associated with a 7% increase in the likelihood of death within 30 days of admission and a 7% increase in the odds of failure-to-rescue.”
Responsibility overload: Risk of fatigue. In the same study, it was established that every new patient added to a nurse’s workload causes a 23% increase in the nurse’s sense of burnout, and a 15% decrease in the nurse’s job satisfaction.
Healthcare facility administration can also avoid discouragement amongst nurses by adequately assigning, tracking, and evaluating the goals set for staff. Housekeeping chores – including delivering food trays and transporting patients should not be assigned to nurses.
Increased Nurse-to-Patient Ratios: Decreased Number of Medical Errors.
Data was gathered on the following adverse outcomes:
- Medication errors
- Patient falls
- Skin breakdown
- Patient and family complaints
- Infections and deaths
Not surprisingly, every one of the measured areas showed better results when there were more nurses available to care for patients.
Resistance To A Mandated Nurse-Patient Ratio
Increasing the ratio is a no-brainer. Or not.
This remains a controversial (and heavily fought) issue in the industry, with many nurses worrying that setting a limit will lead to employers viewing that as the maximum staffing level. In that case, the enforced ratio would be a rigid protocol, without taking factors such as patient situation or staff sickness and temporary leave, into account.
This sentiment doesn’t worry Unison Head of Nursing Gail Adams. She said: “I understand the complexity and people’s apprehension about it becoming the norm and it becoming a ceiling. But the reality is from what nurses are telling us is that we are already there. I think very much that nurses feel we’re already at the bare bones.”
However, the reality is that our nurses continue to be driven out of the profession by burnout, proving that the perfect nurse to patient ratio is still out of reach.
Facility Income Depletion
Running a business without being profitable is like shoveling snow with a spoon, but without a content nursing staff, a facility cannot be successful. With nurses’ salaries consisting of a large percentage of facility expenses, concern about facility income depletion is very real.
That being said, the owner or operator should be cognizant of this reality, and make the best effort ⏤ along with available support partners and tools, to strike the optimal balance. It will affect your residents’ care, your nurses’ morale, and your facility’s future.