How can Safe Staffing impact healthcare outcomes in the United States?

By September 27, 2015Uncategorized

What is your average day like at work?

Are you appropriately staffed or are you tripled in the ICU? Do your patients see you once an hour or twice a shift? Do you find yourself clocking out so you won’t get ‘in trouble’ for finishing your charting because you were too busy to chart a thing all night?

What are the implications of poor Nurse to Patient ratios?vitals_hazards.190.1

Comments from the Members of Show Me Your Stethoscope:

Anonymous:  I took a 5th ER Patient in the Hallway.  He went into V-Tach within an hour.  It was a good outcome but very stressful.

Anonymous: When I worked ER as a tech, before I graduated nursing school, we had a bad night staff wise. I needed help with a patient but no one was available. I ended up dislocating my shoulder and tearing my labrum trying to catch a 96 year old patient. He started to fall and I instinctively tried to catch him. 2 surgeries, 2 years on and off of PT and still hurts.

Anonymous:  One of my patients, a 95 year old, fell and broke her neck. She died three days later in ICU. It still haunts me to this day.

Anonymous: I made a very serious med error. A long term acute care brain injury patient was on phenobarbital for seizure control. Let’s just say I administered the right dose of the very wrong drug. The patient was not harmed and the physician, supervisor, and patient’s mother were understanding, but I was devastated. I was caring for 15 LTAC patients on 3-11 shift that night. I had been an LPN about 10 years at the time. That was 18 years ago.

Anonymous: When I recently have worked in rehab, 23 patients to me – 1 RN. (Mind you, I was the only RN in the building for over 120 patients as well.) Was supposed to have 2 CNA’s. A CNA from our LTC called off so a CNA from our rehab side was sent to another floor. The one I had was told to “float” between different floors as well.
I had a patient with a trach/foley/Peg tube yank off his O2 20+ times. Had another patient in his 80’s in a C-collar (cervical spine fracture) A+O X 1 yanking it off and I put him back into bed myself 35+times in less than 8 hours. Had another patient that same night actively dying, getting naked in bed hollering out for their loved ones. 23 patients and 1/2 of a CNA. Medication administration on 23 patients; 5 FSBS; 4 sliding scale insulin; 2 IV drips for Vanco; Wound care on 9 patients that night; foley care on 3; Peg tube care on 1; trach care on 1; O2 monitoring on 18 patients; 7 complete bed changes; 14 incontinent patients, and I lived to tell about it. These are real staffing issues. I now do RN case management for home health. I have no desire to go back to floor nursing until staffing becomes a reality. Our licenses are on the line. Patient safety is a severe and sad issue. Facilities care about 2 things: their census and how much money is pouring in from Medicare and Medicaid.

And from the other side of the stethoscope:

Janie Garner: When my sister was in the hospital, they were severely short staffed.  A nurse came in to change her PCA pump and kept getting patient related phone calls, and the pump was alarming ‘air in line’.  I had to shout to stop her from priming the tubing full of concentrated hydromorphone into my sister’s IV.  

Read that last one again.  If my sister had been alone in that room, she would have received a fatal dose of dilaudid.  If my sister didn’t have a nurse in the family, she would have died.  I know what unsafe staffing levels can do from both sides of the stethoscope.  And that nurse would have NEVER gotten over it.  Let us remember that Nurses have committed suicide over medical errors.

So, safe staffing levels have been an issue since Florence Nightingale put on a cap.  The lady with the lamp probably didn’t pee for 12 hours either.  There are places in the US where staffing levels are mandated, and it works.  It is a proven fact that safe staffing reduces medical errors.

Ask yourself these questions:

  • Why are hospitals still refusing overtime when floors are short staffed, and not retaining agency staff or hiring more nurses to keep our patients safe?
  • Why does a nurse have oversight for an entire facility, 23 LTAC patients and half a CNA?
  • Why do support staff have to be physically harmed because there is insufficient staff to help with patient transfers?
  • Why are nurses so rushed that they make medication errors?

I think you can answer this for yourself.  There are occasional days where everyone on a nursing unit caught the same virus, but if you are working short every day, it is because your employer is trying to better their bottom line.  This is about money for the corporation, not about your patient’s safety and the safety of your license.

If all staff refuse to work under these conditions, your facility will eventually change.  Refuse inappropriate, unsafe assignments.  Do not move patients by yourself; call your charge nurse or nurse manager and politely demand help.

If you only read the stories of the healthcare professionals that submitted these comments, you can answer for yourself how safe staffing will impact healthcare.  You are a member of Nursing.  Please protect nurses in places where they have no collective bargaining and fear for their jobs.

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Author Janie Garner

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Join the discussion 9 Comments

  • Let’s please band together and effect some very necessary changes needed regarding pt ratios and safe staffing. I have worked many kinds of E.D.s throughout the years and the bottom line to all are profit for share holders and bonuses for executives. Unless Nurses can come together as an intelligent, problem solving entity, nothing will change.

  • My employer uses it’s founding by a religious order as emotional manipulation. They never miss an opportunity to talk about our “calling ” which I believe is this large corporation’s method for squelching any organized attempt to demand more money. I think we need to bring this beyond the grumbling among ourselves and to the public. We need PR, publish corporate salaries as compared to the average RN’s and we are deserving of more money. We who have been in the field for many years may not be the one’s to make this fight but the Millennial’s energy this could happen.

    • janiegarner says:

      I hate to hear that. I also worked for a faith-based organization that went insane if anyone uttered the word ‘union’.

    • Dionne says:

      While yes the bottom line is about the “money”. This article was about safe staffing levels. I would be willing to work for less to have enough nurses, CNAs and other support staff and not fight short staffing levels every shift. More nurses need to be hired. Paying current nurses more money is not a solution. Paying out overtime or bonuses is not a solution. This only makes your overly worked, overly tired, overly stressed nurses work more. And does not create an environment for patient safety. Bottom line we need safe staffing ratios across the board and we need to hire more nurses!

  • Anne says:

    Some CEO’s make 1,000,000 per year. If an RN makes 65,000. That CEO is making 15 years worth of our salary in one year. Now where should the budget cuts come from?

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