05.08.2004

Safety of patients demands adequate staffing of nurses
By Faye Gordon and Carlos Alvarez/ As you were saying . . .
Saturday, May 8, 2004

Massachusetts may be known as a medical mecca, but the best medical care can go for naught if hospitals don't provide enough registered nurses to monitor patients following high-tech treatments and procedures appropriately.

A patient undergoing heart or lung surgery could have the world's best surgeon utilizing the latest technology and cutting-edge medicines, but after surgery an overloaded nurse might lack the time and ability to monitor the patient. The nurse is more likely to miss changes in the patient's condition that could result in a debilitating pneumonia or fatal heart attack. One recent study found that cardiac patients are more likely to die at night in hospitals because of chronic understaffing; another found that the incidence of hospital-acquired pneumonia can be significantly reduced with good RN staffing.

It is in recognition of the vital role nurses play in making the health-care system safe that the American Lung Association, American Heart Association, Greater Boston Diabetes Society, the American Cancer Society, the Mass. Senior Action Council and 60 other organizations have come together to fight for passage of legislation that would establish safe, minimum and flexible RN-to-patient ratios in all Massachusetts hospitals.

By any objective standard, the quality and safety of patient care is in critical condition: the Department of Public Health reports a 76 percent increase in the number of injuries, medication errors and complaints by patients since 1998; 65 percent of nurses report an increase in medication errors due to nurse understaffing; and, most alarming of all, one in three nurses in Massachusetts reports an increase in unnecessary deaths of patients due to understaffing.

The American Medical Association has found that each additional patient above four that a nurse cares for produces a 7 percent increase in the risk of death. If a nurse typically cares for eight patients rather than four, there is a 31 percent increase in the risk of death for those patients.

None of the hospital industry's arguments stands up against this bill. The industry argues there is a shortage of nurses, but Massachusetts has the nation's highest per capita population of nurses.

The respected research firm, Opinion Dynamics Corp., just completed a survey of RNs working part-time in Massachusetts hospitals. The survey found that fully one-third will work more hours if the Safe Patient Care Bill becomes law. In terms of hospital staffing, this is the equivalent of adding more than 1,800 full-time RNs - more than enough to meet the bill's requirements. In practical terms, this news is much better than having to find and train new hires: These part-timers are already receiving benefits, and expensive recruiting and training costs would be eliminated.

The industry argues that the cost of improving staffing is too high. Yet the evidence shows safe RN staffing to be cost-effective - at worst cost-neutral and, by most accounts, likely to save millions of dollars by reducing costly complications.

The Coalition to Protect Massachusetts Patients has looked at the evidence, and we find that it all argues for the passage of this legislation. We can't afford not to respond to this crisis. The ultimate cost of doing nothing, as the hospital industry recommends, is far too high. It's time to guarantee every patient safe RN staffing, because safe staffing saves lives.

(Faye Gordon is the executive director of the Greater Boston Diabetes Society. Carlos Alvarez is the executive director of the American Lung Association of Massachusetts. As You Were Saying is a Herald feature.)

http://news.bostonherald.com/opinion/view.bg?articleid=22069