10.26.2005

Globe Series on ICU Nursing Spotlights Complexity of Nurses' Role
Underscores Need for a Limit on Patients to Provide Safe Care

The Boston Globe is in the midst of running a compelling and eyeopening series of articles detailing the training of intensive care unit nurses at Massachusetts General Hospital that should be required reading for legislators and policymakers considering legislation to establish safe limits on the number of patients a nurse is assigned at one time.

The series depicts in vivid detail just how complex and challenging the role of nurses in today’s technology-driven environment has become, and paints a realistic picture of the modern staff nurse that is rarely captured by today’s mainstream media.

According to MNA president and a former ICU nurse Beth Piknick, “After reading this series, I would challenge any policymaker to argue that there shouldn’t be a safe limit on the number of patients a nurse is assigned.”

As stated in the first installment of the series, “Although television shows such as ‘ER’ make it seem as if doctors do just about everything in hospitals, nurses actually provide nearly 90 percent of intensive care—usually with no doctors in sight. Nurses sometimes feel like second-class citizens, but they are the backbone of the ICU. ... As residents rotate through, seasoned nurses provide continuity of care and a practiced eye for the telltale blood pressure drop, raspy breathing, or other signs that indicate a patient is failing.

“A patient in the SICU typically requires 20 hours of nursing care daily, 13 percent more than in 1999. ... Patients here routinely require a dozen or more intravenous medicines and up to six feeding and monitoring tubes,” the Globe reported.

The Globe series makes reference to the fact that at Mass General, nurses are not allowed to care for more than two patients. But in many hospitals across the state, this is not the case. It is not uncommon for intensive care unit nurses in Massachusetts to be assigned three patients and, on some occasions, four. Nurses on medical surgical units can have as many as 12 patients, a situation that studies show dramatically increases the risk of complications and even death for these patients.

“No matter where nurses work in the hospital, there needs to be a limit in place on the number of patients they are assigned in order to ensure they can fulfill their life-saving and life-preserving function. It’s a matter of simple common sense,” said Piknick.