“Research is now beginning to document what physicians, patients, other health care providers, and nurses themselves have long known: how well we are cared for by nurses affects our health, and sometimes can be a matter of life or death.” –Institute of Medicine, 1999
Today, 12,000 Minnesota nurse are walking the picket line in the name of safe patient care. This strike is historic: it is the largest nursing strike in US history.
The nurses striking today want to establish nurse-to-patient ratios that will guarantee that there are always enough nurses to provide safe, competent, therapeutic and effective care to the patients who have entrusted them with their lives at their most vulnerable moments.
The Minnesota Hospital Association (MHA) has stated in numerous press releases that hospitals need “flexibility” in staffing the hospital. What they aren’t telling the public is that “flexibility” is dangerous to patients. By flexibility, hospitals seek the ability to shift nurses from one specialized unit to another. This concept fundamentally disregards the role of specialized nursing in our increasingly complex medical system. Nurses, like all other healthcare professionals, are highly specialized. Asking a neonatal ICU RN to work in the Emergency Department, for example, is not a safe plan for adapting to fluxes in patient census.
The MHA has also stated that implementing ratios would cost millions and that there is no proof those ratios would improve patient care. Ample research supports that more nurses equates to safer patient care in our hospitals. The latest study from the University of Pennsylvania comparing outcomes in California to those in New Jersey and Pennsylvania found the following:
- New Jersey hospitals would have 14 percent fewer patient deaths and Pennsylvania 11 percent fewer deaths if they matched California’s 1:5 ratios in surgical units.
- Fewer California RNs miss changes in patient conditions because of their workload than New Jersey or Pennsylvania RNs.
- In California hospitals with better compliance with the ratios, RNs cite fewer complaints from patients and families and the nurses have more confidence that patients can manage their own care after discharge.
- California RNs are far more likely to stay at the bedside, and less likely to report burnout than nurses in New Jersey or Pennsylvania.
It should be no surprise that state hospital associations and hospital administrators around the Nation are all singing the same tune. The MHA’s talking points have been uttered to the Press in Ohio, Texas, Massachusetts, Maine, Florida, California, Nevada and any other States where nurses are fighting for safe staffing levels.
A Deep-dive Into Specialty Pharma
A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.
How did we get here? During the mid-1990s, when corporate-managed healthcare transformed the way hospitals are paid, hospitals across the country paid millions to consultants such as Ernst and Young, who told them to re-organize nursing care so that they could use fewer RNs. RNs were laid off around the country. Many nursing tasks were turned over to practical nurses, nursing assistants and paramedics. In today’s hospitals, less skilled nursing assistants or nursing technicians perform a great deal of patient care. This re-engineering of nursing was followed by steady and continued increases in the number of patients that RN’s are responsible to care for. What the consultants failed to consider was that nursing care is the reason that hospitals are in business. The very purpose of a hospital admission is to place the patient under the care of an RN skilled in technical monitoring and intervention.
For nearly two decades, nurses have been sounding an alarm. We have tried many different approaches to secure safety for our patients. We have worked on committees in our hospitals with the hope that having a seat at the table would ensure our concerns were acted upon. We have made staffing plans with our administrators. But the recommendations and plans were cast aside before the ink was even dry. We were assured that this was the right approach. As patients continued to suffer, it became clear that it was not.
The goal of minimum nurse-to-patient ratios, whether codified in the law or guaranteed by a collective bargaining agreement, has caused nurses around the nation to join together and set what the MHA calls “an aggressive national strategy.” Would any other type of strategy be called for when 200,000 patients die every year as a result of preventable medical errors? Anything less would be a tragedy. When patients lives are at stake the time for action is now the MN nurses have heard the call to arms support them as they strike for patient safety.
