Are Nurses Caring for Too Many Patients?

It is a topic that has been discussed and debated at length. There has been news coverage and research done on the topic.  So the question is...what is a safe nurse-patient ratio? Are nurses taking on too much responsibility and putting the patients at risk?

According to Huber, there mismatch between nursing staff available and the need for health care services (2010).  We are facing a nursing shortage due to an “aging workforce, capacity problems in the colleges of nursing, an inability to retain nurses in clinical practice, and recruitment into the profession” (Huber, 2010). Despite the nursing shortage, there is an increase in the demand for health care services. More patients and fewer nurses equal a difficult situation.

Nurse leaders are aware that staffing significantly affects patient outcomes. According to the Agency for Healthcare Research and Quality (AHRQ), for every ONE additional patient a nurse cares for results in the following:

•     30-Day patient mortality increases by 7%
•     7% failure-to-rescue rate increased
•     Job dissatisfaction increased by 15%
•     Nurse burnout increased by 23%

Legislation 

In 1999, California passed the Assembly Bill 394, requiring hospitals provide a minimum staffing ratio. The ratios were gradually implemented over the course of several years. The set standards are depicted in the image shown on the right. Since California many states have followed in their footsteps and petitioned for the same laws mandating staffing ratios. In 2008, Illinois amended the Illinois Hospital Licensing Act requiring hospitals to develop staffing plans that reflects the acuity of the patient population (Huber, 2010). Minnesota is another state aiming to pass legislation regarding safe staffing. The Minnesota’s Nurses Association (MNA) is petitioning for minimum staffing standards, claiming too many patients are falling through the cracks (MNA, 2013). To read more facts about minimum staffing standards from MNA click here.

 

So I challenge you to form an opinion. Are nurses taking on too many patients? Are we providing our patients with the best care and best possible outcomes? Or are we falling short? 

AHRQ, (2012). State-mandated nurse staffing levels alleviate workloads, leading to lower patient mortality and higher nurse satisfaction. AHRQ Healthcare Innovations Exchange. Retrieved from: http://innovations.ahrq.gov/content.aspx?id=3708

Huber, D. (2010). Leadership and nursing care management (4th ed.). Philadelphia, PA: Saunders Elsevier

MNA. (2013). Safe staffing for all patients. Retrieved from: http://www.mnnurses.org/safestaffingforallpatients

Absence of mental illness does NOT equal positive mental health

Today mental health is a hot topic on the news and within politics. Recent tragedies and mass shootings have led to a sudden awareness in this area.

 

So…what’s with all the hype?

According to the CDC, and approximately 26% of individuals over the age of 18 suffer from a diagnosable mental disorder each year! Many more individuals go undiagnosed due to lack of available care and the stigma surrounding mental illness.

What does this have to do with nursing?

The correlation between mental illness (MI) and chronic disease states are striking! Tobacco us in individuals with MI is twice as high as those without, injury rates are 26 times higher, and there is a strong correlation between MI and diabetes, alcohol use, asthmas, and cancer (CDC, 2011). Nursing is moving beyond the walls of acute care facilities and out into the community. Nurses have an opportunity right now to be advocates for mental health! “Health care policy making is highly pluralistic, with policy decisions occurring at multiple levels of society” (Huber, 2010, p345). President Obama, as part of his legislation on gun control, has called for a change in improving mental health care [read full article here].  It is time to end the stigma surrounding mental illness. It is time for nurses, patients, and policy makers to recognize the need for change! My question to you is, how can YOU be an advocate?

In this powerful video, Laura Bain discusses what it is like living with Bipolar disorder and the stigma associated!

Centers for Disease Control. (2011). Public health action plan to integrate mental health promotion and mental illness prevention, with chronic disease prevention. Retrieved from: http://www.cdc.gov/mentalhealth/docs/11_220990_Sturgis_MHMIActionPlan_FINAL-Web_tag508.pdf

Huber, D. (2010). Leadership and nursing care management (4th ed.). Philadelphia, PA: Saunders Elsevier