It’s the time of year when nurses start to reflect on the birth of the founding mother of our profession, Florence Nightingale. At hospitals and workplaces across the country, celebrations are held and awards given to recognize outstanding nurses. At ANA, we recognize her legacy by hosting a Capitol Hill briefing on an issue that is pertinent to nursing and the patients we serve. In the past, we have covered such issues as mandatory overtime, safe patient handling and movement, advanced practice nurse legislation and, yes, even nurse staffing. As we plan these events, we also partner with different groups, such as unions, hospital administrators, physical therapists, and patients, to demonstrate that these issues impact more than nurses.
This year, with a Democratic White House and Congress and a coming together of diverse opinions and perspectives, I would like to recommend that nursing take a big leap and come together to address one issue that continues to plague our profession and our patients—safe staffing.
I know that in the past many players have come together to support increased funding to address nursing education and faculty shortages. The American Medical Association supports efforts to address these shortages, and even the American Hospital Association and AARP advocate for funding increases. These collaborations have borne fruit, as currently demonstrated by the investments Congress and the administration have made in nursing workforce development programs.
But I ask you now, how can we retain new graduates, entice others to stay in the profession, and engage in patient care when the same issues that plagued our profession still exist? Short staffing, overtime, and workplace environments that leave you emotionally and physically exhausted are still all too commonplace. With 2.9 million nurses, how can we stand by and continue to ignore what is happening at these workplaces without banding together to make a difference?
Most nurses agree that everyone needs access to an affordable, available package of basic healthcare services. However, without an adequate number of nurses, our country will not be able to provide it. Therefore, I ask you to join together and make a difference for nurses and patients by working with us to support legislative efforts to address safe staffing, which will make a difference to our profession and patient care.
However, we first need to educate ourselves about safe staffing. Consider the following facts:
- Adding RNs to unit staffing has been shown to eliminate almost one-fifth of all hospital deaths, and to reduce the relative risk of adverse patient events.
- Evidence has shown a link between mandatory staffing plan legislation and nurses’ perception of a more positive nurse work environment when compared with mandatory ratios or no staffing plans.
- Retaining nurses is also a cost-saving measure, as it reduces the amount hospitals spend on recruiting and training new staff.
- Increasing the number of RNs can yield a cost-savings of almost $3 billion—the result of more than four million avoided extra-stay days for adverse patient events, such as infection and bleeding, that occur in the hospital.
- Some nurses support legislating fixed nurse-to-patient ratio numbers. While such legislated numerical ratios seem to offer a quick solution and may appear to be a good fit for some workplaces, many variables—including acuity of patients, level of experience of nursing staff, layout of the unit, and level of ancillary support—are key to establishing the correct nurse-to-patient ratio for any one unit. In addition, a legislated ratio approach treats nurses as “numbers,” rather than recognizing them as professionals with a say in the care that they provide. Above all, nurses’ expertise should play a role in the solution.Now that you know the facts, let’s work together to make a real difference for nurses and our patients by sharing this information with lawmakers at the federal and local levels. Shouldn’t we put nurses in the driver’s seat? Shouldn’t they guide staffing decisions for patient care? Shouldn’t we work together to get this done? Let’s make safe staffing a priority this year. It’s time.
Selected references
Cox KS, Anderson SC, Teasley SL, Sexton KA, Carroll CA. Nurses’ work environment perceptions when employed in states with and without mandatory staffing ratios and/or mandatory staffing plans. Policy Polit Nurs Pract. 2005;6(3):191-197.
Kane R, Shamliyan RA, Mueller C, Duval S, Wilt TJ. The association of registered nurse staffing levels and patient outcomes: systematic review and meta-analysis. Medical Care. 2007;45(12):1195-1204.
Needleman J, Buerhaus PI, Stewart M, Zelevinsky K, Mattke S. Nurse staffing in hospitals: is there a business case for quality? Health Aff. 2006;25(1):204-211.
Rose Gonzalez is the director of Government Affairs for the American Nurses Association.
