News & Events
Safe patient care -- President's column
by Jeff Breslin, RN; MNA President
I listened to the speakers at the 2012 Michigan Nurses March and began to think about how nursing has changed since the days of Florence Nightingale. The first presentation, which was given by Dr. Louise Selanders, an international expert on Florence Nightingale, provided great insight to the struggles Florence faced and how she tackled each challenge. This was done by using her knowledge and expertise to overcome outside barriers with one purpose – to improve the outcome of the patients she came in contact with. Although the obstacles may have changed, many of the same struggles still exist today.
A lot has changed in the last one hundred years. Technology helps to improve our ability to take care of patients and produce better outcomes, but it comes with risks. Technological advances can make it more difficult to take care of the patient and push us toward treating all patients the same. If we are not careful, we may find ourselves taking care of the technology instead of the patient. We have had to change the way we are looking at each situation and develop new and innovative ways to protect our patients. Much like the Nightingale story of yesteryear, we now have the charge of advancing our ability to provide safe, effective, compassionate patient care. We must advocate in ways that were not even thought of just a number of years ago. We must take the necessary steps to ensure that patients are going to be taken care of in their time of need no matter what facility they are admitted to. We must put protections in place to make sure we have the resources available to properly care for our patients and to hold those accountable who would value profit over safety.
At the MARCH!, I listened to Representative Jon Switalski who talked about HB 5426. This bill will put into place minimum staffing ratios that must be met no matter what facility a patient may be admitted to. This bill requires hospitals to develop and implement a written staffing plan that provides sufficient, qualified nursing staff on each unit in the hospital to meet the patients’ individualized needs. Hospitals would accomplish this through the creation of staffing committees for each unit. The legislation includes some of the following ratios: Critical Care and Operating Room 1:1, Non-Trauma or Non-Critical Care 1:3, Medical/Surgical and Pediatrics 1:4. Some hospitals have nurses caring for 10-15 patients at a time. With the patient acuity continually on the rise, this is an appalling safety issue for both nurse and patient.
Opponents of this legislation claim that we are in the middle of a nursing shortage, and they will not be able to find enough nurses to meet even the minimum numbers set out in the bill. As seen when California passed similar legislation, the number of licensed RNs increased by 40 percent. They found that by improving the conditions at the bedside, nurses who left the profession, for various reasons including other professions or retirement, were willing to come back to practice.
Opponents also claim that the cost to employ enough nurses to meet the numbers in the bill would be more than their institutions could handle. But by adding 133,000 nurses to the U.S. hospital workforce, medical savings could be as high as $1.6 billion in reduced patient care costs. (Medical Care, Jan. 2009). Also, by raising the proportion of nurses by increasing staffing to match the top 25 percent best-staffed hospitals, a short term cost savings of $242 million would be produced (Health Affairs, Jan./Feb. 2006).
We have patients – our patients – our loved ones, who are suffering because of misguided ideas that are not allowing them to have the attentive, individualized care they deserve. All of the hospitals have had the opportunity to make a change in this direction, yet very few have done so. Just as Florence used the means that were available to her to help improve the care her patients received, we too must use the tools and resources available to us. This means supporting Safe Patient Care legislation and pushing to get it passed into law. Our patients, our families, our communities are counting on us to take care of them.