The numbers are astounding. According to reports by the American Health Care Association and the American Hospital Association, as of July 2007, there were more than 135,000 total unfilled registered nurse positions, translating to a national registered nurse vacancy rate of 8.1 percent. Dr. Peter Buerhaus, in the July/August 2009 issue of Health Affairs, projected this figure to climb to more than 260,000 available nurse jobs by 2025.
Not only are hospitals taking virtually no steps to curtail this crisis, but the government is not alleviating the problem either. Alarmingly, House Bill 4138, The Registered Nurse Safe Staffing Act of 2007, is no longer current and must be reintroduced and pass in order to become a federal law. This Bill would have amended the Social Security Act to improve minimum nurse staffing ratios in hospitals participating in the Medicare program. An updated version of this legislation, Senate Bill 54 – The Registered Nurse Safe Staffing Act of 2009, was introduced in January 2009 and now resides in the Senate’s Committee on Finance. Again, this vitally crucial law was stalled during the latest legislative session.
While the government does not seem to be making the passage of Senate Bill 54 a priority, certain states have taken it upon themselves to pass smaller scale legislation to address some of these issues. Unfortunately, these are only small-scale attempts at rectifying a problem that requires sweeping, national reform.
Citing numerous studies to support their claim that safe staffing is at the core of patient safety, the American Nurses Association (“ANA”) has long been an advocate for nurse staffing reform for more than a decade. Knowing firsthand the traumatic effects of inadequate staffing levels on patient care, not to mention the well-being of nurses themselves, it was the ANA that helped introduce and support H.R. 4138.
Without some sort of reform, the effects of a continued nurse shortage will be devastating for a healthcare system that will see a generation age into its twilight, while another generation gains access to healthcare at historic numbers. The ongoing increase in patient visits and hospital stays is already stretching depleted nursing staffs dangerously thin. As nursing staffs become emasculated, safe patient care is in jeopardy.
While the effects of burnout and stress on a nurse’s life can be dangerous and far-reaching, it is the side-effects of fatigue that can cause safety issues for patients. Not only are hospital nursing staffs understaffed, the nurses that are there are often dangerously overworked and tired. It only takes one exhausted nurse or one less nurse to cause serious health risks to patients in need. When you have an entire country full of weary nurses and understaffed healthcare facilities – the results can be catastrophic. How many preventable injuries, needless medication errors, and deaths can be attributed to these failures? It is frightening what the statistics show!
Hospital administrations must do a more diligent job when assigning nurse staffing levels for their facilities and departments. By not properly monitoring nurse workloads and staffing needs, hospitals are placing patient safety at a huge risk.
But hospitals are not alone – the federal government must also shoulder some of the blame. The failed bill, H.R. 4138, would have required safe, baseline nursing staff numbers for healthcare facilities on a national level. Although there have been similar laws addressing a portion of these concerns passed at the state level in Illinois, Florida, Texas, Massachusetts, Michigan, and New York, federal law is paramount to national patient safety.
With instances of medical error and negligence continuing to rise in the United States, patients must be aware of the demands and limitations of nurses providing their healthcare. As always, patients are encouraged to be proactive in their medical care and treatment. If a patient believes that his or her nursing staff is fatigued, short staffed, or incapable of providing safe and reliable care, he or she must be their own patient advocate. Patients must always ask questions and demand appropriate answers.