More nurses equals better care

PENNSYLVANIA'S registered nurses are leaving the bedside in droves, and unsafe nurse-to-patient staffing is the impetus behind the exodus.

RNs across this state and throughout the country are frequently burdened with far more than a safe number of patients.

We often don't have time to provide the care our patients need and deserve. For nurses, whose profession rests on the premise that our care is delivered in the sole interest of our patients, this presents a terrible dilemma.

I've been a registered nurse for 33 years, and for the last 10 have worked in a busy emergency room. As president of our state's largest professional RN union, I have the opportunity to speak to a lot of nurses from hospitals all over the state. They report that their patient loads can be 10 extremely ill patients on a general medical floor. For our patients, this presents an unsafe and unfair situation. After all, we expect to go into a hospital to get better, not be the casualty of a serious error caused by inadequate staffing.

Understaffing of nurses was found to be a key factor in the spread of methicillin-resistant staph infection (MRSA), the most dangerous type of hospital-acquired infection. (Lancet Infectious Disease, July 2008.) Low staffing levels are also a key cause of 98,000 preventable deaths each year, according to the Institute of Medicine.

Are these risks we want our patients and families to endure?

The good news is that we know how to fix this problem. The Pennsylvania Association of Staff Nurses and Allied Professionals, affiliated with the National Nurses Organizing Committee, is sponsoring vital legislation in Pennsylvania (SB 742, the Pennsylvania Hospital Patient Protection Act of 2009) and nationally that will guarantee a minimum safe-staffing ratio of RNs per patient in our hospitals.

No longer will RNs have to go home after work and wonder if they forgot a vital medication or treatment, and no longer will patients lack appropriate nursing care.

Where will the extra RNs come from? Isn't there a nursing shortage? In California, where a similar law has been in place since 2002, nearly 100,000 additional RNs have been licensed, a yearly average that's triple the number before the law.

There are more than 60 studies by the nation's most respected scientific and medical researchers that affirm the significance of safe RN-to-patient ratios for patient safety and cost-savings. Raising the proportion of RNs by increasing RN staffing to match the top 25 percent best-staffed hospitals would produce net short-term cost savings of $242 million (according to Health Affairs, January/February 2006).

Cost-savings, improved patient care, more nurses - why is this not a done deal already?

Ratios are commonsense minimum safety standards, just as we have in other areas of public life. We have ratios for schoolteachers and prison guards, and standards for clean air and water. Why not in our hospitals?

For too many years, nurses and patients haven't had a voice as health-care policies have been debated among insurance corporations, hospital chains and drug companies. It has taken a statewide and national movement of nurses to win this lifesaving patient safety reform.

During this year's Nurse Week, members of major nurses unions gathered in the nation's capital to urge Congress to approve legislation that would guarantee safe ratios of nurses to patients nationally. Sen. Barbara Boxer (D-Calif.) introduced the National Nursing Reform and Patient Advocacy Act.

The event was coordinated by the National Nurses Organizing Committee, United American Nurses and Massachusetts Nurses Association, who are forming a new national union of 150,000 RNs with the major goal of organizing nurses across the nation.

IN ADDITION, the bills protect the rights of nurses to advocate on behalf of their patients, and to invest in training new nurses, and provide whistleblower protection for nurses who report unsafe conditions.

Registered nurses are the heart of our medical system.

How well we are cared for by nurses affects our health, and sometimes can be a matter of life or death. It's time to take care of nurses - so nurses will be able to take care of us. *

Patricia Eakin, registered nurse, is president, Temple University Hospital Emergency Department, Pennsylvania Association of Staff Nurses and Allied Professionals.