Overworked and Understaffed-Why are Hospitals Failing Patients and Nurses

Make no mistake about it; a qualified and adequate nursing staff is required by any facility to ensure safe and appropriate patient care.  Unfortunately, hospitals in America are facing a historic nursing shortage that is only going to worsen as baby boomers continue to get older and require increasing medical care.  Even worse, hospitals are not doing anything about this lack of nurses and the consequences are being seen by the patients they serve.

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 registered nurse positions open, 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 unfilled nurse jobs by 2025.

Not only are hospitals taking virtually no steps to stem this crisis, but the government is not lessening the problem either.  Alarmingly, House Bill 4138, The Registered Nurse Safe Staffing Act of 2007, is no longer active and must be reintroduced and pass in order to become a federal law.  H.R. 4138 would have amended the Social Security Act to increase minimum nurse staffing ratios in hospitals participating in Medicare program.  A revised version of this legislation, Senate Bill 54 - The Registered Nurse Safe Staffing Act of 2009, was introduced in January 2009, but still resides in the Senate's Committee on Finance. Again, this crucial law was stalled during the legislative session.

While the government does not seem to be making Senate Bill 54 a priority, certain states have chosen to take it upon themselves to pass smaller-scale legislation to address some of the more pressing issues.  Unfortunately, they 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 has long been an advocate for nurse staffing reform for more than a decade.  Knowing firsthand the awful 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, and another generation gain 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 depleted, safe patient care is in jeopardy.

While the effects of burnout and stress on a nurse's life can be dangerous and far-reaching, the side-effects of fatigue are what cause safety issues for the patients themselves.  Not only are hospital nursing staffs' undermanned; the nurses that are there are often seriously overworked and exhausted.  It only takes one fatigued nurse or one less nurse to cause real health risks to those patients in need. How many preventable injuries, needless medication and dosing errors, and deaths can be attributed to these failures? What the statistics show is frightening!

Hospital administrations have to do a more diligent job when assigning nurse staffing levels for their facilities and departments.  By not properly monitoring nurse workloads, schedules, and staffing needs, hospitals are putting patient safety at a huge risk.

But hospitals are not alone - the federal government also shoulders 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: federal law is paramount to national patient safety. 

With instances of medical error and negligence rising continuously in the United States, patients must be aware of the demands and limitations of those nurses providing their healthcare.  As always, patients are encouraged to be proactive in their medical care and treatment.  If a patient believes that their nursing staff is exhausted, short staffed, or unable to provide safe, reliable care, they have to be their own advocate.  Patients must ask questions, and demand appropriate answers.