Nurses Need Help

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Sep 27, 2023

brown bear plush toy on white bed — Photo by Kristine Wook on Unsplash

Happy Wednesday Advocates

I just couldn’t put in a depressing picture so today it’s a teddy bear.

I would like to encourage comments and suggestions from you if you have time. If there is a special topic you’d like to see please let me know. Please use the comment button below. By the way lots of deep breaths help.

Nursing

Recently I wrote about nursing and physician shortages in the United States. One of our readers, a retired professor of nursing, suggested I examine the nursing profession in more detail.

Overview

According to the US government Bureau of Labor:

Registered nurses (RNs) provide and coordinate patient care and educate patients and the public about various health conditions. Here is the official description.

Registered nurses work in hospitals, physicians’ offices, home healthcare services, and nursing care facilities. Others work in outpatient clinics and schools.

Registered nurses usually take one of three education paths: a bachelor’s degree in nursing, an associate’s degree in nursing, or a diploma from an approved nursing program. Registered nurses must be licensed. Here is a description of how to become a nurse.

The median annual wage for registered nurses was $81,220 in May 2022. (reference)

Problems In the Workplace

Recent statistics reveal that over 17% of new nurses will quit within the first year, and about 56% will quit after the first two years. (link)

There are a number of issues that make nursing particularly challenging. Here is a National Library of Medicine article on the topic.

Two of the most important are work overload and workplace injuries.

Workload

We have heard over and over that nurses are given too many patients to care for and that that creates a strain on the nurses and can result in lower quality care for the patients. Here is a white paper on the subject by the National Nurses Union.

As a result of not having mandated nurse to patient ratios registered nurses are consistently required to care for more patients than is safe, compromising patient care and negatively impacting patient outcomes.

The federal government and most states have NO MAXIMUM PATIENT TO NURSE RATIOS thus allowing hospitals to overburden the staff. An exception is California, that has mandated ratios. In fact, the California ratios mandate has proven to reduce costs for hospitals by improving nurse safety and job satisfaction, reducing spending on temporary RNs, and reducing overtime costs and staff turnover.

Moreover, regarding patient outcomes, compared to California, New Jersey hospitals would have 13.9% fewer patient deaths and Pennsylvania 10.6% fewer deaths if they matched California’s ratios in medical-surgical units according to the study “Implications of the California nurse staffing mandate for other states.” by L. Aiken, et al in Health Services Research. 2010; 45(4): 904-21, 917.

It is worth noting that after the California law was implemented, thousands of RNs returned to the bedside from within the state and out-of-state RNs were attracted to California because of the staffing ratios.

Workplace Injuries

According to the Bureau of Labor and Statistics. In 2020, there were 78,740 cases of nonfatal workplace injuries and illnesses that resulted in at least one day away from work among registered nurses in private industry. This was a 290.8% increase, almost 4 times, compared with 2019, when there were 20,150 such cases. The increase in days away from work for registered nurses in private industry was driven by a drastic increase in cases due to exposure to harmful substances or environments.

Another source of these injuries is related to the difficulty in moving patients, in particular lifting patients. The VA and a few other sites have invested in equipment to lift and move patients, instead of nurse muscle power and found those injuries drop by 80%. Just a thought.

Generally, when employees are overloaded, stressed on long shifts in hostile environments (did I mention that workplace violence is near the top of the list for nurses?), accidents happen and nurses suffer.

Learn More and Extra Credit

I encourage you, as a healthcare advocate to learn more about nursing. The National Nurses Union is working to make life better for nurses everywhere. Here is their website.

They are strong advocates for Universal Healthcare and you can join them here.

Summary

There is not one easy solution to the problem of improving the environment for nurses, but there is a place where we can start. That is with workloads. Since improving the workload worked well in California, let’s pursue that nationally. We need to let our legislators know it worked there and will work nationwide.

A bill has been introduced in Congress (S. 1113 / HR 2350 - same bill in both houses), The Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act of 2023, that specifies safer staffing levels. It will reduce the stress on nurses and save patients lives, as well as save money for the hospitals by reducing the need to hire expensive temporary staff.

Specifically it calls for

One patient in trauma emergency units,
One patient in operating room units, provided that a minimum of 1 additional person serves as a scrub assistant in such unit.
Two patients in critical care units, including neonatal intensive care units, emergency critical care and intensive care units, labor and delivery units, coronary care units, acute respiratory care units, post-anesthesia units, and burn units.
Three patients in emergency room units, pediatrics units, stepdown units, telemetry units, antepartum units, and combined labor, deliver, and postpartum units.
Four patients in medical-surgical units, intermediate care nursery units, acute care psychiatric units, and other specialty care units.
Five patients in rehabilitation units and skilled nursing units.
Six patients in postpartum (3 couplets) units and well-baby nursery units.

Let’s educate our Congressperson and Senators so they know what to do to make healthcare safer for nurses and for patients.

ACTION

Call/email your Congressperson and Senators and let them know it is time to pass S. 1113 / HR 2350 The Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act of 2023. They should also pass S.2840 - Bipartisan Primary Care and Health Workforce Act that seeks to enable an additional 60,000 nurses to complete their training. Their contact info is here.

You can use RESISTBOT to send the message by texting to 50409 SIGN PIHEWR to send the message below.

“I am your constituent and I just learned that the work environment for nurses in the US is not safe. Their number of workplace injuries has skyrocketed up almost 300% in the last year, the number of patients they are responsible for is so large that they cannot provide adequate care. When comparing states that have maximum nurse to patient ratios to those that do not it was found that the number of deaths in hospital surgery units could be dropped by 13% (California to New Jersey Comparison - see L. Aiken, et al in Health Services Research. 2010; 45(4): 904-21, 917).

Moreover, when safe staffing levels were implemented in California, hospital expenditures for overtime and temporary staffing dropped and reduced costs.

Let me remind you that the improved Medicare for All Act HR 3421, sets safe staffing levels for nurse to patient ratios. However, until you enact that bill, I want you to cosponsor and support S. 1113 / HR 2350 , The Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act of 2023, that specifies safer staffing levels and while I have your attention I want you to cosponsor and support S.2840 - Bipartisan Primary Care and Health Workforce Act that seeks to enable an additional 60,000 nurses to complete their training.

We all deserve a healthcare system that works for all of us. That includes nurses and patients. Thank you.”

RESOURCES

Healthcare Advocacy (Us)

Website

Our Newsletter resources including reproductive healthcare

Healthcare Advocacy Reading List

Find My Elected Officials

Contact the White House https://www.whitehouse.gov/contact/

Contact State and Federal Representatives

https://www.commoncause.org/find-your-representative/addr/

Important Healthcare Resources

League of Women Voters Healthcare Reform Toolkit

Organizations to Contact

National Nurses United Medicare4All

Physicians for a National Health Plan

Reproductive Health

NARAL - Pro Choice America

Charley. NARAL’s abortion resource

Planned Parenthood

Miscarriage and Abortion Hotline has references about where to procure abortion medications. They also assist women in the process of self managed abortion or miscarriage by phone or text and will respond in an hour. Details and hours of operation at their website.

United State of Women Reproductive health page (bottom of the page) has important resources such as medical support, access to Telehealth, prescriptions by mail, and legal support references.

Practice careful communications - The Digital Defense Fund has a number of tips to keep texts, calls, and internet use private. Here is their site.