November 22, 2024
Column

Bill backs patient care by backing RN ratios

You’re in the hospital, you’re in pain. Will someone be there for you when you need help? Unfortunately, the answer might be no for far too many Maine patients.

Patient care standards today are rapidly eroding. One major reason is the often unbearable conditions for registered nurses who are a patient’s primary lifeline and advocate.

Hospitals force them to juggle too many patients at one time, endangering patients and overwhelming caregivers. All too often, this means that RNs don’t have the time to assess and properly care for any of their patients, particularly since hospital patients today are much sicker and need more complex medical treatments than in the past.

Rather than continue to practice in conditions that are unsafe for the patient and caregiver, increasing numbers of nurses simply choose to leave the bedside; meaning that when you need an RN there might not be one available.

That is why the Maine State Nurses Association and National Nurses Organizing committee are working with Rep. Sean Faircloth to pass An Act to Increase the Safety of Hospital Patients (LD 1538), which will significantly improve patient safety in our hospitals with enhanced standards for nurses and stronger protections for patients.

The Labor Committee is holding a hearing on this critical legislation today.

The bill would set minimum, safe RN-to-patient staffing ratios, and is modeled after a groundbreaking law California approved a decade ago. The California law has provided nurses there the support and time they need to provide higher quality care – and helped ease that state’s nursing shortage.

More nurses are staying at the bedside, and more are entering the work force with the promise of better conditions. Since the law was enacted, more than 70,000 additional RNs have been licensed, a yearly average that is triple the number before the law.

Talk to nurses across Maine today and you will hear why the law is needed here. Among testimonials we have heard: “Unable to answer patient call bells;” “Labor patient came in without calling at 2:40 a.m. In order to evaluate her, I had to leave an infant unattended in the nursery;” “Late meds and treatments.” Are these risks we want Maine patients and families to endure?

The law would also bar hospitals from retaliating against nurses who blow the whistle on unsafe conditions like these.

Ratios are common-sense minimum safety standards, just as we have in other areas of public life. We have ratios for airline pilots and licensed day-care employees and specific standards for clean air and water.

Numerous studies have documented the effects of hospital nursing ratios – and what happens when you don’t have them. The latest, in the journal Medical Care, found that in an especially busy hospital, a 10 percent increase in the number of patients a nurse must care for led to a 28 percent increase in avoidable adverse events, such as hospital acquired infections, accidents and medication errors.

Similarly, a five-year study by the Joint Commission on Accreditation of Hospitals found that inadequate RN staffing in hospitals precipitated one out of every four unexpected deaths or serious or permanent injuries.

Another study in the Journal of the American Medical Association found that each additional patient assigned to a registered nurse led to a 7 percent increase in death within 30 days. All told, when RNs go from caring for four to caring for eight patients, death rates jumped 31 percent. And the New England Journal of Medicine reported some of the problems prevented with safe RN-to-patient staffing ratios include cardiac arrest, shock, pneumonia, urinary infections and gastrointestinal bleeding.

Given these sobering numbers, how can Maine not move to protect patients by enacting safe nurse-to-patient ratios? Whose life is not worth saving? The sad truth is that too many hospitals today act as big businesses, putting their bottom line ahead of best safety standards for Maine residents. That’s why this modest reform is needed.

Registered nurses are at the heart of our medical system. It’s time for Maine to take care of them – so they will be there for us and our family members.

Maureen Caristi, RNC, is president of the Maine State Nurses Association.


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