Why we need more nurses

| 08 Nov 2023 | 11:22

    What if I told you there was a way to limit the number of deaths that occur in NY hospitals? Would you want to know how or if it was truly possible? What if I told you we could not only decrease deaths, but also ensure our family members receive safer care and better results during their hospital stay? Despite innumerable research studies proving this is exactly what safe staffing ratios could do for our healthcare system, 49 out of 50 U.S. states have yet to pass a bill that enforces a strict nurse-to-patient ratio.

    I have been a Neonatal ICU nurse in some of the top hospitals in the tristate area for almost 15 years and witnessed unsafe staffing way more times than I’d like to admit. Unfortunately, I have seen exactly what happens to these tiny babies when the workload is too overwhelming, when patients in critical condition are assigned to a nurse who has one or even two other babies, and when nurses are stretched way too thin day after day. I can say first hand it is scary, draining, and disheartening to feel like your patient load is so heavy you cannot possibly deliver safe, good quality care.

    Not only are nurses getting burned out from constantly having to manage an unsafe amount of patients at one time, but decreased nurse-to-patient ratios can lead to so many benefits for both the patients and hospital administration. According to a prospective study done in London in 2021 on the effects of nurse-to-patient ratio legislation, improved patient outcomes, shorter length of stays, and fewer mortalities were reported with lower nurse-to-patient ratios and fewer readmissions. The study goes on to include that the monetary savings of decreased lengths of stay and decreased readmissions were estimated to be at least twice the amount of money it would cost to adequately staff these in-patient units. In an observational study done on in-patient NY hospitals also done in 2021 found that if patient-to-nurse ratios were 4:1 instead of the average of 6.3 patients per nurse, some 4370 fewer deaths could occur. This same study projected over $650 million could be saved just from shorter lengths of stay alone and over $60 million from fewer readmissions.

    Yes, we all know more nurses equates to hospitals needing to spend more money, but we also know from years and years of research that more nurses also equates to decreased adverse events. These avoidable negative experiences include hospital-acquired infections, poor control of blood sugars, and more importantly, death. Adverse outcomes such as cardiac arrests, pneumonia, gastrointestinal bleeds, shock, and urinary tract infections are higher in hospitals with low nurse staffing and higher patient-to-nurse ratios. If there were more nurses each of them would be able to spend more time with their patients and deliver safe, good quality care.

    In 2021 New York State passed Bill No. A6571, under Governor Cuomo, that approved a nurse-to-patient ratio of no more than two patients assigned to one nurse in intensive care and critical care units, however this law is not being strictly enforced. Multiple nursing organizations including New York State Nurse Association and National Nurses United have been advocating for safe staffing for decades. Earlier this year the Department of Health finally sent out notifications stating they will begin to enforce that hospitals must at least have a plan or “committee” that focuses on safe staffing, and staffing should also be dependent on the acuity of the patient, or they would face civil penalties. Unfortunately, these staffing committees include hospital leadership, as well as bedside nurses, and we all know how easy it is to convince our bosses that they need to spend more money in order to achieve better outcomes. Although we made a huge step in the right direction this year, we still have a long way to go to get specific nurse-to-patient ratios enforced by our legislators the way they have successfully implemented in California hospitals. The fight for you and your family’s safety when receiving care in NY hospitals is not over yet. We must all continue to support our local nursing organizations and demand to our local legislators that we need more nurses.

    Amaris Burgos, BSN, RNC-NIC, C-ELBW