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The Importance of Nursing Care
II recently responded to a question on my message board in which an individual asked about the potential benefits of being taken care of by "big city" versus a "small city" cardiologist. Apparently the poster was having a discussion with a sibling, who thought that their mom should be going to the city for her medical care.
In my response I pointed out that the most important factor in hospitalization and recovery without complications is not the surgeon or the physician, it's the nursing care. Now before all my physician readers get their knickers in a knot (sorry, I just love that visual), I did point out that it is important to make sure that the doctor is qualified to perform the surgery or manage the type of illness in question, and that there are circumstances in which a city hospital's expertise is warranted. In other words, you might want to read the original message.
Now in the journal "Health Affairs" and reported on Reuters Health Information, there is an article about a study that attempts to quantify the potential costs and savings to hospitals by increasing registered nursing hours.
Based on data from 800 acute-care hospitals, researchers concluded that increasing the RN to LPN ratio, while keeping the number of total nursing hours the same, would cost hospitals $811 million, but save $1 billion in the short term. The study found that hospitals could avoid 5,000 annual patient deaths if they boosted the number of registered nurses by replacing some licensed practical nurses with RNs; LPNs require less training and education compared with RNs. Although this appears to limit job opportunities for LPNs, the study actually calls for an overall increase in the number of RNs and LPNs in practice; it just changes the "mix" on any given unit and shift.
A number of studies in the last decade have pointed to human error in the frequency of patient deaths, and in hospital complications such as urinary tract infections, heart attacks, and poor post-operative outcomes.
A large number of these studies point to improved outcomes with increased nurse to patient ratios. As a result the state of Rhode Island, where I practice, is going to start publishing the nurse to patient ratios at all of the state's hospitals annually, so that individuals may use this as a factor in their choice of hospital for elective admissions. It will be amazing to see what happens to nursing salaries once this goes into effect and hospitals have to compete with one another for staff. Stay tuned for that ride folks!
So as I pointed out to the person writing to me at WebMD, the best choice may be the facility that has the greatest number of registered nurses on staff. There is just one problem with this plan: there aren't enough nurses to go around. The state of California implemented laws to mandate staffing ratios in 2004, but many hospitals haven't been able to implement them due to the nursing shortage. Other countries, such as England and Australia are complaining about U.S. efforts to recruit nurses away from home with higher salaries; those countries are suffering similar nursing shortages and have lower pay scales. The U.S. Department of Labor projects that we will need 1 million replacement nurses by 2012, just 6 years from now, and yet the American Association of Colleges of Nursing reports that nursing schools turned away 32,000 interested students in 2004 because they didn't have enough faculty to teach them.
Fixing nursing ratios will take time and money; in the current political climate it seems unlikely that additional federal funding will be forthcoming to encourage students to go to nursing school, to provide LPN to RN training for experienced practical nurses, and to encourage nursing leaders to teach by improving salaries of those who take on this challenging career. It's too bad that the value of saving human lives matters so little to our current administration. But that's the subject of another blog....
Laurie
The art of medicine consists in amusing the patient while nature cures the disease.
Voltaire (1694 - 1778)
Fortunately nurses are good at this...
Related Topics: The Baby Boomer Heart: A User's Guide, Finding Good Medical Care
Technorati Tags: healthcare, nurse, RN, LPN
In my response I pointed out that the most important factor in hospitalization and recovery without complications is not the surgeon or the physician, it's the nursing care. Now before all my physician readers get their knickers in a knot (sorry, I just love that visual), I did point out that it is important to make sure that the doctor is qualified to perform the surgery or manage the type of illness in question, and that there are circumstances in which a city hospital's expertise is warranted. In other words, you might want to read the original message.
Now in the journal "Health Affairs" and reported on Reuters Health Information, there is an article about a study that attempts to quantify the potential costs and savings to hospitals by increasing registered nursing hours.
Based on data from 800 acute-care hospitals, researchers concluded that increasing the RN to LPN ratio, while keeping the number of total nursing hours the same, would cost hospitals $811 million, but save $1 billion in the short term. The study found that hospitals could avoid 5,000 annual patient deaths if they boosted the number of registered nurses by replacing some licensed practical nurses with RNs; LPNs require less training and education compared with RNs. Although this appears to limit job opportunities for LPNs, the study actually calls for an overall increase in the number of RNs and LPNs in practice; it just changes the "mix" on any given unit and shift.
A number of studies in the last decade have pointed to human error in the frequency of patient deaths, and in hospital complications such as urinary tract infections, heart attacks, and poor post-operative outcomes.
A large number of these studies point to improved outcomes with increased nurse to patient ratios. As a result the state of Rhode Island, where I practice, is going to start publishing the nurse to patient ratios at all of the state's hospitals annually, so that individuals may use this as a factor in their choice of hospital for elective admissions. It will be amazing to see what happens to nursing salaries once this goes into effect and hospitals have to compete with one another for staff. Stay tuned for that ride folks!
So as I pointed out to the person writing to me at WebMD, the best choice may be the facility that has the greatest number of registered nurses on staff. There is just one problem with this plan: there aren't enough nurses to go around. The state of California implemented laws to mandate staffing ratios in 2004, but many hospitals haven't been able to implement them due to the nursing shortage. Other countries, such as England and Australia are complaining about U.S. efforts to recruit nurses away from home with higher salaries; those countries are suffering similar nursing shortages and have lower pay scales. The U.S. Department of Labor projects that we will need 1 million replacement nurses by 2012, just 6 years from now, and yet the American Association of Colleges of Nursing reports that nursing schools turned away 32,000 interested students in 2004 because they didn't have enough faculty to teach them.
Fixing nursing ratios will take time and money; in the current political climate it seems unlikely that additional federal funding will be forthcoming to encourage students to go to nursing school, to provide LPN to RN training for experienced practical nurses, and to encourage nursing leaders to teach by improving salaries of those who take on this challenging career. It's too bad that the value of saving human lives matters so little to our current administration. But that's the subject of another blog....
Laurie
The art of medicine consists in amusing the patient while nature cures the disease.
Voltaire (1694 - 1778)
Fortunately nurses are good at this...
Related Topics: The Baby Boomer Heart: A User's Guide, Finding Good Medical Care
Technorati Tags: healthcare, nurse, RN, LPN
