Keep Patients Safe
Are patients in the hospital being cared for as well as they should be? No. As a registered nurse (RN) working in a hospital in the state of West Virginia, I experience the first-hand circumstances of unsafe nurse staffing. During the 2019 legislative session, House Bill 2611, a bill that would require hospitals to create an “acuity based classification system” which would set standard practices/policies for nurse-to-patient staffing ratios based on each inpatient population was introduced (HB-2611, 2019).
As a bedside nurse, I want to address the importance of patient safety in the hospital setting.
State-mandated safe-staffing ratios are crucial to ensure the safety of patients and nurses (Gutsan et.al, 2018). Johns Hopkins safety experts calculated that more than 250,000 deaths per year are due to medical error, surpassing respiratory disease deaths, which makes medical error the third leading cause of death in the U.S. (Johns Hopkins Medicine, 2016). A standard nurse to patient ratio is 1:4. With each additional patient added to that ratio, a 7% increase in hospital morality is incorporated into that nurse’s work setting (DPE, 2016).
Do you want you or your family to be part of that 7%?
Speaking from personal experience, I know that it is not safe for one nurse to care for upwards of six patients. Nurses begin their shifts with a physical assessment of each patient, medication administration, morning care such as toileting and bathing, and documentation of all tasks completed for each patient.
Outside of these standard practices, there are consistent unforeseen situations that arise throughout a shift that could, and often do, take nurses away from their patients. These unforeseen circumstances include emergencies that pull nurses away from their routine care. Without adequate staffing, patient care and safety suffer and no one wants that. How are we supposed to provide safe and patient-centered care if we add more patients to our workload? It is important to be able to provide ethically steady care to our patients while catering to their diverse needs.
House Bill 2611 proposes a list of various nurse-to-patient ratios that are safe for hospitals. Hospitals may claim that the cost to hire nurses to adhere to these ratios is unrealistic; however, a key to solving this cost issue is not about more nurses but better retention. According the American Association of Colleges of Nursing (AACN), the average Registered Nurse (RN) cost-per-hire is around $2,820 (DPE, 2016). Other studies estimate the overall turnover cost per RN at $65,000 (DPE, 2016).
The average hospital is estimated to lose about $300,000 per year for each percentage point increase in annual nurse turnover (DPE, 2016). Adequate and safe nurse staffing are key to nurse retention. Safe-staffing ratios lead to increased nurse retention and better patient outcomes.
House Bill 2611 was referred to the House Health and Human Services Committee at the end of January and action on the legislation is still pending. Now, more than ever, the citizens of West Virginia need to voice their opinions about the issue of patient safety associated with nurse-patient staffing ratios.
Specifically, contact your local legislators, especially those who serve on the House Health and Human Services Committee and voice your support for this important bill. Encourage your friends and neighbors to do the same. If the issue of patient safety is not adequately addressed, we may likely see an increase in nurse turnover rate, out-migration of nurses in search of safer work environments, increased hospital length of stay and poor patient outcomes, and decreased in patient satisfaction scores for our hospitals. The state of West Virginia needs to prove that they care about their citizens, and that they believe patients deserve to be provided the safest care possible.