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Nurse-to-Patient Ratios The healthcare in United States deals with many internal issues that the general public used to be unaware of, until recent times. Still, upon seeing nurses going on strike, most of the people conclude that it has only to do with their demands of better wages and additional social benefits, while in fact, this matter is much more complicated. Majority of nurses demand that the number of patients, they provide services for, should be limited. They argue that is a patients health, which is their foremost concern. Quoted in the article of Kim Norris Health Care: Nurse-to-patient ratio equals conflict the president of American Nurses Association Cheryl Johnson says: If you can't see them (patients), you can't keep them safe. We're not fighting for us, we're fighting for the patients (Norris, Detroit Free Press). The public debate over what is the appropriate nurse-to-patient ratio in hospitals has been ongoing for more than ten years.
At the beginning of nineties the new republican administration of George Bush introduced cuts to the healthcare budget. This led to the layoffs among nurse personnel, as they constitute about one forth of hospitals workforce. It is estimated that about 60% of all hospitals spending are labor related. In the few years, after these cuts took place, it has been observed that the patients mortality rate has risen up to 7% across America. Still, it has taken another few years to realize that there was a direct connection between this trend and the policy of nurse layoffs. After an extensive research of this issue by the few credible sociological institutions, it was being concluded that providing an adequate number of nurses to the patients in hospitals is one of the most important factors that contribute to their well-being. The year 1995 marks the emergence of a new term in the field of healthcare: nurse-to-patient ratio.
It stands for the number of patients that one nurse can effectively care for. Up until now, there is still no accepted numeric figure for such ratio, on the nationwide scale. In 1996 the American Institute of Medicine conducted a study, in order to set the standard for nurse-to-patient ratio. It was meant to be taken in consideration by hospitals managers and those responsible for the nurse staffing. The Institutes study proved the existence of relationship between nurse-to-patient ratios and the risk of post-surgery complications in Intensive Care Units (ICU). There was a clear indication that in ICU, where there were more than three patients for one nurse, the risk of medical complications was increased by 12%, comparing to the units with better nurse-to-patient ratio.
This study also showed that the rate of patients recovery depended largely on psychological factors. There are many cases when patients, with even incurable illnesses, can successfully deal with their problem by cheer will power. For example, as long as patient is strongly convinced that some particular pills are going to help him, they really will, even though they might not be containing any medicinal ingredients at all. It goes without saying that it is very important to keep patients in good spirits, while theyre at the hospital, as only this sometimes can guarantee that they will act according to doctors wishes, after being diagnosed. The similar researches were being conducted in several hospitals across the nation. They all confirmed the fact that nurses can only provide effective care for the limited number of patients.
Nevertheless, this conclusion contradicts the code of medical ethics. Nurses, just like doctors, are often required to work extra hours, since their services are essential. It is necessary for every potential nurse to prove that she or him is going to be able to care for as many patients as possible, in order to get good grades at the college. The principles of nurse education, which are still being practiced in colleges, are based on medicinal science that is 50 years old. Back than, it was assumed that as long as nurse is able to help patient medicinally, she fully complies with her professional duties. But in the light of recent discoveries in the field of psychology and genetics, it appears that this is simply not enough. Every patient requires personal approach. It especially applies to elderly people.
Healthcare workers ability to find a psychological contact with such patients, accounts like no other factor for their professional success. It has to be remembered at all times that the most of elderly patients are quite psychologically unstable and it takes an extra effort, on the part of doctors and nurses, to establish a bond of trust with them. In this respect, nurses dont have to be really interested in listening to patients stories, yet they must appear as they do. This can be only accomplished if every hospital employs an adequate number of nurses. In 2002 California became the first state that enacted healthcare regulations, concerning nurse-to patient ration within specific units. For example, nurses in surgical sections can care for no more then six patients, while in ER patients number is limited to four and even two, if their condition is critical.
At present time, the legislators of 8 more states consider enacting similar staffing regulations. This, just like any issue of public concern, has its critics and supporters. Critics point out to the fact that mandating nurse-to-patience ratios will result in cutting expenditures for other important sectors of public healthcare. Also, it is much easier to enact nurse-to-patient regulations with the mean of legislative acts, then being able to implement them on practical level. The numbers of patients that arrive in hospital vary greatly from month to month. Does it mean that more nurses are to be hired if more ill people require their care and laid off, when their services are no longer needed? Critics say that if the trend of staffing hospitals with more nurses is brought to its logical conclusion, than it will be only the matter of time before people begin to demand that there should be no more then one patient for the nurse to take care of.
It goes without saying that this will result in increasing the quality of healthcare overall. But what if some patients start complaining that even having a personal nurse is not sufficient for them? It is not a very unlikely scenario The arguments of those whore in favor of giving the nurse-to-patient ratios mandatory status are also very convincing. They say that having a limited number of nurses in hospital does not necessarily result in its financial efficiency. For example, if there is inadequate number of nurses, it will inevitably lead to an increased use of hospitals resources. The principle is simple: the less there are nurses - the longer is the length of patients stay. The longer patient stays the more it costs for the hospital. In her article More Nurses, Better Patient Outcomes: Why Isnt It Obvious? the certified nurse Linda Aiken says: We also found that the hospitals that had the most favorable nurse-to-patient ratios had significantly shorter overall length of stay as well as fewer ICU days. Thus, the overall cost of care was no greater than in hospitals with less favorable nurse-to-patient ratio (Aiken).
Also, it is generally accepted that the medicinal mistakes is the third most important factor, which results in increasing of mortality rate in every hospital. In his article Davis releases his rules for nurse-to-patient ratio Sam Russell provides us with some conclusion: from a recent Institute of Medicine (IOM) study, which deals with this issue: In November 1999 IOM estimated that anywhere from 44,000 to 98,000 hospitalized patients a year die from medical mistakes in America The report called for major changes in the nations health care system to protect hospital patients. It suggested that mistakes are not necessarily from the recklessness of individuals, but rather from flaws within the system as a whole (Russell, San Francisco Chronicle). Among its recommendations of how to improve the effectiveness of healthcare system in America, IOM has named the enacting of Federal law, which would assign a mandatory status to nurse-to-patient ratios in every particular state. According to IOM, this measure can reduce the number of patients that die from medicinal mistakes down to 60% every year. Im personally in favor of enacting nurse-to patient ratios with the mean of proper legislative acts in all of the states. As a matter of fact, there are many highly qualified nurses from Britain and other European countries who dream of being able to work in America for the half of what is being usually paid to Americans.
The process of them getting accreditation to work in U.S. hospitals should be simplified. Currently, the issue of nurse-to-patient ratio is being exploited by the nurse unions, which exist for no other reason but to protect its members jobs. However, hiring more nurses would automatically mean that there would be less social benefits provided to them. That is why, in my opinion, the nurse unions are not genuinely interested in providing the adequate healthcare to the patients, as their main objective. Their only true concern seems to be the extracting as much money as possible from Federal government.
While declaring that they strive to have more nurses hired to work in U.S. hospitals, they suggest the applying of stricter requirements for the accreditation of such nurses. The practice shows that gaining excellence in nursing corresponds, on the part of health care worker, corresponds to attaining practical experience the most. That is why the hiring nurses to provide appropriate nurse-to patient ratio in hospitals should be thought as a priority. It is a classical example when quantity acquires the properties of quality. I would suggest that the third party has to handle the issue of staffing hospitals with nurses.
The nurse-to-patient ratio should be calculated according to the population density in every particular area. There are many factors that need to be considered, in order to come up with proper figure. It is important to understand that the lowering of death rate among patients has to be evaluated from social prospective. It is not only the health of every particular individual that needs to be considered, but also the well-being of the whole community. I think that it would be more than sufficient to provide one nurse to care for three patients. If this ratio proves to be insufficient, it means that the root of this problem lies in the field of designing social policies, rather than in the field of healthcare. Bibliography: Aiken, L.
More Nurses, Better Patient Outcomes: Why Isnt It Obvious?(2001). University of Pennsylvania. Retrieved March 26, 2005 from http://www.rwjf.org/files/research/aiken-more%20nu rses.pdf. Norris, K. Health Care: Nurse-to-patient ratio equals conflict. (August 21, 2004). Detroit Free Press Site.
Retrieved on March 26, 2005 from http://www.freep.com/money/business/nursestaffing2 1e_20040821.htm Russell, S. State moves to freeze nurse-patient ratio (November 5, 2004). ArnoldWatch.Org. Retrieved March 26, 2005 from http://www.arnoldwatch.org/articles/articles_00050 1.php3 Russell, S. Davis releases his rules for nurse-to-patient ratio (January23, 2002). San Francisco Chronicle. Retrieved March 26, 2005 from http://www.psych-health.com/staff08.htm Wabbit, T. Judge Orders Hospitals to Meet Nurse-to-Patient Ratio (2004).
Yahoo! News. Retrieved March 26, 2005 from http://news.yahoo.com/news?tmpl=story&u=/sddt/2005 0316/lo_sddt/judgeordershospitalstomeetnursetopati entratio.
Research essay sample on Nurse to patient Ratios