Last week our beloved Governor must have thought that he’s wondered into a John Leslie movie. 3,000 nurses protested his visit to a women’s conference (no less), and he told his audience that "I kick their butts" and that nurses–the most trusted people in the health care system–were "special interests". Oh and by the way this was at a conference in which CEOs who contributed to Schwarzeneger’s campaign were allowed to actively promote their own companies. While I resisted the temptation to use the headline Arnie takes on 3,000 Nurses, Matt Quinn doesn’t want this to slip by THCB:
Don’t think that you’ve covered the Governator’s decision to repeal CA’s mandatory nurse staffing ratios. The reality is that most hospitals can’t (consistently) meet them . . . which speaks to the acuity of the nursing crisis in this country (and especially CA).
While I certainly believe that most hospitals can do a much better job of allocating nursing resources (and some are using "bidding technology" to do so), there simply not enough nurses being produced . . . or staying in the profession.
Instead of encouraging hospitals to fight (and spend more money on bonuses, etc.) to recruit away nurses from other organizations in their areas by mandating ratios, it makes sense to increase the supply of nurses. There are lots of ways that the state and federal governments can make this happen . . . if it’s a priority. Arnold so far doesn’t seem to feel that this is a priority.
While Linda Aitken and others have done great research on correlating staffing with mortality, complications, etc., there remains too little effort in giving individual healthcare organizations the tools that they need to effectively (and empirically) balance staffing with quality, safety, satisfaction, and cost. "Standard" nurse to patient ratios represent too blunt a tool for this.
Ask any nurse (or hospital risk manager) and you’ll find that staffing is at least a contributing factor to the vast majority of medical errors / mistakes. Hurried people make mistakes . . . and can’t provide patients with the care and compassion that they deserve. Hurried and overworked people are also unhappy. While I applaud the (currently under funded by highly emphasized) efforts to implement IT as a solution to patient safety, having enough nurses (or clinical workers) should rank as high or higher…
There have been some pretty good articles about this in the Sacramento Bee of late.