Nurses’ Experience Counts


Who would have thunk it?  It turns out that patients may get the best care when treated in hospital units staffed by highly experienced nurses.  

  • Researchers analyzed data from more than 900,000 patients admitted over four years to U.S. Veterans Administration hospitals and found that for each one-year increase in the average tenure of registered nurses in a hospital unit, patients spent 1.3 percent less time in the hospital.
  • They also found that patients’ length of stay increased when a team of RNs (registered nurses) had to do without an experienced member or had a new member assigned to them.
  • Reducing length of stay is the holy grail of hospital management because it means patients are getting higher quality, more cost-effective care. (I still hate when they throw around the term QUALITY, though – DF)
  • When the same team of nurses works together over the years, the nurses develop a rhythm and routines that lead to more efficient care.
  • Hospitals need to keep this in mind when making staffing decisions — disrupting the balance of a team can make quality go down and costs go up.
  • The findings show that hospital chief executives should consider policies to retain the most experienced nurses and create a work environment that encourages nurses to remain in their current units.

Just like doctors, it is extremely important to have good and experienced nurses.  Unfortunately, we have to speak the language that administrators know so they will understand and hopefully listen. That language is money and NOT care.  But maybe a study like this will help!


Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  9 comments for “Nurses’ Experience Counts

  1. V N
    April 27, 2014 at 11:26 am

    I can say the same of doctors. Lots of hubris to a lot of the ones I knew.

  2. V N
    April 27, 2014 at 11:15 am

    It took one time of showing me how to take blood from my own PICC line and I did it there after. Was I the most trained person? No. Could I do the job? Yes. It freed up a nurse to go elsewhere and saved $$$ for me.

    How about leaving simple things like colds, flu, wellness checks, etc. to people who can be trained to do them and then allow nurses to watch patients & use all that training for something, and then use doctors for the more complicated stuff? If you do that, docs might have more time per patient.

  3. Mary K
    April 23, 2014 at 9:59 am

    VN talks about the real problem that we nurses have seen at the bedside–NO TIME AT THE BEDSIDE. As a retired RN of over 20 years service I can tell you that I went from giving caring compassionate care to “putting out fires” as my workload went from 8-hour days with 3 to 5 patients to 12-hour days with 7-8 patients. And now I see a study out there that says that “perhaps” the number of patients per nurse DOES matter. Hmmm, it took some bright researcher to figure that out?? The RNs and LPNs in the nation could have told him that years ago!!!!

    • V N
      April 23, 2014 at 10:15 am

      Yes, they have these nurses doing dumb stuff and why any way do you need a nurse for some of this mess?

      It does NOT take a Bachelors degree to make sure someone takes their pills. Change an IV bag. For the love of heaven.

      It drives me crazy too to see patients that can’t simply do some things for themselves. I told them teach me what I can do to get this dumb IV alarm going off. I’ll do it myself. I did except when I went comatose (hey at least they knew when to really say OH CRAP).

      Then again, they’re not happy when you possess a tool kit and try to monkey with IV’s and all but hey … the body might be sick but the mind isn’t.

  4. John A. Mayer, MD
    April 22, 2014 at 1:26 pm

    Does anyone else share my opinion that “Three Year RN’s” are often superior to baccalaureate nurses? Even with new graduates, it has always been my experience that three years of actual OJT/apprenticeship, living in a hospital, working all shifts, actually dealing with patients instead of dealing with clipboards and assigning peons to care plans makes a much better care-giver. When an old 3-year nurse tells you that Mr. So-and-so’s “color isn’t right” you had better go check Mr. So-and-so. Unfortunately, the Nurses’ Protective Society has made them a thing of the past.

    • Frank J. Rubino MD
      April 23, 2014 at 9:38 am

      I agree. It has become the academic (BSN) degree that counts. (I might add: the tuition dollars to the nursing school that counts). I am sure that before long an MS and a Phd will be required to be a floor nurse. The whole process is a “Jobs Program for Academia”. They will need to hold a Phd in the “philosophy of nursing” or the “sociology of the nursing profession” to be able to fully understand what a patient is saying. Academic nursing schools have become removed from the real world.

  5. Pat
    April 21, 2014 at 9:49 pm

    We have been looking down the barrel of a worsening nurse shortage for over a decade, even as the population ages and the average in-patient acuity has increased.

    Every year hospitals waste money on useless JCHAO, HIPPA, CMS, et al regulations, rather than spending on better nursing pay and more experienced nurses. And we need top-notch ass kicking nurses a lot more than we need more LELTs, but we have to pay ’em.

    Again and again, big wasted health bucks to those who provide no care, and only get in the way of those who do.

    • V N
      April 21, 2014 at 10:58 pm

      Here here!!!

      Agreed. I saw one nurse so frazzled, I asked was she ok. She said she had a headache and hadn’t eaten. I said I had some food she could have but that’s all I could do for her. She said she had a candy bar but couldn’t get a chance to eat it. I said well stay in my room and I’ll make an excuse for you to be in here so you can at least get that down.

      Its just crazy …

  6. V N
    April 21, 2014 at 10:55 am

    When we’re talking experience do we mean education or experience on the job? I know some nurses that are getting hit up to go back for their BSN when they have over 10 years experience and KNOW what they’re doing and give excellent care. Where do we draw the line between the two?

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