Understaffed Hospital Nurses

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Being a nurse is ridiculously hard.  I have no idea why someone would even take that path in life anymore.  I have worked with so many great ones that I know it was a true calling from them.  But the job is getting worse and worse.  Besides the fact that they have to deal with arrogant physicians and increasingly difficult patients, they are being more and more stretched at the hospitals.  I had seen this trend worsen over the years with many of my nurse friends burning out and quitting.  They LOVED their profession but they still quit. Why? They had no choice.  No one listened to them. Not only was the job overwhelming but they felt they were putting their patients at risk. Here is an Op-Ed in the NY Times that talks about this. It explains the issue of understaffing nurses in hospitals and I took the liberty to highlight some points below:

  • The nurses were scared because their department was so understaffed that they believed their patients — and their nursing licenses — were in danger, and because they knew that when tensions ran high and nurses were spread thin, patients could snap and turn violent.
  • The nurses were regularly assigned seven to nine patients at a time, when the safe maximum is generally considered four (and just two for patients bound for the intensive-care unit).
  • In a survey of nurses in Massachusetts released this month, 25 percent said that understaffing was directly responsible for patient deaths, 50 percent blamed understaffing for harm or injury to patients and 85 percent said that patient care is suffering because of the high numbers of patients assigned to each nurse.
  • According to the New York State Nurses Association, this month Jack D. Weiler Hospital of the Albert Einstein College of Medicine in New York threatened nurses with arrest, and even escorted seven nurses out of the building, because, during a breakfast to celebrate National Nurses Week, the nurses discussed staffing shortages. (A spokesman for the hospital disputed this characterization of the events.)
  • “The biggest change in the last five to 10 years is the unrelenting emphasis on boosting their profit margins at the expense of patient safety,” said David Schildmeier, a spokesman for the Massachusetts Nurses Association. “Absolutely every decision is made on the basis of cost savings.”
  • Experts said that many hospital administrators assume the studies don’t apply to them and fault individuals, not the system, for negative outcomes.

You will see a common thread between physicians’ complaints on this blog and the nurses’ complaints above, that thread being the ever increasing growth and power behind administrators.  The sheer number of them has increased 3000% over the past 30 years and they cost the system jobs.  Whose jobs?  Nurses!  They are the biggest reason we have less nurses on the floor in the hospital.  You are cutting nurse positions to fund a high paying administrator so that he or she can go to meetings all day and eat bagels.  Why this article doesn’t say it is beyond me.  Of course you will hear that studies show other budgetary reasons causing these staffing cuts, but these studies were created by and for administrators.  Don’t let them fool you.  How many more nurses could you keep employed if you cut the CEO’s salary from $5 million a year to $4 million a year?  All someone needs to do is take ONE hospital and add up all the salaries and benefits of the administrators and compare that to all the salaries and benefits of the nurses.  Once that data is published, then true change may occur.

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] 

  5 comments for “Understaffed Hospital Nurses

  1. Pat
    May 31, 2015 at 4:28 pm

    Agree with all the above, and Lance stole most of my answer.

    I’ve wondered for years how many extra nurses could be hired (or salaries raised) just with the money waste on JCHAO pre-inspections and inspections that improve absolutely nothing. How many nurses could be hired for the cost of mandated EHR’s.

    We properly blame administrators, Big Insurance, and hospital corporations. We also correctly blame gov’t mandates and lawyers. But we would also blame patients. They continue to empower these entities that degrade and eliminate what they claim to want.

  2. Seneca
    May 31, 2015 at 1:01 pm

    It is quite unbelievable how little attention administrative costs in the US healthcare system have gotten in the lay press. Here is a source from the administrators’ own journal which estimates it at almost 25% of hospital costs and rising!

    http://www.beckershospitalreview.com/finance/why-u-s-hospital-administrative-costs-are-among-the-highest-in-the-world-7-things-to-know.html

    Do these guys have a PR secret we doctors should know? There are actually articles from 15 years ago which demonstrate an inverse relationship between amount of administration and medical quality.

  3. Bill Ameen MD
    May 31, 2015 at 10:56 am

    Dr. Doug, As a spouse of a recently retired critical care nurse (watching her bundling all her nursing journals for recycling this weekend) I can testify every word is true. She was reprimanded a couple of years ago for not acknowledging the clueless DON who came through ICU dressed as the Easter Bunny in the middle of the night handing out chocolate and told she needed time off for “attitude adjustment” (which I happily gave her as “her doctor”). Then after she returned two months later one of the thoracic surgeon’s patients had a seizure at 2 am on the bedside commode and the doctor cursed her when she called him. She demanded an apology when she reported him to the CMO who did nothing because this guy was a cash cow for the hospital. They’re busy firing all the older higher-paid nurses to pay for the bagels and administrators. Someone in government needs to turn attention to the frivolous salaries paid to hospital administrations and away from FIFA (like, who cares?)…

  4. Sir Lance-a-lot
    May 31, 2015 at 8:15 am

    Dead-on right, Doug.

    The job or the nurse used to be to pay attention to and care for the patient, and act as a last line of defense, and final set of eyes and ears, for the doctor.
    Now the job of the nurse is to dispense meds to 20 patients and to sit and complete voluminous documentation.

    It’s one of the most shameful aspects of American medicine today.

    • Steve O'
      June 1, 2015 at 8:26 am

      Nursing went from a decent, professional vocation (that still needed improvement) down to wage slavery, from 1980-2000 That was when quality declined in hospital and community care, and the Oblivious decided to wade in and “Fix Medicine.” Now, it mirrors frighteningly the job of Public School teachers. Get started, and get away from direct contact as soon as you possibly can. It’s the front lines, it is a blame magnet, and it pays the least. Jump to administration and oversight as soon as you can.

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