The research that has been done into the effects of short staffed unit has shown that no patient on an acute ward is at all safe if his nurse has more than 5 other patients. In the UK his nurse has at least 10 to 12 or many many more other patients. That is why nursing care sucks here. It has nothing to do with nurse training, or nurse bitchiness, or bad attitudes ,or a lack of training. Even if it was, the piss poor ratios would still have a larger impact. "Dignity Training" can only help so much if the nurses are overwhelmed. Overwhelmed is an understatement for what British nurses are going through. Everyday in Britain, hardworking, well trained caring nurses are giving terrible care.
It's all about the ratios.
Nursing ratios save money and lives
By Suzanne Gordon
July 9, 2008
BEFORE ITS legislative session ends in July, the Massachusetts Senate has an
opportunity to protect hospital patients as well as the nurses who care for them
by approving the Patient Safety Act that was passed overwhelmingly in the House
a month ago.
The ratios bill would require that the Massachusetts
Department of Public Health implement enforceable limits on the number of
patients a registered nurse can be assigned, thus providing patient protection
in all acute care hospitals. As the Senate debates this measure, it should
consider the positive effects that legally mandated nurse-patient ratios have
had where they've already been enacted - in California and Australia.
In California, since 2005, no nurse on medical surgical
floors can be assigned more than five patients at a time. On equivalent
units in Victoria - the second largest state in Australia - the minimum required
staffing for every 20 patients is five RNs, backed up by a "charge nurse" who
has no patient load of her own and is thus free to assist other RNs.
both California and Victoria, ratios were originally introduced because
excessive RN workloads were putting both nurses and patients in jeopardy, while
adding to overall healthcare costs. More than 60 studies have documented
that hospital understaffing results in more patient deaths, plus more
preventable complications like pneumonia, urinary tract and catheter infections,
and medication errors. A study done in 2005 by Michael B. Rothberg in
the journal Medical Care put a price tag on these problems, concluding that a
nurse who had time to prevent a case of pneumonia "saved $22,390 to $28,505, or
$4,225 to $5,279 per additional hospital day." When nurses prevent an adverse
drug event, they save the patient from an "added 2.2 hospital days at a cost of
$3,344." On the other hand, if understaffing leads to complications after
surgery, the resulting patient stay can be 8.1 days longer than normal, adding
nearly $11,000 to the total expense.
Unmanageable workloads have also
created an exodus of nurses into other fields or nonpatient-care jobs. According
to a study by L.J. Hayes that appeared in the Journal of International Nursing
Studies, hospital nurse turnover in 2006 - outside of California - ranged from
15 to 36 percent per year.
A study by economist Joanne Spetz, just
published in the nursing journal Politics, Policy, & Nursing Practice, finds
that ratios in California have increased RN job satisfaction and reduced
turnover. According to Spetz, nurses are happier at work because they now get to
spend more time at the bedside - particularly on patient education - which has a
positive impact on nurse turnover and thus on the quality of care.
Researchers at the University of Pennsylvania have compared nurses in
California with those in Pennsylvania and New Jersey - states without minimum
staffing requirements. California RNs reported greater job satisfaction, leading
to less burnout.
The nurse patient ratio laws in California and Victoria are by no means perfect. They are relatively new and more research needs to be done. Like all new things there are a lot of bugs that need to be ironed out. How these ratios were implented by each different hospital makes has a huge impact on outcomes.
But it is a start. And we need these laws in Britain.
You certainly won't hear patients in California say that they were left hungry, cold, and in agony. They won't be left waiting for a bedpan or pain pills. They are clean, their nurse answers their call bell and spends time with them. Their nurse maintains their dignity and provides basic nursing care, she uses her knowledge and training to prevent complications and keep her patients safe. This is done without neglecting basic care. And all this care is done by highly educated nurses who only have 4- 6 patients at a time.
Now lets look at the current situation in the UK where the vast majority of the nursing staff on the wards were trained back in the "good old days" and have 15 patients at a time, sometimes more.............
Need I say more.