SAFE PATIENT CARE

By Nancy L. Bassett

Tighter nurse:patient ratios due to decreasing budgets are causing RN burnout and turnover rates higher than ever before, increased use of Float and Agency personnel, and more frequent and more potentially dangerous medication errors.

Nurses and aides start their shift - usually for 12 hours - with a larger number of patients than ever before. Because managed care frequently dictates the use of high-cost high-acuity rooms, each nurse usually moves half of his/her patient load to a less acute area during each shift, and admits the same number or patients - or more - into these now empty beds before the shift is over. Documentation requirements are so strict that the nurse usually spends more time writing about what has been accomplished than actually doing it. Emergency rooms are packed with patients who wait for hours, frequently because no RNs can be located to accept patients.

Frustrated RNs transfer to better nurse:patient ratio units, hoping to handle fewer patients and provide better care. As they try to give safe care to extremely ill patients with rooms full of equipment, and meet the demands of the families, physicians and supervisors, these RNs are burning out at a faster rate than ever before. They not only leave acute and sub-acute facilities, they leave the nursing field completely.

The best way to reverse this frightening trend is, again, to PUT THE AVAILABLE RESOURCES INTO PATIENT CARE AND EQUIPMENT.

We need to re-think our values and where we put our shrinking reimbursement dollars. Putting those dollars into the education and support of the staff for competent and high quality care is my goal for Board direction.