NEW YORK NURSE: June/July 2012
by Julie B. Pinkham, RN
There is a famous slogan from the first campaign to elect President Bill Clinton in which his chief campaign strategist posted signs in every office that read: “It’s about the economy, stupid.” The message was a clear directive about the one issue that was most important to the electorate for that campaign, and what all involved in the campaign needed to keep their eye on throughout the long struggle they faced. For NYSNA’s members and for the patients we care for every day, there is an equally singular, though more industry-specific message that we all need to focus on, and that message, based on the overwhelming vote at our meeting on May 17 is “IT’S ABOUT STAFFING!”
There is no issue more important to the patients and nurses on the front lines than safe staffing. To this point, there are literally dozens of studies in the most prestigious medical and nursing journals that make the unequivocal case that the single most important evidenced based component to ensure patient safety is the establishment of a safe limit on the number of patients a registered nurse is assigned (no matter what their point of entry into nursing practice. ) This is the issue that we all must keep our eyes on, as this is the issue that will pay the greatest benefit for nurses and our patients.
The research is crystal clear: on medical surgical floors, no nurse should ever have more than four patients, and in critical care, no nurse should every have more than two patients.
Despite this research and these findings, and again, the research is overwhelming, the industry has fought tooth and nail any limitations on nurses’ patient assignment, using a number of absurd objections, including, when their profits were in the billions, that they couldn’t afford it, nor could they find the nurses needed to fill these requirements for better staffing. The other favorite argument against safe staffing was they would need to fire all ancillary staff if these regulations were passed. However, none of these arguments survive the test of rational examination.
In 2004, the state of California enacted legislation similar to that we are seeking here in New York state. Since that law has been enacted, the facts are their nursing population increased dramatically and they have had little problem finding nurses to fill the slots needed to meet the ratios. No hospitals closed in California as a result of the law, and in fact, hospital profits in the state soared in the years following the passage and implementation of the ratio law. More recently Linda Aiken, a nurse researcher, who has been looking at nurse staffing and patient outcomes for a number of years, compared New Jersey and Pennsylvania nurse staffing against California – and determined the number of patient injuries and deaths that would be avoided by adhering to the California ratio standards. Her findings were that patients are safe in California and there are fewer patient deaths, and that the legislation has worked for nurses and for patients.
If we are to truly advocate for our patients there are two pivotal goals: 1) pass ratio legislation and 2) protect the public safety net and commitment to it. This industry has rapidly changed to a pure business and corporate climate – without a strong, vibrant respected and well financed public safety net, all of our standards will erode through business competition which values profit and expansion far greater than care of populations in less fortunate positions of influence.
And so it’s about staffing. 2,500 nurses on May 17 said it loud and clear; nurses throughout the state and country are all raising the rally cry and call to action. So New York, as a book end to the country in one of the renowned areas for health care, it’s time to move a campaign that protects New York patients and allows New York nurses to practice nursing the way it was intended. We need to move this issue with unabridged passion and institutional discipline at the facility and state level, in the streets, in the media, at the capital, marshalling all of our resources in a targeted manner, doing whatever it takes to get it done. All of us collectively pushing with our neighbors and allies will get it done. We start immediately. On July 24, we will hold a staffing summit bringing leaders on this issue from a number of organizations and working to flesh out the best strategies – we will move at the facility and state level, and our upcoming business meeting will target this issue to educate and mobilize member leaders. There will be action for everyone to participate in as we move forward. Let’s get to it.