Can adding more nurses to hospitals save lives?

Inadequate staffing of nurses in hospitals is a nationwide problem that can result in serious health risks for patients, as well as increased stress and burnout for nurses, according to an op-ed in the New York Times.

Aside from California, no other states have set minimum requirements for hospital-wide nurse-to-patient ratios. Without these standards, nurses often end up being spread too thin, sometimes assigned to twice as many patients as the recommended safe maximum, which is generally considered four patients per nurse and just two patients per nurse in the intensive care unit.

Research has repeatedly demonstrated assigning more patients to a nurse increases patients' risk of death, infections, complications, falls, failure-to-rescue rates, readmissions and length of hospital stays. In pediatrics adding even just one more surgical patient to a nurse's ratio increases a patient's likelihood of hospital readmission by nearly 50 percent, according to the article.

If every hospital improved its nurses' working conditions to the levels of the top 25 percent of hospitals and assigned more reasonable nurse-to-patient ratios, more than 40,000 lives would be saved each year, according to The Center for Health Outcomes and Policy Research.

Nurses are fully aware of this issue. In a recent survey of nurses in Massachusetts sponsored by the Massachusetts Nurse Association, 25 percent identified understaffing as a direct contributor to patient deaths, 50 percent pointed to understaffing as cause of harm or injury to patients and 85 percent said patient care is suffering because of the large amounts of patients assigned to each nurse.

Unfortunately, many nurses feel intimidated or are punished by their hospitals for speaking out, according to the New York Times. "It happens all the time, and nurses are harassed into taking what they know are not safe assignments," said Deborah Burger, co-president of National Nurses United, a union. "The pressure has gotten greater to keep your mouth shut. Nurses have gotten blackballed for speaking up."

As hospitals work to lower costs, this can sometimes lead to inadequate staffing. "It's a vicious cycle," said Judy Smetzer, vice president of the Institute for Safe Medication Practices. "When they're understaffed, nurses are required to cut corners to get the work done the best they can. Then, when there's a bad outcome, hospitals fire the nurses for cutting corners."

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