Following the American Psychological Association’s Guidelines
According to cross-sectional studies reported in the article, “Nursing Staff and Inpatient Mortality Rates,” there is a direct correlation between low staff levels concerning registered nurses and increased patient mortality . The article does an in-depth analysis of this study, assessing criticism of the results, while using a sufficient method to secure findings to support the asserted correlation. The method was to observe the affect staff had on inpatient care, specifically mortality rate. Target staffing was considered eight hours. Anything more was considered low, because it meant there were not enough nurses to meet demands. The staff would be considered overworked. Patient turnover rate was also assessed, allotting for staffing rate, as well as check-ins, checkouts, etc. in accordance with how mortality rate was affected. The study included 197,961 patient admissions, 176,696 nursing shifts, at eight hours each, studied within forty-three different hospitals. The goal was to understand RN staffing rates in relation to inpatient mortality rates. The rate of mortality against a high rate of patient turnover was also examined in an effort to assess if this had an impact on mortality or the nursing staff.
The results were conclusive with projections. Registered nurses’ had eight staff hours, which was the target level, eighty-four percent of the study. The mortality rate of inpatients was sixty-one percent of what was originally expected; this was owed to a modification in each group’s diagnosis. The study saw a significant increase in inpatient mortality, however, and registered nurses whose unit shift exceeded eight hours. Exceeding the applicable eight-hour shift also increased the mortality rate during high patient turnover. The study, widely considered as observational, is still under scrutiny. Despite this, it was conclusive when registered nurses were staffed below target levels (e.g. few nurses staffed for too long), it increased the mortality of inpatients in all forty-three facilities observed. The findings demand the staffing of each healthcare facility meets the needs of the number of patients, allotting for proper care for inpatients, as well as turnover, and eliminating the need for lengthy shifts.
The article and its various findings affect the nursing profession in a few ways. To begin, it does not state the increased mortality rate is the fault of a nurse. Rather, the study states it is the fault of facilities being short-staffed, as well as nurses being overworked. The target staff for each nurse was eight hours only and when this was exceeded, the mortality rate would rise. Thus, the findings mean there are often not enough nurses to meet the demands of inpatient care. Essentially, more nurses are needed in the field in order to keep target staffing within a safe range, as well as to keep inpatient mortality from rising due to short-staffing, as well as high patient turnover. If more nurses were available, the few nurses available would not be required to work until it becomes unsafe. A refreshed staff would be more capable and adept at handling any issues that arise with patients, while circulating staff who have already worked eight hours can leave in order to return, prepared to do their job.
The article could also mean negative things for the nursing profession. As stated in the article, the study has been criticized. It is just an observation, and is not taken seriously by some professionals in the field, as well as others who have read it. Many nurses work more than eight hours, and manage to do so without increasing the mortality rate. Moreover, as an exclusive observational study, there is arguably no real proof staffing is correlated to a high mortality rate. Some who read the article could interpret it to mean nurses become careless the longer they are at work, but, horrifyingly, there is no way to know which nurse is going to be careless with a patient and which will not be. Absolute data would be necessary to quell any of these unsubstantiated thoughts. Nevertheless, patients and hospital officials could demand more from an already exhausted registered nursing crew without heeding the warning the article gives. It could make things more difficult, not only on medical facility staffs, but also on patients if the results of the study are not taken seriously or at least observed in each individual facility.
Much like the affect this study has on nursing, it also has implications on the healthcare profession, as well as healthcare in the United States. It says many things that we are willing to overwork our medical staff, literally letting people die, without training or hiring more to replace them in order to keep people alive and well. Health and wellness is what the American healthcare system is supposed to be about, but the possibility that this study may not even be taken seriously speaks loudly about the U.S. healthcare system. It is devolving; everybody is sick, including those who are supposed to be nursing the sick back to health. Who are supposed to rely on if the registered nurses themselves are too overworked to care for us, and there are no more to take their place? What has it come to when they are so overworked people are dying, but we are willing to let that go on rather than hire more?
Healthcare professionals and the healthcare profession in general have been glorified in the U.S. That is part of the U.S. healthcare system. They are heroes in our eyes, as they should be. However, part of the systematic approach to making them heroes has been dehumanizing them in a heroic way. The registered nurse no longer needs to eat or sleep. They need less time away from the hospital, less time with loved ones, less time to unwind. They are a nurse, and as such should be available twenty-four seven at the patient’s demand to make them well. The article represents everything the U.S. healthcare system and healthcare profession does not want to be, but needs to be, because real heroes admit when they need help, especially when it means keeping everybody alive.
Needleman, J., Buerhaus, P., Pankratz, V. S., Leibson, C. L., Stevens, S. R., & Harris, M. (2011). Nursing Staff and Inpatient Hospital Mortality. The New England Journal of Medicine, 1037-1045.