Costs, hospital resistance complicate nurse hiring

Despite research that shows outcomes improve with lower patient-to-nurse ratios, many hospitals find they can't afford to hire additional nurses, according to the Associated Press.

The nursing shortage has largely dissipated, according to the article, but nursing care is still hard to come by in many facilities, particularly nursing homes and struggling rural providers. And although it is milder, there is also room for improvement at bigger urban facilities such as MedStar Washington Hospital Center in the District of Columbia.

Given research tying more nursing care to improved outcomes and an available workforce, why is it hard for hospitals to fill these gaps? The answer largely comes down to cost considerations, Linda Aiken, director of the Center for Health Outcomes and Policy Research at the University of Pennsylvania's nursing school, told the AP. "All the shortage of care at the bedside has to do with how much hospitals want to pay nurses, and whether they want to use their resources on something else," she said.

The National Nurses United union has long pushed for mandatory minimum nurse staffing ratios to combat this perceived underrepresentation, successfully lobbying for a 2002 state minimums law in California where the union is based. Similar legislation was introduced this year in Massachusetts, to the objection of hospital groups. Part of the problem, as hospitals see it, is the extra time and energy required to meet the requirement regardless of individual hospital needs, according to Sue Eckert, R.N., senior vice president of nursing and chief nursing executive for MedStar Washington Hospital Center.

"I have such concern that people think a number is magic, and that number is going to fix the problem," she told the AP.

Staffing levels are one of the top concerns among nurses, particularly in general inpatient settings, according to the article. The American Nursing Association has endorsed requiring hospitals to develop unit-wide staffing plans, while others have suggested increasing transparency by requiring them to disclose staffing ratios to the public.

To learn more:
- here's the AP article