Nurses afraid to speak out about dangerous staff shortages

While it's become clear that patient safety suffers if nurses are spread too thin, individuals who speak up about staff shortages often face harsh reprisals from their employers, according to a New York Times opinion piece.

In interviews she conducted for her recent book about nurses--which also documents widespread peer bullying and the many secrets nurses keep--Alexandra Robbins writes that many described unsafe, stressful conditions in which nurses were assigned too many patients by hospitals mindful of the bottom line. Only California sets a minimum standard for nurse-to-patient ratios in hospitals, she writes--though as FierceHealthcare has reported, groups in a number of states have pushed for similar legislation.

Numerous studies have documented the relationship between patient outcomes and nurses' workload, Robbins writes, noting that one found 40,000 lives could be saved in the U.S. every year if every hospital mimicked the nurse working conditions of the top quarter of hospitals. The Minnesota Nurses Association, however, found it was unable to produce a similar study due to low participation from hospitals in the state, which the Minnesota Hospital Association said occurred because its member hospitals lacked the detailed data that researchers requested.

But a recent study presented at the American Association of Critical Care Nurses' annual exposition in San Diego found that nurse staffing levels directly affect the survival of patients who experience cardiac arrest in the hospital, Medscape reported.

Individual nurses face even worse blowback when they call out understaffing, Robbins writes. "The pressure has gotten even greater to keep your mouth shut," Deborah Burger, co-president of the National Nurses United union, says in the opinion piece, noting that hospitals often harass nurses who speak up. In one case, a nurses' union accused a New York hospital of threatening nurses with arrest when they addressed staff shortages at a celebratory breakfast--a charge the hospital denies, according to Robbins.

Many hospital administrators also don't think the research applies to their facilities, a belief that fuels a "vicious cycle" of nurses cutting corners and then getting punished for doing so,  Judy Smetzer, the vice president of the Institute for Safe Medication Practices, told the Times.

A recent report, however, indicates that demand for traveling nurses has reached a 20-year high, as a better economy and a surge in adults with insurance coverage spur hospitals to fill staffing gaps with temporary staffers.

To learn more:
- read the Times opinion piece
- here's the Medscape article

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