Hospital Impact—A healthcare organization is only as strong as its nurses

Nurse-Patient-Hospital-Credit: Getty/monkeybusinessimages
Healthcare leaders seem to have forgotten the connection between a whole and healthy workforce and the impact on patient quality, safety, clinical outcomes, experience and an organization’s bottom line. (Getty/monkeybusinessimages)
headshot of Thomas Dahlborg
Thomas Dahlborg 

“Me! Me! Me! For an entire day, that’s all I heard. Not one mention of a patient or a family.”

Many years ago, I had the occasion to spend time with a passionate healthcare leader, and this was the message she was sharing about her nursing team.

“Tell me more. Tell me about the context,” I said.

“We were seeking opportunities to improve our culture, our work, our processes, our outcomes," she replied. "And with each question I asked, the response was always about the nurses themselves. ‘I need this … I need that. Me! Me! Me!’”

“Let’s discuss the foundation of your hospital, your culture,” I said. “And while we are at it, what are your current nurse to patient ratios? Let’s start with the med/surg floor?”

“Well, the nurse to patient ratio at night is typically 1 to 11,” she said. “Day shift is 1 to 8.”

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My wife is also a nurse. From obstetrics to pediatrics to med/surg to skilled nursing to nursing homes, she has done and seen much. And I have heard the stories.

There was the overnight nursing ratio of 1 to 40 at a skilled nursing facility caring for veterans, where nurses didn’t have time to deliver necessary treatments, let alone truly care and love their patients.

Then there were the stories of nurses who have left their profession due to similarly high nurse-to-patient ratios. They told me that at the end of every shift, they knew they didn’t do all they could have for patients and their families, and that they probably made at least one mistake.

And we wonder why our nurses are now focused on taking care of themselves.

Perhaps it is because as healthcare leaders, we have lost our focus and are not caring for our nurses? Perhaps our focus has turned to other priorities, such as constructing a bright and shiny new building or implementing a sexy new technological advance, or our next new merger and acquisition?

Perhaps we don’t understand the connection between a whole and healthy workforce and the impact on patient quality, safety, clinical outcomes, experience and an organization’s bottom line? Or perhaps we have forgotten why we decided to work in healthcare to begin with? And why the healthcare system exists in the first place?

I recently read an article that said more than 1 in 4 baby boomer nurses plan to retire in a year. In the research that the article references, half of those surveyed said they don’t think that current leaders care about them as individuals. Surprising? Not at all.

The real question is, what are we going to do about it? And how long are we willing to place our patients, families, communities and one another at risk while our attention is focused elsewhere?

Thomas H. Dahlborg, M.S.H.S.M., is an industry voice for relationship-centered compassionate care and servant leadership. He is a keynote speaker, author, consultant and adviser and is the president of the Dahlborg Healthcare Leadership Group.