The Big Deal
The Big Deal is….who gets to establish the nurse-staffing ratio?
Really. That is what all the fuss is about. Control. The patients have none. The hospital has all. The practicing nurses want some. …And the nurses want the state’s legislature to make the hospitals give them some because there has been no effort on the hospital’s part to do so without this threat.
Patients do not want to be involved in this decision. They want, expect and deserve proper patient care (a la 1:1 nurse-staffing ratios) and customer service (a la Disney). Hospitals and nurses that can provide this seamless type of care to patients (not the 1:1 part; maybe 1:4-5?) throughout their facility will not have negative patient satisfaction comments and ratings. Patients will love this!
Hospitals want to remain in business and excel as evidenced by their profitability and standing in the communities they serve. Positive and responsive care of their clinical professionals – doctors and nurses – will put them there. Hospitals do not want the government managing or mandating how they are to run their business or how many employees they must support. …And they certainly do not want nurse labor unions doing it either.
The clinically practicing professional nurses are the experts in this arena. They should be the ones that create and implement the safe nurse-staffing standard in the medical-surgical units of their own hospital. They know the types of patients they serve. They are familiar with the ebb and flow of patient traffic on their unit. They know the difference between safe and insane.
With the professional courtesies and respect to do a good and reasonable job, they will do a fantastic job.
Nurses know that the ICU’s are well staffed and heavily regulated due to high patient risk. It is the medical-surgical areas that need the additional nurse-per-patient support. Allowing the senior clinically practicing nurses on those units to create and implement a staffing plan would be completely worth the time …and trust.
Transparency of costs, patient days, revenue, supplies, labor expense and through-put is not “above” the understanding of clinical nurses. Yes, labor costs will initially rise, but the savings in other affected areas will equalize (or dwarf) it. (i.e. decreased HAI’s, decreased patient falls, increased bed turnover, delightful patient satisfaction scores, increased nurse recruitment, increased nurse retention, increased nursing satisfaction, increased physician satisfaction, etc…) In fact, if it means their unit and their patients finally achieve the level of staffing they need, the department just might gain 20 or so new business-savvy overseers for no additional costs at all. …And that would be priceless.