NursingLink

By SUZANNE GORDON, Guest Columnist

It’s National Nurses’ Week (May 5-12), and the profession has one cause for celebration. Hospitals are safer and nurses happier both in California and in Victoria, Australia, for a simple reason: Governments there have limited the number of patients that nurses must take care of.

They enacted these measures so that patients wouldn’t suffer or die from hospital cost-cutting that left too few nurses available to provide quality care.

Heavy patient loads so overburdened nurses that in 1999 and 2000, respectively, nursing unions in California and Victoria fought for and won legislation to set a ceiling on patients.

In California, that means there must now be at least one nurse for every five patients on medical/surgical floors — the biggest and busiest wards in a hospital.

The results have been dramatic.

California’s new staffing level has increased nurse job satisfaction and reduced turnover, according to a study by economist Joanne Spetz, just reported in “Politics, Policy & Nursing Practice,” an important nursing journal. Spetz found that nurses in California are happier at work because they now get to spend more time with their patients — particularly on patient education.

Researchers at the University of Pennsylvania have looked at the California experience as well. In a comparative survey of hospital working conditions there and in Pennsylvania and New Jersey, California nurses reported greater job satisfaction, leading to less burnout. In a new book titled, “Safety In Numbers,” published this month by Cornell University Press, my Australian co-authors and I examine the impact of ratios on nurse retention and recruitment in their country and California.

In Victoria — the second largest state in Australia — there are no vacancies in urban hospitals because better staffing levels lured more than 7,000 inactive nurses back into the workforce.

In California, nurses in hospitals that have fully complied with the new standards told us that they are finally able to provide safer patient care. Many who had considered leaving nursing now say they will stay at the bedside.

Such positive results explain why nurses in 13 other states — Arizona, Florida, Illinois, Maine, Massachusetts, Michigan, Minnesota, Missouri, New Jersey, New York, Ohio, Pennsylvania and Texas — are currently lobbying for California-style safe-staffing bills. Unfortunately, their main employer — the hospital industry — is strongly opposed to this much-needed health-care reform.

To overcome such resistance, nurses need the kind of allies they assembled in California and Victoria to make healthy ratios a reality there. Health-care reformers, consumer advocates, patients and their families all need to unite behind safe staffing campaigns.

In many other workplace settings — in day-care centers, public school classrooms, local fire stations and on commercial aircraft, minimum staffing levels are well established and clearly work for the benefit of the public. Why not in hospitals?

Today, it’s still perfectly legal for nurses in 49 states to be assigned 10 or even 15 patients at a time — far more than can be safely handled. It is hoped that by Nurses’ Week next year, more states will have joined California in regulating hospital workloads — so nurses can properly meet their professional responsibilities.

Suzanne Gordon is a health-care journalist and the co-author, with John Buchanan and Tanya Bretherton, of “Safety in Numbers: Nurse-to-Patient Ratios and the Future of Health Care.” The writer wrote this for Progressive Media Project, a source of liberal commentary on domestic and international issues; it is affiliated with The Progressive magazine. Readers may write to the author at: Progressive Media Project, 409 East Main Street, Madison, Wis. 53703; e-mail: pmproj@progressive.org; Web site: www.progressive.org. For information on PMP’s funding, please