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It is a well known fact that nursing is an important part of a hospital work. Each day thousands of nurses help the patients to recover in numerous medical establishments both in rural areas and big cities. The importance of their duty implies special moral and professional demands regarding a person who is planning to be a nurse. However, the controversy of this issue is that despite spending more money on medical sphere than any other country, the US have numerous troubles including the staffing problem, nurse-to-patient ratio, the quality of care in emergency rooms, and so on.
The Analysis of the Issue
First, one should state the fact that the shortage of qualified nurses has been a constant issue for the US hospitals for decades. More than that, with the rise of the requirements with regard to the nursing skills, nursing staffing shortage has become a grave problem. Recently, the specialists have found that significant nursing deficiency tends to be more noticeable in the intensive care unit, operating room and ED. These are the spheres where it is required for nurses to have enough knowledge and skills (Robinson, Jagim, & Ray, 2004). There were also statistic investigations that have proved the connection between patient volume increase and rising patient acuity.
The Illustration of the Issue
The importance of the above mentioned problem can be illustrated with the example of my own nursing experience. I was assigned to a 55 year old male patient who was alert, oriented and ambulating. The man complained about the intermittent midsternal pressure. He had normal EKG; however, the patient’s history included hypertension, congestive heart failure and cardiac stents. He was triaged in the hallway of the emergency room with the nasal cannula used to deliver the oxygen. The man was able to communicate, conversed with ease and was comical most of the time. When a room became available for him, he was transferred there since it was more comfortable. During and after the transfer, the patient’s state indicated he did not require immediate attention. Blood test results indicated the acute renal failure with elevated BUN and creatinine, mild BNP and positive mild troponin levels that required the consultation and analysis of the renal and cardiac team; however, it was not urgent.. The man’s condition did not change, and he remained on oxygen with cardiac and pulse monitoring. While I was caring for the other 8 patients, family member of the 55-year-old patient screamed for help, and I ran into the ward and saw that the patient was hypoxic, lethargic, hypotensive and difficult to arouse. Rapid response team immediately intubated the man and placed the central line and the arterial one for monitoring and infusion of the blood pressure medication. Unfortunately, despite all the intervention, care and attention, the patient had a cardiac arrest and, eventually, expired. The family members were devastated because of the loss of their loved one.
The Importance of Safe Staffing
The mentioned above example reveals the consequences of two grave issues in modern US hospitals: overcrowding and high patient to nurse ratio.
Numerous investigations encourage authorities to react with regard to the issue. For example, the Affordable Care Act’s Hospital Readmission Reduction Program has revealed that hospitals with higher nurse staffing had 25% lower odds of being penalized compared to similar establishments with lower staffing (McHugh, Berez, & Small, 2013). More than that, a 2007 study in Medical Care aimed at analyzing the principles of safe staffing has proved that “an increase of one registered nurse per patient was associated with a 24 percent reduction in time spent in the intensive care unit and a 31 percent reduction in time spent in surgical units” (“Safe-Staffing Ratios”, 2014). Having more registered nurses has also turned out to be effective in long-term care facilities.
Based on the mentioned facts, one can conclude that safe nursing staffing can be achieved by implementing special initiatives. Some of the changes in its quality should be applied by the hospital authorities; however, city authorities have more powers in this sense. Legal initiatives aimed at managing unsatisfactory nurse staffing vary from in-hospital actions to city official acts acceptance.
Safe Staffing Act in California
One of the first states which has taken a legislative decision concerning the problem and accepted the Safe Staffing Act was California. It happened as the result of actions of California Nurses Association. The organization has investigated up-to-date studies in terms of nurses stuffing and patient-per-nurse ratio and came to conclusion that the hospital personnel works in unsafe environment. Their application to the authorities in California was agreed, and in 1999, the state passed AB 394. The latter resulted in enacting the staffing legislation. It was fully put into action in 2004. The major demand was to set the lowest number of nurses to care for the specified quantity of patients. The main goal of the act was to improve the nurses’ working conditions and raise the patients’ safety (“Safe-Staffing Ratios, 2014). All in all, nursing in the state of California has experienced great changes due to the passed act of safe staffing.
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It becomes clear that proper staffing methodology leads to the overall increase in the quality of medical care. Revealed statistics proves that high patient-per-nurse ratios prevent medical workers from giving qualified assistance or in time emergency actions. Under such circumstances, the initiative of passing safe staffing act in the congress of New York seems completely rational (Wood, 2012). The ones, who might be opposing such initiatives, should be informed that after the implementation of a new Safe Staffing Act in California in 2004, there were no closed hospital cases. More than that, the hospital’s income has risen dramatically.
The arguments that have presented to support the passing of the safe staffing act by New York’s congress prove that it will significantly change the drastic situation with the nurse staffing. On the one hand, it will lower the pressure that is put on nurses and let them care for fewer patients simultaneously providing better support in critical conditions and assistance while recovering. The latter is important for the Emergency Departments. Fewer nurses will be experiencing stress and burnouts, and it will improve their personal attitude towards their job. On the other hand, the adoption of such an initiative will enhance the overall quality of caring and lower the cases of mortality among the patients. Such changes are about to help the healthcare economy in general, which has been important for the US for several decades.
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