December 2003 Food For Thought
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IN THIS ISSUE:
Nursing Shortage Update

"Good judgment comes from experience,
and often experience comes from bad judgment."�
" Rita Mae Brown

In the News:
An Update on The Nursing Shortage Crisis

In September, Solutions ran an article
discussing the nursing shortage crisis.
(http://www.clintmaun.com/newsletter/backissue_solutionssep03.shtml)
While tips and strategies have been
recommended, it's obvious that this issue
isn't going to quickly disappear from the
radar screen. In fact, just weeks ago, the
Institute of Medicine of the National
Academies published a report that cites
the grave danger of this situation.

The National Academies' report states
that many nurses and nursing assistants
worked more than 12 consecutive hours,
with some working double shifts of 16
hours. According to the report, the long work
hours pose one of the most serious threats to
patient safety. Associated with the long work
days are fatigue, decreased energy, and
decreased attention to detail, which can all
contribute to errors. The report concludes
that many hospitals and nursing homes are
endangering patients by requiring or even
allowing nurses to work more than 12 hours
a day.

What Needs to be Done

According to the Academy, the nation's
healthcare work force needs to be substantially
transformed to better protect patients from
healthcare errors. More specifically, the
report calls for changes in how nurse
staffing levels are established. For example,
the report states that intensive care units at
hospitals should have one licensed nurse on
duty for every two patients, the report goes
on to state that there should be one registered
nurse for every 32 patients and one nursing
assistant for every 8.5 patients. The report
also recommends mandatory limits on
nurses' work hours as part of a comprehensive
plan to reduce problems that threaten
patient safety.


It's important to point out that the report is
not meant to damage the reputation of the
nursing field. Because the nursing shortage
has reached such crisis proportions,
sometimes there's just no alternative to
overtime. While the panel did not distinguish
between voluntary and mandatory overtime,
they noted that nurses should be more
involved in the day-to-day management of
hospitals and nursing homes. The piece also
points out that nurses defend against medical
errors. For example, a study in two hospitals
found that nurses intercepted 86 percent of
medication errors before they reached patients.
The academy found overwhelming evidence
that as levels of nurse staffing rose the quality
of care improved, because nurses had more
time to monitor patients and can more readily
detect changes in their conditions.

To read this report in its entirety, click on
the following link.
http://www.nap.edu/books/0309090679/html/

For more information on Clint's Nurse
Leadership program check out our 'In Charge'
series of video and audio tapes:
http://www.clintmaun.com/products/idv_team_dev_tools_old.shtml#InCharge