While COVID-19 has ransacked every sector of the economy, it’s placed some unique pressures on the health care industry. Of course, many physicians, physician assistants, nurse practitioners, nurses and other personnel have worked in the front line in treating people battling the coronavirus. But the pandemic has also highlighted some hospital system problems that have long been in place.
A great example of this is nurse staffing ratios. In my experience, long before anyone had ever even heard of COVID, many hospitals, skilled nursing facilities (nursing homes), and rehabilitation facilities operated with an inadequate, unsafe number of nurses on duty.
The simple truth is that no matter how qualified, competent, and trained a licensed vocational nurse (LVN) or registered nurse (RN) is, he or she can’t provide safe, quality patient care when assigned too many patients.
Under the national standard of care and Texas Board of Nursing rules and regulations, nursing care is an individualized, goal-directed process requiring a registered nurse to:
• Perform comprehensive nursing assessments regarding the health status of the patient.
• Make nursing diagnoses that serve as the basis for the strategy of care.
• Develop a plan of care based on the assessment and nursing diagnosis .
• Implement nursing care.
• Evaluate the patient’s responses to nursing interventions.
• Always advocate for patient safety.
Hospitals and facilities set up their nurses—and patients—for failure when they assign too many patients to a nurse. Quality nursing care isn’t a cookie-cutter exercise. It takes time, critical thinking, and custom attention on each individual patient.
Research has shown that short-staffed nursing is associated with increased preventable medical errors, complications that should be avoided, patient falls, bedsores (pressure injuries), increased hospitalization, and higher rates of readmission to the hospital.
National Nurses United has announced a national campaign for safe registered nurse-to-patient staffing ratios through proposed federal legislation called the Patient Safety and Quality Care Act. According to the campaign, inadequate nurse staffing is directly linked to an increase in the patient death rate.
Whether the proposed law passes or not, it’s my hope that hospital administrators and leaders will take this opportunity to reflect on safe nurse staffing. The campaign proposes these ratios:
1:1 care: Operating room and trauma patients in the emergency room
1:2 care: intensive/critical care, neonatal intensive care (NICU), post-anesthesia care unit (recovery room), labor and delivery, intensive care unit (ICU) patient in the emergency room, coronary care, acute respiratory care, and burn unit
1:3 care: antepartum, combined labor and delivery and postpartum, postpartum couplets, pediatrics, emergency room, step down unit, telemetry
1:4 care: medical/surgery, other specialty care units, psychiatry
1:5 care: rehabilitation and skilled nursing facility
In my experience as a Texas medical malpractice lawyer, many patients and families have experienced frustration during hospitalizations by not being able to obtain prompt nursing attention. For example, I’ve seen many cases where a patient needs assistance to the restroom, but a nurse doesn’t answer the call button, so the patient gets up unassisted and falls.
I’ve also handled cases where patients deteriorated and desperate family members called 911 for help, despite the fact that the patients were already in a hospital or nursing facility.
If you’ve been seriously injured because of poor hospital or facility care in Texas, then contact a top-rated experienced Texas medical malpractice lawyer for a free consultation about your case.
