Nurses' union pushes for better staffing By Martha Brannigan
A nurses' union is pushing for mandatory nurse-to-patient ratios at hospitals.
Miami Herald
DAVID ADAME / MIAMI HERALD
Clinical staff nurse Gema Velez, left, talks with Orinthia Taylor, acting nurse manager in the trauma intensive care unit of Ryder Trauma Center.
Suzanne Gordon has seen plenty of suffering at hospitals: Back, neck and shoulder injuries. Infections. Emotional stress. High-blood pressure.
And that's just the nurses.
Gordon -- a nurses' advocate and author -- told a forum at Miami Dade College Medical Center Campus Monday that mandating nurse-to-patient ratios at hospitals is crucial to better patient care.
But there is another key issue: 'It's not just patient outcomes [that are affected by an inadequate level of nurse staffing]. It's nurses' health,'' said Gordon. ``I think it's literally killing nurses.''
Service Employees International Union Local 1991, which represents 3,200 nurses at Jackson Health System, sponsored the forum. It is part of the union's ongoing educational drive as it pushes for national and state legislation to set minimum nurse-to-patient ratios amid a worsening shortage of nurses.
Nursing advocates like Gordon and the union assert that hospitals would lure more nurses back to work and reduce turnover if they would boost staffing levels so that nurses aren't chronically overworked. ''It makes no sense to turn nurses into patients while they are caring for patients,'' said Gordon, who recently published a book on the topic, Safety in Numbers.
Most hospitals are stridently opposed to any mandates, arguing they shackle administrators and impair their flexibility to respond to dynamic hospital situations.
''Obviously, we disagree with their belief that mandated ratios are beneficial to patients,'' Martha DeCastro, vice president for nursing at the Florida Hospital Association, said. Such ratios, she said, ``would hold us to a standard that in some cases may not be possible because of the nursing shortage.''
In Florida, nurse staffing is particularly important.
The Florida Center for Nurses in a survey released in January polled some 1,818 healthcare employers to find at least 5,000 nursing vacancies in the state. Only 37 percent of those surveyed responded, suggesting the overall vacancy rate may be closer to 15,000. The average Florida hospital had 30 vacancies for registered nurses.
Florida currently ranks 37th among states in registered nurses per capita, although the state has the oldest population, according to a November 2007 report from the Nursing Consortium of South Florida.
Many experts warn the long-running nursing shortage threatens to intensify as the current nurse workforce ages, with many nurses already over age 50, and too few young people following in their footsteps to meet growing demand.
''The real train wreck is in the next two decades when we haven't solved this problem,'' said Martha Baker, president of SEIU Local 1991 and nurse manager of the Ryder Trauma Intensive Care Unit at Jackson -- a facility she praises as diligent in maintaining adequate ratios.
A Jackson spokeswoman confirmed that the teaching hospital maintains a ratio of one nurse per four or five patients for its medical-surgical units and one-to-one or one-to-two for intensive care facilities.
Currently California is the only state in the nation with mandatory staffing ratios, which hospitals began implementing in 2004. California standards require hospitals to maintain minimum ratios of, for example, one nurse per five patients in medical-surgical units and one per four in emergency rooms.
Several attempts to pass nurse-to-patient ratio bills in the Florida Legislature have failed, although advocates intend to continue their efforts.
''The nurses are the people on the front lines,'' state Rep. Oscar Braynon II, a recently elected Democrat from Miami, told the forum. ``That's why I sponsored the bill, and I'm going to sponsor it next year.''
Rep. Ronald A. Brisé of North Miami told the group he sponsored a bill to require hospitals to disclose staffing ratios, so that patients could make informed choices of where to seek care.
''We as consumers should have all the information available,'' Brisé said. That bill also died in committee this past session.