Trends seem to come and go. I remember a trend to in the early 1990s in Minnesota to cross-train non-nursing personnel to do nursing functions. These non-nursing personnel doing nursing work included janitors, housekeepers, transport workers, and security guards. So don’t think that it can’t happen in your hospital.
These restructuring methods reduced nursing staff by almost 10 percent. While it might be possible to quickly train these non-nursing staff on tasks, they can’t be quickly and easily trained on observation skills. As nurses, we are not paid for what we do; we are paid for what we know! Nurses are the safety net in the hospital providing a 24-hour-per-day-early–warning-and early-intervention system.
Hospital restructuring has had a devastating effect on nursing care. Layoffs as a result of downsizing have impacted the heart of the hospital which is nursing care. People don’t go into a hospital because they want to be seen by a physician. They can be seen by a physician at a clinic or urgent care. No, they go to a hospital because they need skilled nursing care. Chipping away at the number of nurses in the hospital is having an irreversible effect on patients and their families. This decrease in nursing care has led to documentable deaths. A large European study discovered the odds of dying in a hospital increased by 21 percent for each non-nurse substitution per 25 patients.
Nurses are reporting they are taking care of two to three times the number of patients they took care of in the past. This can equate to as many as 16 patients on a medical surgical floor and up to four patients in the ICU.
Patients are admitted to the hospital to receive nursing care. They can’t survive without this care. However, nurses are finding that they are not able to deliver the care these patients need because there simply are too many patient for each nurse. When the New York State Nurses’ Association surveyed the RNs in their state forty six percent of these nurses responded that they were unable to provide the level of nursing care their patients needed.
Hospitals are seeing their profits eroding and reducing nursing staff is a very attractive strategy for them. Nurses make up about a quarter of the employees in a hospital and account for the largest segment of the hospital’s labor costs. However, decreasing nursing staff is not in the patient’s best interest.
Replacing nurses with nursing assistants does lead to increased odds for the patient of dying in the hospital following surgery, a higher percentage of patient dissatisfaction, and greater odds of poor quality care, such as decubitus, falls, and urinary tract infections.