Heard on the news today:
Your average outpatient today would have been hospitalized in the 1970s. Today’s average inpatient would have been in ICU. Today’s ICU patient in the 1970s would have been dead.
The discussion centered around the current nursing shortage in the USA. According to this woman in her sixties — I don’t remember her name — the current ratio is something like 7 or 8 patients per nurse, varying a little better during the day and a bit worse at night. California controversial law, apparently, mandates a minimum 1:5 ratio for nurses to patients in medical/surgical, and 1:2 in ICU.
Is it really true that your average ICU patient from, say, 1975 is in regular inpatient care, while those in today’s ICU would have been dead then? Is this ostensible increase in survival rates due to nurse staff increases, technology advancements, medical inventions, or something else? Or a combination of the three?
I’m interested in knowing just how true this quote is. Mortality statistics from hospitals, however, are a little difficult to quantify for your Joe-Average blogger.
MedSurg is horrible
I can agree that there is a shortage. My wife, in the almost eight years I’ve known her, has worked in every major medical center from Wilmington, DE to Baltimore, MD.
St. Francis, DE Christiana, DE Union (Elkton), MD Perry Point VAMC, MD Harford Memorial, MD Upper Chesapeake, MD Franklin Sq, MD Union Memorial, MD Mercy, MD GMBC, MD Mercy, MD UC/St Joe’s Home Health, MD
Leaving out the 4000-word blog post about my wife wanderlust nursing career (keep in mind everywhere she’s worked, they loved her. She’s always left, not the other way around), they’re so desperate for nurses she’s been able to find work wherever and whenever she wants.
She won’t work MedSurg anymore, because it’s really glorified babysitting. Way too many patients to one nurse. ICU is more here thing, where it’s much more in-depth and there’s a 1:2 ratio. In ICU, there were three classes of patients: those that were getting better, those that were dying, and those that were never going to leave ICU but might hang around indefinitely. Unless you’re in those final two classes, the hospital is doing it’s best to get you out of the hospital. If you’re lucky, you might get a home health visit if you’re bad enough that you can’t leave your house.
The funny thing is that while there’s a nursing shortage, there’s also complaints about the education level of nurses, so there’s a push to make nursing a mandatory 4-yr bachelor’s program. But most places only give $2-3 more/hr if that for having your BSN. So where’s the motivation to be a nurse when they’re trying to make you go for 4 years instead of 2 for no more pay?
Then throw in the condescending attitude from doctors, the mountains of paperwork, and the joyous bureaucracy of the hospitals themselves, and you wonder why there’s a shortage?
My $.02 Weed
Ditto
I’ve been an RN for nearly 4 years now, First thing.. Matt, you;re talking about Maximum ratios, not minimum. Basically, no MORE than 5 patients per Nurse. You can’t legislate a minimum.
Currently, as a stepdown Nurse (acuity halfway between Med-Surg and ICU) – I can have up to Six patients overnight. Sometimes they;re all like Nursing home patients; sometimes, they,re seemingly healthy with a catastrophic risk (see; Pulmonary Emboli), and sometimes, I will have six patients on heart monitors with with wound care, antibiotic resistant infections (MRSA anyone?) – with an admission and a code on the same night.
The 4 year degrees cover no more information than the basic RN (which is 2 years AFTER prerequisites) – and is often considered to be less efficient. the NCLEX pass ratio was lower at UMD than MC.
I have LOTS to say on this topic.. but no time.. Grr..
Visit the Official Justin Timpane Website Music, Acting, and More! http://www.timpane.com
California’s law
Math language time! I chose “minimum” carefully, because that’s the wording they use in the California law, and is correct when discussing ratios in this context. The minimum nurse:patient ratio in California is 1:5. The maximum patient:nurse ratio is 5:1 (two ways of saying the same thing). Counter-intuitive, but that’s the way ratios work!
OK, so is 1:6 considered an appropriate ratio by you, or is it considered overworked? The other part of this radio program focused on how nurses were treated like over-trained babysitters by patients and doctors much of the time, too, and how nurse responsibilities should be expanded while calling for larger nurse to patient ratios (or smaller patient to nurse ratios).
I hadn’t really been very aware of the nursing shortage in the US until this morning… I was aware there was a shortage, but thought of it much like the IT “shortage” in the US: a number contrived to try to bolster support for political and commercial causes.
—
Matthew P. Barnson