New York Times Examines ‘Emerging Trend’ of Hospitalized Patients Hiring Private Nurses

The New York Times today reports on the "emerging trend" of hospitalized patients hiring private nurses to supplement care provided by hospital nursing staff. Although patients have employed private nurses for decades, demand for the service has increased as a result of hospital nursing shortages, which often force nurses to care for more and sicker patients in less time, the Times reports. Private nurses ensure that patients "will not have to wait for the basics of nursing care." They can help bedbound patients avoid bedsores or remind post-surgery patients to perform breathing exercises. In addition, private nurses can untangle intravenous lines, prevent falls, inform patients about new medications and view discharge instructions. However, no health insurance plans cover the cost -- about $20 per hour for a practical nurse to about $75 per hour for a registered nurse. Private nurses also cannot dispense medication, administer transfusions or chemotherapy or write notes that become part of the hospital record, activities that are the legal responsibility of hospital staff. As a result, the Times reports that private nurses must collaborate on patient care with hospital nurses, who may "ignore and even resent patients who hire outside help."

Some nursing scholars express concern that patients who employ private nurses may "simply be exchanging one set of problems for another, entrusting their care to nurses unfamiliar with a hospital and its routines," possibly resulting in a medical error. Linda Aiken, a nurse who directs the Center for Health Outcomes and Policy Research at the University of Pennsylvania School of Nursing, said, "Our research suggests that the quality of care provided by nurses who are not part of the hospital staff is not as good. There are so many things they are unfamiliar with." Aiken said patients should research hospitals and their nursing staff and select hospitals that the American Nurses Credentialing Center has designated as "magnet" facilities, which have adequate nursing staffs. Aiken also said that patients should interview hospital staff nurses who will provide their care before they enter a facility. "Hiring a nurse is something one should resort to only after exploring other options," she said (Zuger, New York Times, 4/16).