NURSES: RNs Increasingly Spread Thin
As managed care puts the squeeze on hospital budgets, RNs in California and throughout the country are "stretched thin and working double-time to compensate." The Los Angeles Times reports that the nursing shortage in California is particularly evident in specialty areas, such as critical care and oncology, where experienced and trained nurses are in high demand. Veteran nurses in these areas were cut back in the early 1990s and replaced with "cheaper unlicensed or lesser-trained staff," sometimes to the detriment of the patients, according to nurses and patient advocates. The Times notes data from a 1997 study indicating that a reduction in nursing staff results in patients with increased hospital stays and more complications, such as bedsores. Several California regions -- Orange County, San Jose and Contra Costa County -- "have among the lowest number of hospital RNs per capita in the nation" because nurses are leaving the hospital system in favor of home health care or outpatient clinics. A survey conducted by the American Hospital Association found that the public notices the transition from skilled nurses to poorly trained aides, and responds in anger "at the reversal in health care priorities that this represents." While the American Nurses Association is pursuing legislation to create a federal "patient safety" bill to publicize RN-to-patient ratios, a California bill is "seeking to limit the number of patients per RN, depending on the patients' illnesses, and to prohibit unlicensed employees from providing nursing care." Boston nurse activist Barry Adams said, "You don't run with the scissors. When a nurse has 10 patients, 15 patients, it is not conducive to safe nursing practices. When you're ... just pouring pills, just one wrong pill can be the end. Do you know how quickly (wrongly administered) penicillin can kill somebody?" (Marquis, 8/4). Click here to read the entire article in the Los Angeles Times.This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.