How many nurses does it take to keep hospital patients safe and comfortable? It's a long-running source of tension between nurses and hospitals. It's also one that will intensify as hospitals head into a perhaps-unprecedented era of financial strain. Some argue the solution is government-mandated nurse-patient ratios. Others say the key is to give nurses the loudest voice regarding their staffing. Something approaching a worst-case scenario might have occurred recently at Carlisle Regional Medical Center, where the state painted a frightening picture of conditions that allegedly existed over several weeks in May and June. Insufficient nurse staffing was the root of the problems, according to the state Department of Health. For example, the investigation report cites times when as few as three nurses had to care for 30 medical-surgical patients. It said patients commonly were kept for hours in the emergency room -- even after they were officially admitted -- because there weren't enough nurses staffing inpatient units.
A nurses union is accusing Central Florida Regional Hospital of understaffing and jeopardizing patients' health. More than 50 registered nurses, members of the National Nurses United and the National Nurses Organizing Committee-Florida, picketed outside the hospital on Friday. They held signs reading, "Central Nurses say Safe Staffing Now," and "Patients are our only priority." Nurses complain that hospital officials assign them to short-staffed units, such as cardiology, for which they're not trained. "One specialty does not translate to another," said Carl Ginsburg, spokesman for the National Nurses United. "A delay in addressing the staffing needs puts the patients in jeopardy." The hospital would not directly respond to the nurses' claims, but issued a statement: "The hospital has been bargaining in good faith with NNOC-FL since April of this year over a nurses contract. As bargaining moves ahead, we will continue to provide uninterrupted, high-quality healthcare to our patients and the community we serve."
When Bonnie Westra, MD, learned that the Department of Health and Human Services was issuing grants totaling $71.3 million to expand nursing education, she had mixed feelings. On the one hand, Westra was delighted that federal dollars will support entry-level preparation, advanced practice nurses, and faculty to teach the nation's future nursing workforce. On the other hand, she was disappointed that HHS' press release said nothing regarding specific funds directed toward nurse informatics training. "This is a missed opportunity," said Westra, who sits on the board of directors at American Medical Informatics Association and is also co-chair of the Alliance of Nursing Informatics. She also said that as the healthcare sector shifts toward building a health information infrastructure that will support last year's health reform law, HHS should increasingly direct its dollars toward educating nurses in health IT skills.
American kids are increasingly likely to be admitted to the hospital for mental problems, although rates of non-psychiatric hospitalizations have remained flat, a new study shows. From 1996 to 2007, the rate of psychiatric hospital discharges rose by more than 80% for 5-13-year-olds and by 42% for older teens. "This occurs despite numerous efforts to make outpatient services for the more vulnerable kids more widely available," said Joseph C. Blader of Stony Brook State University of New York, whose findings appear in the Archives of General Psychiatry. He said hospitalization is the last resort, because it's so disruptive for normal life. "It's a pretty traumatic thing for a family when your child is admitted to a psych unit," he told Reuters Health. Overall, short-term hospital admissions for mental illness rose from 156 to 283 per 100,000 children per year over the ten-year study period, based on data from the National Hospital Discharge Survey.
Germaine Pierre Laine now knows that when a patient is barrel-chested, that might indicate a lung disease. She has learned how to percuss a patient's back and abdomen, using short, sharp blows and listening to the sound they produce to test for illnesses. But one of the most powerful lessons the 41-year-old Haitian nurse has learned during a six-week course at Regis College is much simpler: that a nurse can sit on a hospital bed with a patient. In Haiti, most nurses consider this practice inappropriate, she said. But after seeing nurses sit on patients' beds here, Laine has decided she will try it when she returns to the National School of Nursing in Cap-Haïtien next month. Laine is one of 12 nursing teachers from Haiti spending part of the summer at Regis for a crash course in American nursing, gaining expertise they will then pass on to a new generation of nurses back home.
The independence of the Board of Nursing to regulate the profession is under question as state investigators probe whether strong-arm tactics by lawmakers caused the board to rescind disciplinary actions. At least two lawmakers, Rep. Tony Shipley and Rep. Dale Ford, pressed for the board to reconsider the suspension of three nurse practitioners accused of over-prescribing narcotics. The Tennessee Bureau of Investigation has launched a probe into these actions, which occurred when the Board of Nursing's right to exist as a regulatory body was up for renewal by the legislature. Sharon Adkins, executive director of the Tennessee Nurses Association, said the profession is closely watching the case. "It is absolutely unacceptable for special interests to put undue pressure on the board to reverse their judgments," Adkins said.