The state is poised for the first time to mandate a minimum level of nurse staffing in hospitals, reigniting a debate over patient safety and health care costs. The Health Policy Commission, the agency that monitors medical costs and related issues, will vote Wednesday on regulations requiring hospitals to staff intensive care units so that each registered nurse is responsible for no more than two patients. If approved, the rules would implement a law passed last year. But a labor union, the 23,000-member Massachusetts Nurses Association, says the proposed rules give hospitals more discretion to assign two patients per ICU nurse than the law intended.
Dozens of studies have found that the more patients assigned to a nurse, the higher the patients' risk of death, infections, complications, falls, failure-to-rescue rates and readmission to the hospital — and the longer their hospital stay. According to one study, for every 100 surgical patients who die in hospitals where nurses are assigned four patients, 131 would die if they were assigned eight. In pediatrics, adding even one extra surgical patient to a nurse's ratio increases a child's likelihood of readmission to the hospital by nearly 50 percent. The Center for Health Outcomes and Policy Research found that if every hospital improved its nurses' working conditions to the levels of the top quarter of hospitals, more than 40,000 lives would be saved nationwide every year.
With her children grown and husband nearing retirement, Amy Reynolds was ready to leave behind snowy Flagstaff, Ariz., to travel but she wasn't ready to give up her nursing career. She didn't have to. For the past three years, Reynolds, 55, has been a travel nurse — working for about three months at a time at hospitals in California, Washington, Texas and Idaho, among other states. Her husband accompanies her on the assignments. "It's been wonderful," she said in May after starting a stint in Sacramento. "It's given us a chance to try out other parts of the country."
Seven former nurses have been charged with criminal neglect in the case of a woman who needed her hand amputated after a broken finger wasn't treated properly, officials announced Tuesday. An indictment issued last month said seven Vineland Developmental Center nurses failed to aid the "physical or mental health" of resident Wendy Hart, whom officials described as physically and mentally disabled. Prosecutors alleged the nurses wrapped a bandage around Hart's hand so tightly that it developed gangrene and had to be amputated in April 2012, according to a state Department of Health and Human Services report.
When Mary Beth Winkeljohn became a family nurse practitioner, she also had to navigate some big financial decisions. Part of her compensation included funds to allocate toward health insurance, disability and retirement. With help from a financial professional, she made selections that had a lasting impact on her future financial security. Many nurses, she says, face similar choices, but might not feel prepared for them because nursing programs don't generally include classes on business, personal finance or economics. "Nurses might be at a disadvantage when it comes to making long-term investment and financial decisions," says Winkeljohn, who resides near Baltimore, Maryland.
In September 2013, just as Covered California was preparing to enroll a million new patients in the state's healthcare system, the state Senate caved to pressure from the California Medical Assn. and voted down a bill that would empower nurse practitioners to see patients without supervision by a medical doctor. Last week, it corrected its error, passing a similar bill despite renewed opposition from the state doctors' guild, which whined, as it has for years, that allowing nurse practitioners to operate independently would put patients at risk. A guild protects its own. Its goal, whether it's an association of medieval blacksmiths or of 21st century forensic accountants, is always the same: to keep its numbers low and its services expensive.