New York hospitals are not adequately staffing nurses, according to a new report.
The New York State Nurses Association report showed between January and October 2024, hospitals failed to staff intensive care units and critical care patients at the state-mandated ratio more than 50% of the time. The report also said most hospitals do not publicly post staffing ratios as state law requires.
Margret Franks, a registered nurse at Vassar Hospital in Poughkeepsie, said it greatly affects patient care.
A new study involving more than 80,000 US nursing homes has found a link between the use of staffing agency nurses and lower quality ratings in the Center for Medicare & Medicaid Services Five-Star system.
The use of agency registered nurses, licensed practical nurses and certified nursing assistants decreased a facility’s chance of attaining higher star ratings by 4%, 5% and 4%, respectively, researchers discovered. Investigators affiliated with a handful of US universities analyzed facility results from 2017 to 2022 to reach their conclusions.
Researchers said the transient nature of agency nursing staff can create significant challenges for residents and permanent staff members.
Nurses licensed in 42 other states and jurisdictions will be eligible to practice in Massachusetts — both in person and via telehealth platforms — as part of the "Nurse Licensure Compact," an agreement aimed at easing nurse staffing shortages. Massachusetts' joining the compact has been in the works for years: a proposal was first filed in the state Legislature over a decade ago. The change to nurse licensure requirements, codified in the economic development bill Governor Maura Healey signed into law last month, could boost health care providers' abilities to hire new nurses at a time when there are many vacancies and high turnover, which especially plague nursing homes, home health care services, and adult day facilities. Advocates hope joining the compact will eliminate administrative burdens for nurses maintaining licenses in multiple states and bolster the nurse workforce in Massachusetts. However, the state's nurses union fears this change will allow hospitals to apply a short-term fix to staffing challenges and ignore the root causes of high nurse turnover, such as difficult working conditions and inadequate pay.
Nurses at Saint Vincent Hospital in Worcester allege that cost-saving measures are causing pervasive lapses in care, including two patients dying after failing to receive potentially life-saving dialysis. The new assertions come nearly three years after nurses there settled the longest nursing strike in state history with the hospital's for-profit owner, Tenet Healthcare, a battle waged in part over staffing levels. Now, they say, the situation has grown even more dangerous, with stretched-thin nurses often struggling to do their jobs right. The Massachusetts Nurses Association, the union that represents about 600 nurses at the hospital, alleged more than 70 concerning incidents between April and November, from preventable bedsores to unsafe rationing of limited supplies, in an 18-page complaint filed in December with federal and state officials and shared exclusively with the Globe. Perhaps the most incendiary allegation is that two female patients in the intensive care unit on Sept. 29 died because there weren't enough nurses to provide them with continuous dialysis, the preferred form of care for critically ill patients with acute kidney failure. Unlike traditional dialysis, which takes three or four hours, this treatment lasts 24 hours and requires constant bedside supervision. "That was probably the worst night of my life," said one nurse, who has many years of experience and spoke to the Globe on condition of anonymity. "And I've had some pretty bad nights." Because six nurses were overseeing 12 patients that night, the union alleges, one of the two patients received traditional dialysis, and it had to be cut short by 30 minutes. The other patient didn't receive dialysis at all. Both died in the intensive care unit. While both patients were very sick to begin with and might have died anyway, the nurses said, understaffing prevented the women from receiving the care doctors had ordered.
Across the U.S., nurse practitioner students face the same problem. Like medical doctors, they need to complete clinical rotations to graduate. Unlike doctors, they don't have access to federal funding to support that training, and their schools often leave them to find their own clinical preceptors. The stakes are high. For many students, it's the only time they'll work with real patients as an NP before entering the workforce. And if they can't get the hours, their graduation will be delayed. So students beg on Facebook for placements, drop off cookies at front desks for potential preceptors—and, when they find someone who's willing, often pay the person themselves. For the public, the ramifications are greater. Even some hospital leaders acknowledge there's so little quality control that patients can't be sure their NP is properly trained to treat them. Struggling to ensure they're prepared to handle the duties assigned them, students have few places to find help.
On Wednesday, New Hampshire's executive council will vote on whether Dartmouth Health should permanently take over operations at Hampstead Hospital.
The proposed agreement comes after a particularly difficult stretch for the mental health facility in Hampstead, with a string of violent patient outbursts over the last two years.
Under the proposal, the state would still oversee the hospital, but Dartmouth Health would take over all the services for children and young adults, such as the hospital's residential inpatient psychiatric treatment.