A new survey of 1,000 bedside nurses across Pennsylvania finds many of them concerned that “dangerous” staffing levels and high turnover are putting patient care at risk in the state.
The report, “Breaking Point: Pennsylvania’s Patient Care Crisis,” was undertaken by Nurses of Pennsylvania, a new nonprofit advocacy group calling for higher nurse-to-patient ratios, more training and other improvements in the field.
Their research cites a study of 168 hospitals in Pennsylvania which found that risks of patient mortality increased by 7 percent for each additional patient added to a nurse’s workload beyond a baseline of four patients.
“As nurses, we take pride in buckling down and figuring out solutions at warp speed, but there is only so far any one of us can stretch,” said Jake Reese, a nurse in Scranton who serves on the nonprofit’s board.
“Giant corporations and multi-billion-dollar hospital systems are making decisions about care and care delivery farther and farther away from the bedside,” Reese said. “This has to stop.”
Staffing, not shortage
According to the report, Pennsylvania is not experiencing a shortage of available nurses. Rather, it posits, staffing decisions made by individual facilities regarding both nurses and support staff are making it more difficult to retain qualified nurses.
It compiles the results of a survey of 1,000 nurses who work in hospitals, schools, rehabilitation facilities, long-term care and other settings across the state. The majority of respondents — approximately 64 percent — have been nurses for more than 15 years, while about 12 percent have been nurses for three to eight years.
While Pennsylvania has 180,000 nurses on its official registry, “this number fails to capture the realities of nurse staffing across the state,” the report states, citing additional survey findings:
Among the report’s findings:
• 51 percent of nurses report that their input on how things are done at work has decreased in the last five years.
• About 69 percent of nurses say their time spent bedside per shift has decreased over the past five years.
• 94 percent of nurses report that their facility does not have enough nursing staff, and 87 percent report that staffing levels affecting patient care are getting worse.
• About 84 percent of nurses report that a high rate of turnover among nurses is a problem in their facility, and about 79 percent report that since they began working at their present job, the rate of turnover among nurses has increased.
• 94 percent of nurses reported that their facility does not have enough nursing staff.
• 87 percent reported that staffing levels affecting patient care are getting worse.
• Approximately 95 percent of nurses report they have experienced a situation where they felt incapable of providing the best care because of inadequate staffing.
The report also cites a June 2015 study by the Pennsylvania Joint State Government Commission on professional bedside nursing which found that “nurse staffing in Pennsylvania hospitals is highly variable,” and that the time nurses are able to spend with their patients has not kept up with national trends and best practices.
Nurses of Pennsylvania, which was founded this summer, already has more than 12,000 members, the group says.
It is governed by a volunteer board of nurses and healthcare advocates, with initial funding coming from union nurses who are members of SEIU Healthcare Pennsylvania.
And the group is not alone in its views.
The Pennsylvania State Nurses Association, a Harrisburg-based advocacy group, lists safe staffing as its top legislative priority.
It’s also listed as a primary concern by the Pennsylvania Association of Staff Nurses and Allied Professionals.
Advocates would like to see Pennsylvania adopt an approach like California, which became the first state to legislate nurse to patient ratios, beginning in 2004.
Fourteen states currently have laws or regulations governing nurse staffing, according to the American Nurses Association, including three of Pennsylvania’s neighbors: New York, New Jersey and Ohio.
Previous efforts to enact such legislation in Pennsylvania faltered. Nurses of Pennsylvania is among those calling for renewed efforts on that front.
“We’re smack in the middle of a perfect storm. Nurse and support staff numbers of dwindling, public health emergencies like the opioid crisis are filling emergency departments, and meanwhile, nurses are burning out or leaving the field altogether,” said Antoinette Kraus, board member of Nurses of Pennsylvania and executive director of the Pennsylvania Health Access Network.
“That’s not responsible health care,” Kraus said.