Some 12,000 nurses in Minnesota went on strike today after failing to reach an agreement with 14 Minnesota hospitals about pensions, wages and, most importantly staff-to-patient ratios. The nurses are arguing that they take care of too many patients and work in too many departments, sometimes performing tasks they have not been specifically trained for.
“We’ve been put into so many positions, where we’re not able to take care of very sick patients the way that we want to. But furthermore, most importantly, the way they deserve to be taken care of,” Mary Ann Vertin told the local CBS affiliate. “We don’t have enough nurses to take care of the patients in the hospitals and it puts the patients at risk. And another thing is, it puts my license at risk. It puts my family at risk. It puts the room over their heads at risk. I make a mistake, because the staffing is unsafe, that’s my license, that’s my livelihood, that’s everybody’s livelihood out here that you see. That’s really what we’re fighting for,” nurse Ryan Giacomini said.
Hospitals are concerned about the increased costs associated with minimum ratios and have cited the uncertainly surrounding the new health care law and the coming end of the fee-for-service system as reasons to forgo a more significant investment in the workforce. But that would be a fundamental misunderstanding of the direction of health care in America. The reality is, the government is moving towards paying for outcomes, not procedures, and if hospitals don’t rely on nurses and other professions to help coordinate care, prevent unnecessary hospital re-admissions, and ensure patient safety, they’re going to get dinged in their reimbursement rates. If hospitals don’t begin in building teams of health professionals — nurses, social workers, educators, tech, counselors, etc — to produce better health outcomes, they’ll be left behind.
The patient safety point is also worth reiterating. As of September 2009, just 14 states and the District of Columbia “had enacted nurse staffing legislation and/or adopted regulations addressing nurse staffing” and at least one RWJF-funded study concluded that under California’s minimum laws, nurses experienced less job burn out, “job dissatisfaction were lower, and nurses reported consistently better quality of care.” That sounds like something worth investing in.