The Case for More Nurses

With 12,000 nurses on strike in Minnesota — the largest such strike in American history — one key issue relates to staffing levels. The nurses say there are too few of them to go around, whereas hospitals say they can’t afford so much personnel. Igor Volsky argues that to the contrary, hospitals can’t afford not to hire generous quantities of nurses:

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.

One way to think about this is that what you see on House is the reverse of cost-effective socially responsible medial practice. And on House you never see nurses do anything important. A handful of hero doctors and a limitless supply of tests is all you need to cure the sick. Which is an interesting premise for a TV show. Effective coordination and sound delivery of the basics would be extremely boring to watch. And yet when you go to the hospital, you don’t want to become a character in an interesting drama, you want to be a character in a boring story about people not screwing anything up and you going home safe. You need a lot of nurses to make that work.