The nurses also reported increased stress and concern over those staffing shortages, as well as over job and retirement security and workplace safety amid hospital consolidations, mergers and sales to for-profit hospitals, according to the survey commissioned by Health Professionals and Allied Employees.
Almost half of the 500 nurses polled, or 44 percent, said they have been unable to provide proper patient care due to low staffing at some point; and 43 percent said staffing has gotten worse over the past few years. More nurses cited staffing issues in hospitals undergoing mergers or sales.
Only 9 percent said staffing has improved where they work, and the majority of nurses surveyed, 77 percent, said they support a law that would establish minimum safe staffing levels for all hospital units. New Jersey currently allows hospitals to set their own systems for defining staffing levels.
“Nurses are continuing to put care first, amidst huge upheavals in the health care industry — including hospital mergers and sales to for-profits — that add to the daily pressure of providing quality patient care in understaffed settings. They need real relief — their No. 1 request is not more money, but more RNs to help provide quality patient care,” said Ann Twomey, president of HPAE, which represents 12,000 nurses and health care workers in New Jersey and Philadelphia.
Aline Holmes, a registered nurse and senior vice president of clinical affairs for the New Jersey Hospital Association and director of the NJHA Institute for Quality and Patient Safety, defended the staffing levels at the state’s hospitals.
Holmes said the survey “measures nurses’ perceptions, and it’s an important perspective. But there’s also hard-and-fast data available that shows the staffing levels at our facilities and the advances in quality of care that are occurring in our health care facilities. That’s the rest of the picture that health care consumers should be aware of.”
Holmes said federal data ranks New Jersey ninth in the nation in hospital quality of care. She said the state’s hospitals have achieved double-digit reductions in areas such as infections, pressure ulcers and hospital readmissions.
Nursing homes likewise have achieved significant improvements in key indicators such as pressure ulcer rates and the appropriate use of anti-psychotic medications, she added.
“The reality is that nurse staffing levels will vary from unit to unit, and from one shift to the next, depending on the types of patients, the severity of their conditions, the volume of patients and the experience and expertise of the unit’s nurses. The health care professionals in our hospitals and other health care facilities make those decisions carefully, and they monitor patients’ outcomes to evaluate appropriate staffing levels. They need flexibility to adjust based on ever-changing demands in patient care,” she said.
She said New Jersey hospitals and nursing homes report their staffing levels to the state Department of Health, and the information is available online for hospitals here and for nursing homes here.
David Knowlton, chief executive of the New Jersey Health Care Quality Institute, said the survey “shows that the need is great for nurse leaders and patient safety experts to come together to develop common sense rules for staffing and overtime that will help nurses and ultimately help patients.”
Knowlton said that improving staffing levels will lead to improved working conditions for nurses and will translate into fewer medical errors, safer hospitals and healthier patients. He also advocated limiting nurses’ overtime.
“Nurses rely on their intricate skills and immense knowledge to improve patient outcomes, and therefore we need to find ways of limiting their fatigue, which can decrease vigilance and increase the chance of error,” Knowlton said.