Nurses, consumers fear declining quality of care
Speed-up, de-skilling seen as rampant
A recent survey of 7,000 nurses revealed that nurses are experiencing a labor trend known as "speed-up." This is when they are expected to work harder and faster with fewer resources.1 In addition, they are providing care for greater numbers of sicker patients. The result is high job turnover and an increase in work-related injuries, a national nursing group claims.
Three-quarters of respondents said they have less time for patient and family education and counseling, less time for documenting care, and less time for professional consults. About the same number said they wouldn’t recommend the hospital where they work to a family member. Two out of five nurses reported an increase in patient complications, errors, nosocomial infections, skin breakdown, and injuries.
Three recent consumer surveys echoed nurses’ concerns about the effect of cost containment on care. Consumers are getting the "de-skilling" message as well. They are increasingly aware that patient care is often in jeopardy. They’ve experienced or witnessed untoward incidents where harm was done because of inappropriate care by unlicensed, untrained personnel. Each survey demonstrated consumers’ belief that health care is becoming more and more impersonal, as shown below:
• A survey commissioned by the National Coalition on Health Care showed that seven out of 10 people agree that there are serious problems with the quality of health care and that care is often compromised to save money.2
• Satisfaction surveys from more than a million patients identified factors that affect their likelihood of recommending a hospital. Of the top 10, six were related to quality of nursing care.3
• Qualitative and quantitative research findings identified consumers’ concerns about the impact of staff decreases and increased use of less-skilled workers on the quality of care.4
References
1. Rothschild J. What’s happening to patient care? Final results of the AJN survey. AJN 1996; 11:24-39.
2. National Coalition on Health Care. How Americans Perceive the Health Care System. Washington, DC; 1997.
3. Press, Ganey Associates. Untitled survey. South Bend, IN; 1997.
4. American Hospital Association, Picker Institute. Eye on Patients: A Report to the American Public. Washington, DC, Boston; 1997.
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