ANA survey: Nurses say patient care is suffering
Shortage, cuts have impact, survey says
The latest American Nurses Association (ANA) staffing survey of its membership shows increasing concern among the nurses that patient care is suffering due to declining working conditions. According to ANA president Mary Foley, MS, RN, three-quarters of the 7,300 respondents to the survey feel the quality of nursing care at the facility in which they work has declined over the past two years.
More than half contend that the time they have available for patient care has decreased, and more than 40% of nurses surveyed said they would not feel comfortable having a family member or someone close to them cared for in the facility in which they work. Other findings include:
- 76% have an increased patient load.
- 48% have seen needed support services decline.
- 45% work in facilities where mandatory overtime is used to cover staffing needs.
- Among those who said care has declined, most felt it was due to inadequate staffing, a decline in nurse satisfaction, a delay in providing basic care such as feeding and bathing, and the discharge of patients without adequate teaching.
- 78% of nurses skip meals and breaks to care for patients.
- More than half reported stress-related illnesses.
- Many are distressed at seeing increased marketing of hospital services, while there is decreased support and reimbursement for continuing education activities.
There is ample evidence that patients have better outcomes in hospitals with higher staffing levels and higher RN ratios in the staffing mix, Foley says, noting that length of stay, pneumonia, post-operative infections, pressure ulcers, and urinary tract infections "are markedly decreased with higher levels of RN involvement."
Protecting whistle-blowers
Foley and the ANA are working to improve the situation by supporting legislation that would protect whistle-blowers and eliminate or severely curtail the use of mandatory overtime. But she would also like to see facilities take note of trends by looking at "nursing-sensitive" quality data.
"Nurses want to know that health care facilities will be made publicly accountable for the quality — not just the cost — of care delivered to patients, and for the staffing levels used to deliver that care. They want to see a mandate that incorporates nursing research, nursing work force data, and other findings into agencies’ reports."
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