I don’t get out much, so on the rare occasion that I’m driving around listening to the radio I always hear something new. Three years ago I heard an ad by the Massachusetts Nursing Association (MNA) in support of legislating nurse:patient ratios. (See Selflessness or naked self-interest?) It had this simplistic and offensive tagline:
Hospitals care about profits, nurses care about patients.
Talk about boiling things down to good versus evil.
Attention in health care has shifted, quite rightly, to concerns about hospital errors and patient safety. And guess what the MNA thinks is the cure for that? That’s right, legislated nurse:patient ratios! The latest ad, which I heard today, is called Boiling Point. Here’s a little taste:
An estimated 2000 people die every year in Massachusetts because of avoidable medical errors and infections they get in the hospital. Setting limits on the number of patients a nurse is responsible for reduces suffering and saves lives. Legislators, patients in your district and across Massachusetts need your help. Please vote yes on House Bill 2059 for safe patient limits. The patient safety crisis is at the boiling point.
During the last sentence you can hear the sound of a tea kettle reaching the boiling point, just in case you didn’t get the message.
It’s clever marketing for the MNA to link nurse staffing and patient safety. They even have a page of studies to back up their assertions. And after, all, what patient wouldn’t want their nurse to be available for them in the hospital? I certainly would want a nurse to be there for me or any friends or relatives who are hospitalized.
And yet I don’t favor mandated work rules as a solution to patient safety problems. Most hospitals are working hard on patient safety. With the emergence of public reporting on quality and safety and the shift by payers away from providing reimbursement for medical errors, hospitals have all the incentive they need to improve patient safety. If they want to base their efforts on increased nurse staffing, it’s fine with me. But they should be free to pursue other approaches as well. To the extent nurse:patient ratios reduce their flexibility I’m against it.April 8, 2008