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Roles of Being A Nurse

A new report came out in The Sydney Morning Herald (Australia) that nursing ratios in New South Wales were double what the nursing union deemed safe. “The minimum ratio sought for general wards at most major hospitals is one nurse for four patients plus a registered nurse (RN) in charge of morning and evening shifts. At night, the ratio could rise to one to seven.” This got me thinking about what the staffing ratios are here in the United States.
I found an interesting article in the Online Journal of Issues in Nursing (OJIN) which addresses this very issue. The study took place in Massachusetts in which “nurse-to-patient staffing ratios on the adult units were 1:5.25 for community hospitals and 1:4.08 for academic medical centers.”
I used to be a high school history teacher, so bear with me. I thought the following was really interesting: The (OJIN) article explains how the roles of nurses change as technology advances. “Until the 1920’s, nearly all hospital functions were carried out by unpaid, student nurses under the watchful eye of the nursing superintendent while graduate (private duty) nurses provided care in the home. The modern hospital was born soon after the First World War with the introduction of a myriad of new technologies.”
Now this is mind-blowing. In just three short decades, the OJIN reports that not only are patient hospital stays drastically reduced, but the nursing work day has increased immensely. The “lengths of hospital stay have decreased from a typically 7 to 8 day stay in the 1980s to a current 4 to 5 day stay, resulting in higher patient turnover as well as overall severity of illness. This ‘sicker and quicker,’ inpatient environment has lead to a significant increase in both the intensity of nursing care for each patient and the need for more nurses, requiring a higher ratio of nurses to patients. Between 1980 and 2004 the average number of registered nursing-care hours per patient day has more than doubled from 4.7 hours per day to 10.7 hours.” Not only is this disconcerting as a nurse, but it’s terrifying to review these facts as a patient. I wouldn’t want to get kicked out of my hospital room until I was confident that my health was stable, however patients are getting more attention in less time. So why aren’t hospitals mandated to have a minimum amount of nurses on duty at any given time. The OJIN explains “the main weakness of the regulatory approach is that hospitals are required to increase the number of registered nurses without receiving increased reimbursement for patient care.” It will be interesting to see the changes that the new health care system will make to the role of nurses.
For more information, please visit: http://www.smh.com.au/nsw/nurse-ratio-is-double-safe-level-union-20101130-18fdr.html
http://www.nursingworld.org/mainmenucategories/anamarketplace/anaperiodicals/ojin/tableofcontents/volume122007/no3sept07/mandatorynursetopatientratios.aspx

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