Hospitals are increasingly trying to find ways to move sick patients out the door more quickly, and while this is obviously not good for patients, there’s been additional fallout from this as well.
Nurses, as well as patients, are struggling to cope with Medicare’s prospective payment system, which pays a fixed amount for a diagnosis, regardless of the length of stay, or the number of hospital beds that are available, TonicVice reports.
Harvard policy researchers have dubbed this the “quicker and sicker” approach and in part, it’s but it’s an approach that puts patients on a merry-go-round of being readmitted to hospitals time and again.
So how does “quicker and sicker” impact nurses?
It’s a complicated issue but nurses are suffering burn out due to the increased volume of patients. This is taking a heavy emotional toll on those who are sometimes the only people protecting our health.
“What’s causing the overwork is the increased acuity of patients,” says Professor Susan Letvak, of the University of North Carolina School of Nursing. “You are only in a hospital if you are so acutely sick that you can barely move. The minute you can move you are kicked out the door.”
On a physical level, this causes nurses to work much harder because not only does this mean more patients are readmitted, but nurses usually must work 12-hour shifts. And that in itself causes increased burnout for them and increases the chances for mistakes to be made.
“The push is to get everybody out of the hospital as fast as we can,” says Bernadette Melnyk, dean of the College of Nursing at the Ohio State University, where she’s also the Chief Wellness Officer.
“It’s not healthy for the nurses, it’s not safe for the patients,” she says.
She and her colleagues recently published a paper that highlights how mistakes on the job and burnout spark depression in nurses.
You’d think that sending patients home earlier would benefit nurses in some small way because after all, fewer patients could mean a slower shift. But you’d be wrong.
“Minimum staffing is maximum staffing,” Letvak says. “We don’t have any easy days anymore. If the [patient load] is low, which happens all the time, they send the nurses home, instead of them having a light afternoon.”
“How few do we need? That’s all you’re getting,” she added. “Every time you are at work, it is a bad day. There really isn’t a chance of having a lighter day anymore.”
Nursing is a profession where there’s little room for mistakes. According to this study, the situation works best when there are four patients to each nurse. Would you want your child or your mom or dad to be patient number five? It’s something to think about.
Because even if the number of patients goes up just a little, the stress on that nurse who’s helping your precious family member goes up a lot. Really, it does. Another study, this time by Linda Aiken and her colleagues at the University of Pennsylvania shows just how many patient’s lives are affected when nurses are overworked. Add one extra patient to a nurse’s four patient workload and the chances of that patient dying increase by seven percent. And the chances that this nurse will feel stressed-out jump to 23 percent.
But that’s not all. Additional studies conducted by Aiken and her colleagues show that for every 10 percent increase in the proportion of nurses with Bachelor’s degrees, the risk of patients dying drops by five percent. And an unrelated study shows that a 10 percent increase in the size of a hospital’s registered nursing staff saves an additional five out of every 1000 lives. That may not seem like much but try telling that to your loved ones in the hospital.
And nurses are doing all this as baby boomers grow older and sicker. As Republicans fear monger and continue to hack away at Medicare and Medicaid and the rights of people with pre-existing health problems to receive the help they need, it’s clear this system is broken.
It’s also breaking the people we need the most when we’re sick. The nation’s healthcare system needs a nurse.