NAA Today Blog

NAA Today Blog

Posted by on in Nursing Practice

The U.S. Is Running Out of Nurses

The country has experienced nursing shortages for decades, but an aging population means the problem is about to get much worse.

Five years ago, my mother was rushed to the hospital for an aneurysm. For the next two weeks, my family and I sat huddled around her bed in the intensive-care unit, oscillating between panic, fear, uncertainty, and exhaustion.

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Posted by on in Current Issues

  NURSES’ RIGHTS: My Story, My FightFlorence Nightengale 2

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Posted by on in Leadership
Weber, Emily MS, RN, CPN, NEA-BC; Ward, Jacqueline MSN, RN, NEA-BC; Walsh, Terese
Does pondering whether you have a leadership pipeline for the future keep you up at night? Further, as you consider the future of healthcare, are you certain that your current leadership team is equipped with the knowledge, skills, and abilities to navigate the turbulent tides of healthcare reform? At Texas Children's Hospital, we wanted to be armed and ready for the charge. Our journey leveraged a strategic partnership between the nursing and human resources departments. The aim was to transform the existing nurse leadership model to align with our strategic priorities, support the changing healthcare landscape, and position the organization to produce high-quality outcomes. We embarked on a large scale nursing restructure and utilized key competencies in the job creation and interview process, nursing leadership education curriculum, and ongoing performance assessments for the foundation of a robust talent strategy and development of a succession plan.
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      Daniel-Zwerdling  NPR, Special Series, Injured Nurses

      Updated February 25, 20155:09 PM ET

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Nurse-patient Ratio Law in MA Raises Cost, Quality Concerns

Alexandra Wilson Pecci, for HealthLeaders Media , June 23, 2015
Data shows that mandated nurse-patient staffing ratios are good for nurses, but patient safety benefits have not been clearly demonstrated. In California, where a similar law has been in effect for 11 years, hospital operating expenses have risen.
Eleven years after passage in California, the country's first mandated nurse-patient ratio law has largely resolved the nurse burnout problem.
Still, the Massachusetts Health Policy Commission voted unanimously this month to approve the state's first nurse staffing mandate. It calls for no more than two patients to be assigned to a single nurse in all ICUs, including burn units and NICUs, and in some cases, just one patient per nurse.
To determine proper staffing levels, hospitals must use an acuity tool to, according to the final rule. A nurse manager will intervene if there's a disagreement between an RN and the tool. Also, hospitals must report on four ICU quality measures:
Central line-associated blood stream infection
Catheter-associated urinary tract infection
Hospital-acquired pressure ulcers, and
Patient falls with injury
Although there are no monetary or other specific penalties in the law, Patricia M. Noga, PhD, RN, vice president of clinical affairs for the Massachusetts Hospital Association, says the law will have a financial impact.
"There will be costs associated with implementing the law, such as developing acuity tools," she said, responding to questions by email. "We'll be monitoring the implementation of the regulations to assess the cost over time."
Massachusetts joins California as the only other state in the nation to have adopted a mandated nurse-patient ratio. However, California's law goes far beyond ICUs, mandating minimum nurse-to-patient ratios at all times on a unit. And 11 years after its passage, it remains to be seen whether it's a model or a cautionary tale.
"I think it's a bit of both," says Patrick S. Romano, MD,professor of medicine and pediatrics and senior faculty in the Graduate Groups in Epidemiology, Public Health, Clinical Research, and Nursing Science and Healthcare Leadership at the University of California Davis.
"I think it's a cautionary tale in that it was certainly expensive, and the benefit in terms of patient safety has not been clearly demonstrated, and the process has certainly been contentious," he says. "But on the other hand it is a model, perhaps, because it has largely resolved the [nurse] burnout problem."
Romano was one of the co-investigators who did work for the state of California in the early 2000s to estimate the impact of different ratio proposals.
Because of the California law, hiring increases happened almost across the board. Although a few hospital leaders said staffing was already at or above mandate levels, most "reported that they needed to hire more RNs to meet the requirements, particularly to cover meals and breaks," according to a California HealthCare Foundation study.
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