Registered nurses feel that there is a relationship between inadequate staffing and the declining quality of patient care in the health care facilities where they work. The American Nurses Association (ANA) Staffing Survey, released February 6th, 2001, received over 7,000 responses from nurses to questions about their working conditions and the safety and quality of patient care. The survey was conducted from December 2000 through January 2001 on the ANA’s website. Of the nurses surveyed 75% felt that the care provided by their facility had declined over the last two years. Over 40% of the respondents said that they would not feel comfortable with a family member being cared for in the facility in which they worked. The results of this survey is supported by the findings of an earlier ANA study (March 2000) where patients were found to have better health-care outcomes in hospitals with higher staffing levels and higher ratios of registered nurses on staff.
Almost half of those surveyed said that they felt "exhausted and discouraged" by the end of their shift and almost all agreed that they were "discouraged and saddened by what they couldn''t provide for their patients". They also spoke of skipping meals and breaks to attend to patients, about being pressured to work overtime, and not having the time to attend continuing education programs. The ANA foresees problems recruiting young people into a profession with such high levels of dissatisfaction. Considering the current demographics within the profession – about 69% of the survey respondents will probably be retiring within 10 years – where will their replacements come from? Add to this the aging of the baby boon generation and you have a healthcare system under severe stress.
ANA Identifies Legislative Priorities for 2001
Restrictions on mandatory overtime – tired nurses do not offer optimum care.
Increased whistleblower protections – nurses want to be able to report unsafe conditions without fearing employer retaliation.
Nursing research and workforce data to be collected and made available so that healthcare facilities can be held publicly accountable for their quality of care.
Establishment of patient classification system that will establish the appropriate mix of nursing staff -- registered nurses, licensed practical nurses and unlicensed assistants -- needed to give safe, quality care.
As ANA President Mary Foley says, "the bottom line is that we have to improve working conditions in order to enable older nurses to stay in nursing longer, and so that young people will be attracted into the profession".