But the problem is serious, contributing to 19 percent of medical errors resulting in death or serious injury, according the a recent report by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), a nonprofit health care monitoring group.
And the patients aren't the only ones suffering:
83 percent of nurses who have remained in the profession have experienced a recent spike in the number of patients under their care, according to a 2001 study by the University of Pennsylvania. "Some nurses are looking after 20 patients at once," says Aiken. "They're beginning to think their jobs are impossible because they simply can't provide quality care."Part of the problem is growing demand for highly trained nurses:
The challenge has taken a physical toll, causing nurses to develop chronic back pain and repetitive stress injuries. It's taken a psychological toll, making them feel harried and overwhelmed. The study says 41 percent of nurses are dissatisfied with their jobs and 43 percent suffer from burnout. In addition, 75 percent of nurses believe the quality of care at their hospitals is declining, and 40 percent would not feel comfortable having a family member cared for at their facility, according to a 2001 survey by the Washington, D.C.-based American Nurses Association.
But the government's reduction in Medicare reimbursements have led hospitals to cut their nursing staffs, while HMO's pressure hospitals to cut corners.
there have been dramatic technological improvements in health care. There are more diagnostic tests to run, more medications to administer and more machines to monitor. Care is becoming more specialized, requiring a greater number of nurses and nurses with more comprehensive training. Nursing has consequently become one of the five the fastest-growing professions in the United States, according to the Washington, D.C.-based Department of Labor.
In response, some states, with support from unions representating nurses such as
California recently mandated a ratio of no more than six patients to every nurse. Ten states have limited overtime for nurses and 20 more states are considering similar measuresBut much more needs to be done: "The American Hospital Association says 13 percent of nursing positions nationwide are vacant today and 20 percent are likely to be vacant by 2015. "