May 5, 2000 -- As more and more hospitals try to cut costs by trimming their staffs, a new study suggests that registered nurses (RNs) should be some of the last staffers to go -- because patients fare better in hospitals with more RNs.
In the study, researchers found that patients treated in hospitals with greater numbers of registered nurses had shorter hospital stays, fewer cases of hospital-acquired pneumonia and fewer post-surgery infections, bed sores, and urinary tract infections than patients at hospitals with fewer RNs.
"Shorter lengths of stay and fewer complications translate into lower hospital costs," writes Mary Foley, MS, RN, in a research announcement. Foley is the president of the American Nurses Association (ANA), which released the study's results at the Nurse Staffing Summit, held in Washington, D.C., on Monday and Tuesday.
"Not only do patients fare better," Foley writes, "but hospitals can actually save money by using highly skilled nurses in adequate numbers." The new findings come at a time when many hospitals are experiencing a shortage of nurses.
"It makes no sense for hospitals to cut RN staff or replace RNs with unlicensed assistive personnel who lack the education and judgment of RNs," she says. "For years, hospitals have tried to cut corners in this way but the data keep disproving this approach."
Now RNs have the data to support their value to hospital patients, she says.
To arrive at the findings, the researchers from Network Inc., a hospital and health care research organization, reviewed hospital and insurance data from nine states. Overall, patients in hospitals with more nurses had fewer complications than patients who received their care in hospitals with fewer RNs on staff, the study showed.
Few RNs are surprised by the new findings.
"Nursing care is critical to patients in the hospital," Christine Kovner, RN, PhD, a professor in the division of nursing at New York University in New York City, tells WebMD. "Nurses are the people that are there 24 hours a day monitoring patients and assessing what is going on with the patients."
For example, if a nurse is there to monitor a patient after surgery, he or she can catch any early warning signs of pneumonia by monitoring the patient's breathing and the sounds in his or her chest.
"The No. 1 reason we need more nurses is that patients who are monitored carefully will likely do [better] than patients who aren't," she tells WebMD.
A nurse's primary responsibilities are to dispense medications and handle any emergencies, Kovner says. But when there are not enough nurses on staff, the ones present don't have the time to do monitoring to prevent complications, she says.
"We are concerned about the status of patients who need care and monitoring and that care not being available," says Sally Raphel, MSN, RN, director of nursing practice and quality initiative at the ANA.
Nurses also work with patient's families and educate them about the illness and treatment, Raphel tells WebMD. "Nurses are valued by patients."
"We can now show that patient outcomes are directly correlated with staffing mix," Raphel says. "We are very pleased with the results."
Kimberly Lisa Fiedelman, a nursing student at Fiorella LaGuardia School of Nursing in Queens, N.Y., tells WebMD that she is concerned that good nursing jobs may not be plentiful when she completes her schooling.
"I'm glad that this and other studies are helping to better define and delineate the value of nurses in hospitals," she says.
- At a recent conference, The American Nurses Association released a study that found patients have better results at hospitals that employ the most registered nurses.
- Nurses say they add a level of monitoring to care that is not present when hospitals stretch their nursing staff too thinly.
- The nurses say the study indicates cutting nursing staff doesn't save hospitals money, but could result in making care more expensive if patients go on to suffer further illness that nurses could help prevent.