Skip the Fancy Towels, and Hire More Nurses

This was my interesting reading this morning. I love this contributor.

Alexandra Robbins is the author of "The Nurses: A Year of Secrets, Drama and Miracles with the Heroes of the Hospital." She is on Facebook and Twitter(@AlexndraRobbins).

New York Times Link

It’s possible that on-demand meals could improve patient nutrition, and massages could ease patient anxiety. But too many hospitals are spending precious resources on hotel-like amenities when they should be hiring additional nurses, an expenditure that directly improves patient health.

A hospital patient’s primary goal is to get better, not to take a vacation. Uniformed valets and flat-screen TVs will not improve patient health.

Nurse understaffing is a health care crisis that severely endangers patients. Hospitals cut corners by assigning nurses unsafe patient loads. California is the only state that legally requires a minimum standard for hospital-wide nurse-to-patient ratios.

This week, a psychiatric nurse told me she was forced to care for 12 patients simultaneously, at leastdouble the number experts recommend as a safemaximum. When one of the patients became suicidal, her doctor ordered one-to-one care, an impossibility because administrators had cut costs by sending the only other nurse on the shift home early. Meanwhile, the same hospital recently funded extraneous patient amenities such as flat-screen TVs, a gazebo patio for smoke breaks, monogrammed towels, a fancy gym, a pool and espresso machines (none of which the exhausted nurses are allowed to use).

"Concierge treatment” also impedes patient care, said a nurse who works in postpartum and I.C.U. units that are both chronically understaffed. Her hospital recently asked nurses to deliver non-alcoholic champagne toasts to every new mother. “It takes time away from our real jobs. The public needs to know how their money is being wasted and their lives are being put at risk,” she said.

A hospital patient’s primary goal is to get better, not to take a vacation. Uniformed valets and flat-screens will not improve patient health. But reams of studies show that when hospitals hire more nurses, patient risks of death, infections, complications, falls, failure-to-rescue rates and readmission drop.

Hospitals are acting like amateur magicians, razzle-dazzling patients with slick patter and shiny baubles to distract them from the real problem: they undervalue their nurses, who are often stretched too thin to provide optimal care.

In March, 22 percent of surveyed Michigan nurses reported knowing of a patient death linked to staffing levels and 57 percent reported infections or other complications. A current nurse at Henry Ford West Bloomfield in Detroit (the hospital featured in The Times report about hospitals emulating hotels) told me recently that the hospital doesn't have enough nurses or ancillary staff, which obligates some nurses to perform secretarial duties in addition to managing patients.

The tradeoff seems like a no-brainer. Would you rather meet a professional greeter when you arrive or feel better when you leave? Would you rather wash your face with monogrammed towels or remain, for one thing, not dead?

After all, federal data (measured between July 2013 and June 2015) indicates that, while it wouldn’t be considered an overall poor performer, Henry Ford West Bloomfield scores worse than the national average in the categories of serious complications and serious blood clots after surgery – meaning that, even if patients are entertained during their stay, they don’t necessarily get what they came for.