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Nurses are pushing to limit the number of patients that can be assigned to a single person — a move that advocates say will make care safer and improve working conditions.
The American Nurses Association, which officially threw its support behind minimum nurse-to-patient ratio mandates in 2022, tracked nurse staffing bills in 21 states this year, many involving ratios. Federal ratio legislation was also introduced.
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Higher levels of registered nurse staffing are associated with a lower likelihood of Medicare patients’ dying from sepsis in hospitals, according to a recent study published in JAMA Health Forum. An estimated 1.7 million cases of sepsis occur each year, killing 270,000 annually. Even more concerning is one in three patients who die in the hospital has sepsis, according to the CDC. Not all of those deaths occur because of sepsis, but it’s a contributing factor in nearly all cases.
The vast majority of infections that cause sepsis, however — 87% of them — begin outside the hospital, according to the CDC. The difference between life and death depends on early identification of sepsis and immediate treatment. Registered nurses play a significant role in that process because they have more regular interaction with patients and more opportunities to observe symptoms of sepsis.
Why does this study matter to journalists?: Nurses continue to be an under-appreciated and under-utilized resource for better understanding health care issues. Here are some key takeaways from this study:
Nada Hassanein (Photo courtesy of Alicia Devine)
When Nada Hassanein read the press release about a survey that shed light on racism nurses of color are enduring in the workplace, she seized the opportunity to write a story to give real-world context to the findings. In telling the story, the environmental and health inequities reporter for USA Today, said she wanted to “weave [the survey results] into a kind of narrative about nurses’ experiences.”
In this “How I Did It,” Hassanein shares her reporting process for the story, talks about why leaning heavily on data may matter more for some stories over others, and offers tips for cultivating and building the trust that allows sources to open up about painful experiences.
This interview has been edited for clarity and brevity.
You get this press release and decide that there’s a bigger story here other than the survey. What was your next step? How did you find the sources for the story?
First, I asked the [National Commission to Address Racism in Nursing] if someone from the Commission — a nurse of color — would be willing to talk with me. And that nurse connected me with other nurses that are not part of the Commission.
How hard was it for nurses to be candid about their experiences?
The nurses I spoke with were quite open and candid about their experiences. I think they felt that someone was listening and, therefore, were willing to share their experiences.
How did you weave in context about the profession?
I found demographic breakdowns of nursing staff or registered nurses in certain states to show how they are minorities or underrepresented. Being a health reporter, I see a lot of discussion about racism among physicians and residents but less so about nurses.
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Independent Journalist Sarah DiGregorio recently offered good advice in a March 14 perspective opinion article in the Washington Post to reporters following current challenges in hospital staffing. She urged a deeper examination of the root causes for reported instability in the nursing workforce and the resulting recent cases of notably high salaries now offered for those willing to take on temporary work away from their homes.
In the article, DiGregorio shared stories from her reporting on nursing to explain why the recent spike in salaries for travel nurses reflects deeper concerns.
The pandemic has added to the stresses of nursing, leading to departures from permanent jobs and creating a situation where people willing to take on temporary employment may get $3,500 a week “and sometimes even more,” DiGregorio noted.
“Yet the problematic explosion of traveling nursing is only a symptom of a longer-running, self-inflicted disaster,” DiGregorio wrote. “Over the long-term, hospitals have failed to hire and support enough nurses to weather crises.”
DiGregorio, who is working on a book on the history of nursing, writes about how hospital executives furloughed or laid off nurses early on in the pandemic when elective procedures were suspended, and then they later had to scramble to raise staff levels.
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A half-hour before nursing supervisor Jotis Lee was scheduled to end her shift on the Friday before July 4th, the text came through: A 24-year-old who was fully vaccinated against COVID-19 had, nevertheless, contracted the virus and just been admitted to the Department of Veterans Affairs’ hospital.
That patient’s admission was another marker of the pandemic’s persistence, said Lee, who, at that Little Rock, Ark hospital, supervises a team of nurses in an outpatient clinic that mainly has done telehealth care during the pandemic.
“In many ways, the pressure has gotten worse,” Lee said, of the anxiety, depression and other stresses members of her team are experiencing. Continue reading
