No Such Thing As Safety Without Nurses

As we approach Patient Safety Awareness Week (March 13-19), clinicians and health systems are called to focus their institutional safety culture as well as the practices that support improved outcomes for patients.

What is at stake?

The National Patient Safety Goals for Hospitals identified by the Joint Commission for 2022 highlight specific call-outs for improvement, including examples like “improve staff communication” and “use medicines safely.” While these goals remain important aspects of quality clinical care, ask any healthcare provider what’s keeping them up at night?

Their answers align globally: poor staffing.

Prior to March 2020, there was an estimated worldwide nursing shortage of 6 millions nurses. While all frontline healthcare professions are feeling the squeeze of the Great Resignation, nursing’s effect on patient outcomes is most widely studied. Prior to the pandemic, the nursing shortage was caused by a rapidly retiring older demographic with insufficient numbers of new grads to fill vacancies. But now, two years later? The previous problem still remains – except the nursing shortage is facing a new factor: the mass exodus of nurses as a result of overwhelming burnout.

A recent survey of over 9,500 US nurses by the American Nurse’s Foundation (published October 2021) found 50% of all nurse respondents were considering leaving their nursing positions in the next 6 months. One quarter of those nurses indicated they intended to leave by April 2022. 

Only a few short months after that survey was published, health systems are reeling from the loss of staff. You’re hard pressed to watch the news or read the newspaper without some mention of the problem. 

When the surveyed nurses in the above study were asked reasons why they were leaving their positions? Their motivations were clear:

  • 47% responded that work was negatively affecting their health and well-being
  • 41% responded because of staffing shortages
  • 31% cited a lack of support from their employer during the pandemic
  • 25% responded they were unable to provide quality care consistently 

Despite other public claims, burn-out is overwhelmingly the research-based source of nursing resignations.

What do nurses need?

In America, nurses are consistently voted the most trusted profession. Their dedication to patients and families is without question. Throughout the pandemic, they’ve held the frontlines and showed up without fail at risk to their own personal safety and health.

So how can we help them recover and bounce back stronger than before?

A huge body of evidence from the past 20 years demonstrates an incontrovertible link between adequate nursing resources and patient outcomes. Necessary nursing resources include: proper equipment & supplies, safe staffing ratios, and overall staff satisfaction. Happier nurses in healthy nursing environments equal safer hospitals and better patient outcomes. The Center for Health Outcomes and Policy Research founded by Dr. Linda Aiken at the University of Pennsylvania School of Nursing has been instrumental in providing research-based recommendations to improve outcomes by targeting hospital working environments. Research-based safe-staffing ratios championed by the Center have been implemented in states like California and countries throughout the world. In institutions that follow safe staffing ratios and prioritize nursing satisfaction, institutions save money and see better patient outcomes.

As we move into March and celebrate Patient Safety Awareness Week, thank a nurse and/or frontline worker for their dedication to patient care, but also ask them what they need to do their job safely. We can’t talk about patient safety in 2022 without also talking about health care work environments and staff retention. The data already exists to show health care systems what to fix to make hospitals safer for staff and patients. A post-pandemic world is a great place to start.

Kelly Convery is the Clinical Quality Manager for Keriton. She’s a registered nurse and has worked in health care for over 15 years. She’s spent the majority of her nursing career in the Neonatal Intensive Care Unit and has been active in quality improvement projects and implementing best practice initiatives throughout her tenure.