Nurses: Overworked and Understaffed

November 11, 2003

Earlier this month, the National Academy of Sciences issued a report calling for the government to establish "minimum standards for registered and licensed nurse staffing in nursing homes."

The National Academy's report cited extensive documentation to show that hospital and nursing homes across the country endanger patients by systematically understaffing nurses and nursing assistants and by forcing these workers to put in long hours of overtime. The Academy emphasized that higher levels of nurse staffing are necessary to better monitor patients and detect changes in their conditions. The report said: "studies show that increased infections bleeding and cardiac and respiratory failure are associated with inadequate numbers of nurses." In addition, one study included in the report showed that 27% of nurses at hospitals and nursing homes work more than 13 consecutive hours at least once a week and that such extreme overwork is another "serious threat to patient safety, because fatigue slows reaction time, decreases energy, diminishes attention to detail and otherwise contributes to error."

The report called for regulations prohibiting nurses from working more than 12 hours in any 24-hour period or more than 60 hours a week. It also called for mandatory staffing minimums, insisting, for example, that intensive care units at hospitals must have at least one licensed nurse on duty for every two patients and that nursing homes should have at least one registered nurse for every 32 patients and one nursing assistant for every 8.5 patients.

The Bush administration has consistently refused to set any minimum staffing limits saying that it would cost the nursing home companies billions of dollars per year.

Facing such extreme overwork and insisting on improving the quality care, nurses and other health care workers have been waging many struggles across the country to win minimum staffing levels and relief from forced overtime. In many contract struggles, unionized workers have gained such standards and in many states political struggles are underway to gain and enforce statewide regulations.