Contact: Rick Fuentes
(St. Paul) – March 15, 2016 – Nurse members of the Minnesota Nurses Association reported more than 2,700 incidents of unsafe staffing in Minnesota hospitals last year, according to a qualitative study released today at the Minnesota Nurses Association’s annual lobby day in St. Paul. These incidents are reported in Concern for Safe Staffing (CFSS) forms that nurses file in unsafe situations.
The report issued today showed nurses filed 32.93 percent more CFSS forms in calendar year 2015 than they did in 2014, which totaled 2,062 incidents. The reports document substandard patient care, such as delays in treatments or medications, inability to answer call lights, and incomplete discharges or assessments. In many cases, a patient was lying in a hospital bed waiting for help, but nursing staff already had too many other patients to respond.
“The rapid rise in CFSS forms shows that the professional judgment of the nurse isn’t being taken seriously,” said Carrie Mortrud, RN and one of report’s authors. “Nurses are alerting hospital management to a serious situation that could have a tragic impact on patient safety and care, but the staffing decision that caused the situation remained.”
Mortrud and co-author Mathew Keller compiled and analyzed CFSS forms from both years and noted that some categories of consequences to patients showed disproportionately greater increases. The three biggest gains came in “unit short-staffed 25 percent or greater than what is needed,” with 86 percent; too many patients for beds and/or staffed caused nurses to “close the unit” to more patients went up 75 percent; and patients receiving “incomplete discharge instruction” increased by 72 percent over the past year.
“It’s evident that hospitals are cutting costs with staff,” Keller, a nurse and attorney, said. “Fewer staff means more dollars for the hospitals that already pocketed $600 million more income after expenditures last year. The patient has to pay the same, regardless if their nurse is juggling two other patients or six.”
The report details “near-misses” or patient harms that do not rise to the legally defined Adverse Health Event or hospital Incident Report level. However, CFSS forms are also collected to share with state regulatory agencies. Currently, only the Minnesota Department of Health reports negative patient outcomes where the victim died or required long-term hospitalization.
The authors also quoted nurses’ descriptions of unsafe staffing incidents in the report but shielded the nurses’ identities to protect them and their patients. Such quotes include, “patient who cannot walk jumping out of bed,” “patient screaming in pain for 40 minutes,” and “4-6 RNs working doubles, 16-20 hour shifts. Several since Friday.”
“Nurses always continue to smile and care for their patients the best they can,” Mortrud said. “But that care has been and will continue to suffer until there are quality patient care standards that address staffing.”
“The staffing problem cannot be blamed on a nursing shortage,” Keller said. “Nursing schools are graduating two RNs for every new job opening in the state. Nurses simply are not being hired to fill needed positions.”
The full Concern for Safe Staffing Form Annual Report: 2015 can be found on the MNA website at: https://mnnurses.org/issues-advocacy/issues/concern-safe-staffing-report-2015.