One of the dominant factors to determine the quality of care in a medical facility is the performance of its nursing services. Unfortunately, due to cost considerations, the relative expenditure on nursing seems to decline in recent years. As a result, not only that the quantity of nursing time per patient is declining (i.e. growth in the patients-per-nurse ratio), but the quality of the service provider may also deteriorate to the extent of risking patients’ lives.
As shown by Aiken et al (2002), higher patient-per-nurse ratios are significantly linked to higher mortality rates. The authors report that each additional patient per nurse was associated with a 7% increase in the odds ratio for dying within 30 days of admission and a similar increase in failure-to-rescue. Moreover, each additional patient was also associated with a 15% increase in the odds ratio of nurses’ job satisfaction. The possibility of increased patient mortality as a result of poorer budgeting has three major reasons:
First, as mentioned earlier, less nurses per patient essentially means a lower ability to give enough attention and consideration to the patients and their status. Second, with higher workloads, nurses are more prone to burnout, i.e. physical and mental anxiety, tiredness and focus on work. Third, increased job dissatisfaction cause motivation and enthusiasm to help to decline, thus bringing about a decline in performance of life-saving tasks and crucial routines, as well as the willingness (and the time) to learn and develop professionally.
Finally, nurses’ pay plays an additional role. With nurses’ compensation is in decline and the current pay scales show relatively slow course of progress and low margins, which do not exceed a 50% development over 20 years of experience (PaySacle, 2009), it would be sound to argue that nurses have rather inadequate return for their efforts. Thus, it is not unlikely to assume that the overall level of prospective nurses in nursing schools will decline, and that highly skilled and trained nurses will choose to discontinue their employment in the mainstream of the healthcare system, which provides care for the majority of Americans.
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