The following column originally appeared in the Patriot News.
On Aug. 9, Pennsylvanians awoke to shocking news: Two patients at Carlisle Regional Medical Center might have died because of persistent and dangerous understaffing at the hospital.
Pennsylvania Department of Health investigators found that from June 27 to July 23, the hospital was severely understaffed, with 233 nurse shifts not covered in the busy emergency room. Patients spent as long as 18 hours waiting for emergency care. Meanwhile, the nurses who raised concerns about unsafe conditions were called “troublemakers” and feared losing their jobs.
Few Pennsylvania nurses are surprised by this tragic account. Every day in health care facilities across the commonwealth, nurses see firsthand how inadequate staffing — a direct result of a health care system that too often puts profits ahead of patients — threatens the quality of care and leads to unnecessary patient deaths.
Health care today is increasingly a big business in which decisions are too often based on what’s best for corporate executives and Wall Street investors rather than the patients who need safe, high-quality care.
Health Management Associates, the Florida-based company that purchased Carlisle Regional Medical Center in 2001, is one of the largest for-profit hospital companies in the country with more than $185 million in profits in just the first six months of this year. Last year its CEO, Gary Newsome, brought home more than $6 million.
Tennessee-based Community Health Systems, which is the second-largest for-profit
hospital chain, has acquired 13 community hospitals in Pennsylvania. CHS posted more than $273 million in profits in just the first six months of this year, and last year its CEO Wayne Smith raked in nearly $21 million.
And nonprofit health care facilities function in much the same way. Many of the so-called “not-for-profit” hospitals are, in fact, huge, multibillion dollar health systems whose “not-for-profit” status merely excuses them from paying federal, state or local taxes to support our communities.
Data and firsthand nursing experience make clear that safe staffing saves lives. Nationally recognized research on hospital staffing from Dr. Linda Aiken and her team at the University of Pennsylvania finds that the safest staffing ratio for surgical patients is one RN to four patients. For every additional patient in a registered nurse’s care, the risk of death increases by 7 percent.
In hospitals where nurses are forced to juggle the care of eight patients, patients have a 31 percent greater risk of dying than those in hospitals where each RN cares for four patients. Members of the Nurse Alliance of SEIU, a statewide coalition of nurses dedicated to improving quality patient care, are working to make sure hospitals are putting patients ahead of profits by instituting safe staffing standards. Senate Bill 438, which is pending action by the Legislature, is modeled on California’s landmark nurse staffing law, which ensures minimum, safe RN-to-patient ratios at all hospitals.
Dr. Aiken’s team estimates that a similar law would have prevented 264 patient deaths in Pennsylvania during a two-year period. These are not just statistics. These are the lives of our family members, our friends and our neighbors who have been lost because hospitals are not ensuring the safe, high-quality care every patient deserves.
In the absence of legislated safe staffing standards, nurses who are members of SEIU Healthcare Pennsylvania have been able to use their union voice to establish safe nurse-to-patient ratios in hospitals while improving the nurse work environment. But across Pennsylvania, a majority of nurses lack a voice on the job and protection from management retaliation for speaking up about unsafe conditions.
As nurses, we work hard to ensure our patients receive the best possible care. No one should have to worry about the quality of the care their loved one receives. It’s long past time for legislators to pass Senate Bill 438 to ensure safe RN-to-patient ratios at all Pennsylvania hospitals — before another life is lost because of a health care industry that too often puts profits ahead of patient care.