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Health Care System Leaves Patients Frustrated--Nurses Work for a Solution

National Nurses United is pushing to establish nationwide nurse-ratio guidelines in acute-care facilities, and to strengthen training programs to build the nursing workforce.

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  • New Jersey hospitals would have 14 percent fewer patient deaths and Pennsylvania 11 percent fewer deaths if they matched California's 1:5 ratios in surgical units.
  • California RNs have far more time to spend with patients, and more of their hospitals have enough RNs on staff to provide quality patient care.
  • Fewer California RNs miss changes in patient conditions because of their workload than New Jersey or Pennsylvania RNs.
  • In California hospitals with better compliance with the ratios, RNs cite fewer complaints from patients and families and the nurses have more confidence that patients can manage their own care after discharge.
  • California RNs are far more likely to stay at the bedside, and less likely to report burnout than nurses in New Jersey or Pennsylvania.

So what’s stopping hospitals from following California’s lead? In the NPR story, the American Hospital Association argues that “hospitals are facing big financial challenges” amid the growing needs of patients and increasingly complex treatments and medical advances.

But the crisis can't be explained simply by an overall “shortage” of nurses. The real cause of the staffing squeeze might be the tight fists of hospital CEOs, who don’t want to invest in maintaining an adequate, qualified workforce. CNA representative Chuck Idelson told In These Times, “The problems are systemic, primarily because the focus of the corporate giants that control most hospitals now is on profits, not on safe patient care.”

The perverse incentives afflict every level of the health system. One nurse told NPR about feeling overwhelmed on the job and lamented, "these are human beings... not products on conveyor belts." The system that dehumanizes patients expects nurses to work like machines.

Beyond the hospital walls, nurse advocates have tied patient-care issues to gaps in social equity, agitating for a living wage and a just tax code. Idelson said a single-payer health care system would be the ultimate fix: “That way, you take away much of the profit incentive in health care, which is the key barrier to safer patient care.”

The movement for truly universal health care remains plagued by political stagnation. But for now, National Nurses United is pushing for federal legislation to establish nationwide nurse-ratio guidelines in acute-care facilities, and to strengthen training programs to build the nursing workforce. It’s not a cure-all, but the initiative would compel hospitals to treat workers and patients more like real people, not units of profit.

Michelle Chen is a contributing editor at In These Times. She is a regular contributor to the labor rights blog Working In These Times,, and Pacifica’s WBAI. Her work has also appeared in Alternet, Ms. Magazine, Newsday, and her old zine, cain. Follow her on Twitter at @meeshellchen or reach her at michellechen @

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