In recent days, nurses and patients alike have shared their distress about nursing care not being delivered to in-patients in our public hospitals. Two District Health Boards (DHBs) have been highlighted. Predictably, defensive comments have come from DHB leaders and the Minister of Health.
The DHBs have the right to be defensive since this is not just a problem for their hospitals, but indeed, is a national and international phenomenon, as well.
Research from multiple countries over the last ten or more years has now proved beyond doubt that nurses can no longer provide the full level of care on many days. Hospital wards are no longer staffed to sufficient levels to make that possible.
Insufficient nursing care not only makes patients miserable and uncomfortable. It also causes dangerous adverse events. Case in point? A patient who does not have their teeth cleaned and is not moved in bed is much more likely to get pneumonia. Lack of so-called basic care can lead to infected surgical wounds, bed sores, blood clots in the lungs, and many other life threatening events.
Such events don’t just make patients miserable and put their lives at risk. They are also very expensive, by prolonging hospital stays, or resulting in rapid re-admission in addition to generating the need for complex care in the community.
My own published study of 12 million patient discharges over many years in NZ demonstrates clearly the close link between registered nurse staffing and the incidence of adverse events.
As a member of an international consortium studying care rationing, I know from previous research that missed care occurs. That’s why we are now moving to explore what measures of nurse staffing will most likely to reduce missed care.
We call it care rationing because around the world, as health budgets become smaller, deliberate decisions will be made to keep nurse staffing to minimum levels. This is a global challenge for all countries including New Zealand.
It’s time now to choose to invest upfront in proper levels of nurse staffing and proper levels of nursing education at undergraduate and post graduate levels. Employing our new nursing graduates is critically important. If we don’t? The alternative is increasingly costly health care for all taxpayers as we pay the price for missed nursing care.
It would be good to see us move beyond arguing defensively about this topic and to combine our efforts to resolve it.
All countries face a growing level of need for health care in the face of reducing availability of workforce and tight health budgets. Funders and policy makers must read and explore the evidence, which supports nursing as an asset rather than a cost to budget bottom lines. Equally importantly for our small country is the need to curb the escalation of chronic disease and the long term conditions resulting in expensive hospital care.
The health sector needs to stop arguing and pool its resources to acknowledge that as long as nurses remain under relentless pressure, patients will suffer because our budgets and bottom lines fail to balance.
Opinion author: Jenny Carryer is a professor at Massey University's School of Nursing and executive director of the College of Nurses Aotearoa.
