New year, same issues.

Back and still recovering from the jet lag. Italy is a beautiful country, the people are hospitable and the food, exquisite. Staying with an Italian family helped me move through the country fairly easy and stress free. I even passed by Berlusconi's "castle" in Portofino and walked along the walkway that he had built for himself by the sea so he would not have to jog on the road. I read about his visit to the US for his pacemaker placement, and not only did he forsake his own country's health care system, (in which his administration underfunded), he showed his gratitude by spewing sexist and derogatory remarks about "ugly" American nurses. Mr. B you are one class act. You will hear from me soon. Ciao.

The Washington Post reported on 12/25/2006 that college for health care professionals continues to bottle neck, refusing up to 2/3 of nursing school applicants for admission. Evidently the problem is not lack of interest..it is lack of funding. Colleges are not financially equipped to handle these students and there is a dearth of instructors. Registered nurses will make more money at the bedside than as teaching instructors. However there have been some effort put forth. For example, Timothy M Kaine (D) of North Virginia , proposed a 10% increase in nursing instructors salaries. The state was alloted $1.5 million funding for education of registered nurses. Great work.

And thank you Kaisernetwork.org for continuing to research and give the nursing profession the proper attention that it needs in the media and policy formation.

Hospitals Fight Nurse-to-Patient Ratios, Seek Alternatives To Use Nursing Staff More Efficiently

The Kaiser Family Foundation reported today that "The Wall Street Journal on Wednesday examined how "hospitals are fighting back against efforts to set minimum nurse-to-patient ratios and adopting new strategies to use nursing staff more efficiently" as the U.S. faces "a worsening" nurse shortage. According to the Journal, "an increasing number of states ... are considering legislation to ensure minimum" nurse-to-patient ratios at hospitals, and California already has passed a law mandating ratios in medical-surgical units. Proponents of the ratios say that "forcing hospitals to meet minimum staffing requirements is the only way to ensure patient safety, reduce patients deaths, recruit new nurses, and stop the ones already on the job from burning out and leaving the profession," the Journal reports. However, critics say that the ratios are not flexible enough to allow hospitals to operate safely and efficiently and that certain hospital units could be forced to close if the ratios cannot be met. In addition, opponents of ratios say there is no direct evidence that staffing ratios improve patient care. Pat Rutherford, a nurse and vice president of the not-for-profit Institute for Healthcare Improvement, at a patient-safety conference on Wednesday plans to propose that rather than impose staffing ratios, medical-surgical units should be restructured so nurses spend less time on paperwork, charting, finding supplies and operational problems. The Journal reports that hospitals also are "turning to more sophisticated computer programs and models to help them analyze their staffing needs and allocate nurses on staff more efficiently." In addition, staffing specialists are working with organizations like the American Nurses Association to develop "nurse-staff reporting cards that help hospitals compare staffing levels and patient outcomes with those of other hospitals," according to the Journal. The goal of such comparisons is to ensure that nurses with proper training and backgrounds are in certain units when needed, according to Gina Mumolie, a nurse and vice president of Aon Consulting (Landro, Wall Street Journal, 12/13)."

Dr. Linda Aiken did have supportive research concluding that hospitals with high patient-to-nurse ratios patient experience higher risk-adjusted 30-day mortality and failure to rescue rates. Supportive research needs to be conceived in this area as it is only looking at part of elephant. Individual institutions might benefit from conducting their own analysis of nurse-to-patient ratios and it's impact on quality and outcomes. However, the concept of ratios should not be ignored, besides a decrease in quality care, nurses are more likely to leave the patients bedside if they are burned out and feel powerless to change their work environment. This is a problem that is not easily solved and with each "knot released" there is the potential to create further complications.