Minnesota Nurses Association: Will Care Be There? - Study Reveals Depth of Nursing Concerns About Quality of Care

A recent study of nursing trends in acute care settings conducted by the Minnesota Nurses Association and released at its 94th annual convention held October 17 - 20 in Mankato, documents that, due to lack of staff, an alarming 70% of study participants were unable to perform the fundamental valuable duties of nursing such as assessment, observation and monitoring of patients on a timely basis. 52% of nurses report being constrained by time from doing even the basic care of hygiene, feeding and toileting their patients on time, if at all. Medication orders, including IVs, are not dispensed, or given late, 22% of the time.

“The caregiver closest to the patient is deeply concerned about patient safety as well as their own practice,” said Susan Johnston Lynx, Program Director for the Minnesota Nurses Association and project administrator for the study. “This front-line knowledge portends a critical situation in health care that could worsen if not attended to and treated aggressively,” she added.

The report, entitled “Concern For Care,” also paints a dispiriting workplace situation that is not satisfying for nurses. “The current work environments do not facilitate a sense of belonging to a group or a feeling of basic respect and dignity,” states author, Carol Diemert, RN BSN, MSN.

Nurses interviewed were convinced that a lack of organizational and peer support can and does—translate into a negative impact on patient care.

Minnesota health care is currently facing a high demand for skilled nursing personnel and struggling to fill these positions. Diemert cautions however, that lack of staffing in a unit shouldn’t automatically be attributed to lack of nurses. “While the national nursing shortage is a dominant issue of the nursing profession at large, the concerns of nurses in this study are also localized and specific to the personal and professional experiences of their everyday lives,” states Diemert.

One key factor contributing to daily turmoil is the inability to adequately pre-plan appropriate staffing levels. Respondents claim that current formulas to determine staff-to-patient ratios are neither comprehensive nor accurate.

Nurses contend that patient acuity levels and total volume of patients on a unit impact scheduled staff. Neither variable is adequately accounted for in staff scheduling. Nurses also believe that other, nursing-related characteristics should be included in planning. Managers need to take into consideration such variables as geographical and structure features of the unit, and type of staff mix available.

The report identifies a number of actions that could be undertaken to address nursing’s concerns about safe staffing levels.

On a community level, the report recommends convening a statewide forum exploring the relationship of nurse practice and staffing issues.

Internally, health care environments can implement a process that would better help determine staffing guidelines and principles. Diemert points to an existing document published by the American Nurses Association, entitled “Principles for Safe Staffing,” as an excellent resource.

“Concern for Care” was commissioned by the Minnesota Nurses Association and made possible through a grant from the American Nurses Association. The study was conducted from January through June, 1999.

Data for the study was reported by registered nurses employed by facilities with collective bargaining units represented by MNA. Information was gathered using a variety of sources including focus groups, individual interviews of both staff nurses and nursing administrators, and reviewing forms submitted to MNA from 1995 to 1999. The forms, Concern for Safe Staffing and Concern for Practice are official documents created by MNA. They are completed and submitted to MNA by registered nurses in situations where they viewed staffing levels in their units as inadequate for the provision of safe, quality care.
For copies of this document, please contact Jan Rabbers at Minnesota Nurses Association, 651.646.4807, jrabbers@mnnurses.org