With more than 3 million members, the nursing profession is the largest segment of the nation’s healthcare workforce. Consistently on the front line, nurses play a vital role in the care and healing of patients in all institutions of our healthcare system.
The American Nurses Association (ANA) defines nursing as: “the protection, promotion and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response and advocacy in the care of individuals, families, communities and populations.”
The ANA Code of Ethics directs nurses to practice:with compassion and respect for the inherent dignity, worth, and uniqueness of every individual, unrestricted by considerations of social or economic status, personal attributes or the nature of health problems.” Nurses are expected to provide care for all patients with the same degree of compassion and professionalism without allowing personal biases to influence their practice. They are expected to insure patient safety and quality of care at all times.
At the patients bedside, nurses are expected to give their full attention to each and every patient,no matter how many patients they are attending to. In today’s medical environment of funding changes, technological advances and government regulations, they are also expected to avoid disparities in care, expertly deploy all of the new technologies and insure patient safety.
I recently spent several days in the hospital following back surgery and my experience with the nurses at the Massachusetts General Hospital was nothing short of excellent. The nurses were competent, helpful and caring. They provided excellent advice on how to medicate for my pain following surgery and attended to my needs unfailingly. In my particular circumstance, despite the fact that I was in a teaching hospital which is famous for providing patients with frequent visits from hospitalists, residents, medical students, and other professionals, I experienced the best in nursing care.strong>
Although the goals of the ANA are commendable nurses continue to practice in the untenable position of being expected to take responsibility for and reduce medical errors. These are errors which they often have no role in causing. Although doctors continue to be perceived by patients and families as captains of the healthcare team, physicians often spend just a few short minutes with the patient. Basic, essential daily care is left to the nurses who play a critical role in ensuring patient safety by monitoring patients for clinical deterioration, detecting errors and near misses and understanding care processes and weaknesses inherent in some systems. These problems can lead to the kinds of errors that could endanger the patient including: wrong site, wrong patient, medication errors, failure to follow best practice and procedures, that prevent infection and errors that allow unsupervised patients to fall.
Many of these errors happen because of a system that leaves nurses powerless to intervene. When nurses cannot speak out and advocate for the safety and well being of their patients without fear of retaliation and threats to their job security; or for speaking out about unsafe conditions, nobody wins; not the patients, not the nursing staff and not the medical staff or the health care institutions. There are reliable studies that have concluded that there is a correlation between patient safety and nurse to patient ratios. In 1999, California adopted a law mandating smaller nurse-to-patient ratios; more states need to adopt these regulations.
Right now we have an opportunity to transform our health system by removing barriers that would help nurses achieve the safe, high quality compassionate care that I personally experienced. We need to give nurses more credit for what they so diligently do every day on the job; We need stronger patient safety legislation that nurses across the country have advocated for from the beginning of this century. We need to respect and appreciate the nurses who take care of us when we are in the most need of their assistance.
