The Problem of Nursing Understaffing

Medical Malpractice Attorney

Registered nurses fulfill valuable roles in her health care setting. Hospitals were originally started by nurses in order to render constant care to patients with urgent, emergent and critical care needs. They were not started by doctors. Now, corporate medicine is trying to minimize the role of nurses through a number of tactics, such as permitting less skilled health-care workers to perform the functions of nurses (“deskilling”), using telehealth and artificial intelligence in the place of bedside nursing and permitting hospitals to understaff nurses. New research shows that nursing understaffing contributes to patient neglect and poor outcomes.

In an article in the American Journal of Infection Control, entitled “Evaluation of Hospital Nurse to Patient Staffing Ratios and Sepsis Bundles on Patient Outcomes,” discusses how understaffing of nurses leads to increased rates of infection. The study showed that “each additional patient per nurse was associated with 12% higher odds of in-hospital mortality, 7% higher odds of sixty-day mortality, 7% higher odds of sixty-day readmission, and longer lengths of stay….”

As a medical malpractice attorney, the issue of nurse understaffing is vexing. We know that poor nurse-to-patient ratios result in increased rates of infection, medical errors, medical mistakes and medical negligence. We know that patient outcomes are affected by the number of nurses that are available to care for patients. Currently, only the State of California has legislation that requires specified nurse to patient ratios. In addition, Medicare regulations require certain nurse-to-patient ratios in the nursing home setting, but these ratios are grossly ineffective. 

When a hospital is understaffed, can this be used to prove a case of malpractice against the hospital? Unfortunately, the answer is no.  Generally, medical malpractice lawyers have not attempted to show systemic understaffing contributes to poor patient outcomes. There are a number of reasons for this. First, to conduct an audit of a hospital or nursing home staffing practices, would require additional significant additional time and expense. Next, because 49 states do not require specific staffing ratios, a medical malpractice lawyer cannot argue that subpar staffing falls below accepted standards of care since no standard of care exists. When it comes to nursing home staffing ratios, the Medicare standard is so poorly written that even a compliant nursing home can provide ineffectual care. Finally, the ultimate goal of the medical malpractice attorney is to prove that the hospital or nursing home’s nursing staff was negligent. Systemic understaffing would only serve to permit a claim for punitive damages.

While it is clear that understaffing of nurses leads to patient harm, the courtroom has not proven to be an effective way to reverse this trend. It will take legislation in all 50 states before patients are made safe by specific nurse-to-patient ratios.  If you are the victim of a medical malpractice accident resulting in serious personal injuries, you should contact a medical malpractice attorney, like the office of Mishkind Kulwicki Law Co., L.P.A. to determine your rights.