August 19, 2020

Public health implications of chronic hospital nurse understaffing in COVID-19 era

By: Judy Mathias
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Editor's Note

This study by noted nurse researcher Linda Aiken, PhD, RN, FAAN, and colleagues at the University of Pennsylvania School of Nursing, Philadelphia, finds that hospital nurses were burned out and working in understaffed conditions in the weeks preceding the COVID-19 pandemic, posing risks to the public’s health.

The researchers surveyed all RNs in New York state and Illinois in 254 hospitals between December 16, 2019, and February 24, 2020. Patient-to-nurse ratios ranged considerably across both states from means of 3.3 to 9.7 on adult medical-surgical units.


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Half of those surveyed were experiencing high burnout, 31% were dissatisfied with their jobs, and 22% planned to leave their jobs within a year.

Half reported unfavorable patient safety ratings, and 70% said they would definitely not recommend their hospitals to family and friends.

About 65% of nurses reported delays in care were common because of insufficient staff, and some 40% reported frequent delay in care because of missing supplies including medications and mission or broken equipment.

Patients corroborated the nurses’ assessments with more than two-thirds rating their hospital less than excellent and reporting they would definitely not recommend it.

It is a credit to nurses who, in such exhausted states before the pandemic, were able to reach within themselves to stay at the hospital bedside for very long hours and save lives during the COVID-19 emergency, the researchers say.

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