Patients at Risk in America's Hospitals

Normally in this column, I deal with the risk to public health from ineffective products, poor research techniques or governmental inaction. This week the focus will switch to an area which might be even more critical to public health and safety than any of these combined. That issue is the plight of hospital patients who are put at risk by overworked and sometimes under trained Registered Nurses.

It has recently come to the attention of the media that since 1995, at least 1,720 hospital patients have been accidentally killed and 9,584 others injured from the actions or inaction of registered nurses. Nurses have traditionally been the staff member in most hospitals who had the most contact with patients and were the primary caregiver to them. Their concern and caring are legendary and that reputation went without tarnish for decades. Now however, due to cutbacks, financial pressures, and other factors, the reputation of Registered Nurses has been degraded.

The Chicago Tribune analyzed over three million medical reports and records in their attempt to inform the public of the risks associated with improper nursing care. Many of these records indicated that RN's have seen an increase in patient load over the past few years, stressing their ability to perform to its absolute limits. Other reports indicate that hospitals, in an attempt to recoup money lost from changes in Medicare payments have often placed support staff in the roles of nurses in an attempt to save money and have used equipment which lacked important safety features in an attempt to save money. It is also reported that some manufacturers of medical equipment provide instructions for disabling the safety features, so that their use becomes at the discretion of the hospital staff.

According to research, at least 25 states do not require Registered Nurses to undergo any type of advanced certification training and the American Hospital Association indicates that particularly hospitals with financial problems have scaled back their training programs to save money. Consider for a moment that your hair dresser is required to complete additional training courses in order to be licensed, but the nurse by your bedside is not. This to me seems to be a strangely ironic situation.

All of these factors, and many more, are putting the public health at risk and need to be addressed by medical associations, state and federal government officials, the hospitals themselves, and most importantly the patients and their families, who have to most to lose if this situation continues. In the face of financial considerations, it appears to this writer that only a public outcry of gigantic proportions can force the industry to take action. And only your close observation of the workings of your local hospital can insure that your family receives the best care possible. To quote one of my favorite television programs, "Trust No One!". If you have a family member hospitalized, ask questions, demand answers, and force issues when you see them conflicting with the care your family is receiving. Only through action can the safety of the hospitalized patient be guarded. It is obvious, the system can't or won't do it.

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