Patients at heart of strike

Both nurses and hospitals have merit in the dispute between care and cost.

In the looming Minnesota Nurses Association strike, real lives are at stake. And this is not an issue that hospital officials can lightly dismiss by invoking the mantra of âÄúcost-efficiency.âÄù That claim does have merit, to be sure, but so does the MNAâÄôs demand of lower nurse-to-patient ratios. There is a middle ground, and the two sides should meet there soon. Previous research indicates an association between nurse workload and patient morbidity and mortality. A 2002 study found a higher prevalence of infections when the nursesâÄô workload was high. A 1999 study, conducted on surgical patients at 168 Pennsylvania hospitals, found that for each additional patient a nurse was assigned, there was a 7-percent increase in the likelihood of that patient dying under the nurseâÄôs care. Indeed, staff shortages and the potential risks associated with them support the very reason why the nurses are striking in the first place. MNA also asserts that lower nurse-to-patient ratios will mitigate long-term costs for care because quality of care would rise with lower ratios. But hospitals say those are rosy and unsubstantiated estimates and that the MNA demands would cost them millions of dollars. But in the end, the current debate offers an opportunity to seriously think about creative and more flexible approaches to âÄî ahem âÄî strike a better balance between cost and patient care, which should be the heart of the matter.