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LETTERS

NurseStaffingandPatientSafety
JUNE2,2015

TotheEditor:
ReWeNeedMoreNurses,byAlexandraRobbins(OpEd,May28):
Studiesshowthatinadequatenursestaffingputspatientsatriskforlongerhospitalstays,increased
infections,medicalerrors,injuriesandevendeath.Afterall,oneofthereasonssomeoneisadmittedtoa
hospitalisthatheorsheneeds24/7nursingcare.Butitsnotjustpatientswhosuffer:Nurseswhoare
overloadedaremorepronetoburnout,exhaustionandstress,andhavelesstimetoeducate,comfortand
coordinatecare.Thatisatoxicformulaforpatientshealthandsafety.
Toprotectpatientsfromunsafenursestaffing,theAmericanNursesAssociationsupportstheRegistered
NurseSafeStaffingAct,whichrequireshospitals,withtheinputofbedsidenurses,toestablishnursestaffing
plansforeachcareunitandnursingshift,basedoneverchangingpatientneeds.Appropriatenursestaffing
protectspatientsbyreducingmedicalerrors,lengthofhospitalstaysandcostlyreadmissions.Itsasound
investmentthatwillhelpcuttheoverallcostsofcare,improvepatientoutcomesandkeepnursesatthe
bedside.
PAMELAF.CIPRIANO
President
AmericanNursesAssociation
SilverSpring,Md.
TotheEditor:
AlexandraRobbinspaintsamorallydistressingpictureoftheoccupationaloppressionofnursesinsome
Americanhospitals.Whennursescannotadvocateforthesafetyandwellbeingoftheirpatientswithoutfear
ofretaliationandthreatstotheirjobsecurityforspeakingoutaboutperceivedunsafestaffingconditions,
nobodywinsnotpatients,nursesorhealthcareinstitutions.
Wecannotaffordtoloseasinglenurseinthiscountry,butwhyshouldnursescontinuetoworkin
unhealthyhospitalenvironmentswhentheycannotmeettheirprofessionalandmoralobligationstotheir
patients?
Theeverwideningdisparitybetweenthephilosophyofprofitandthephilosophyofcarewillcontinueto
createpotentiallystressfulandunsafeworkingconditionsfornurses.Withoutnurses,thelargestgroupof
healthcareprofessionalsinthiscountry,theresimplyisnoqualityhealthcaresystem.
Changetoourantiquateddeliverysystemislongoverdue.Innovativeinstitutionalleaderswholistento
andsupportnursesvoices,heedtheirsafetyconcernsandrespecttheskillstheybringtopatientcarewould
beagoodstart.
CONNIEM.ULRICH
Philadelphia
Thewriter,aregisterednurse,isanassociateprofessorofbioethicsandnursingattheUniversityof
PennsylvaniaSchoolofNursing.
TotheEditor:
WeNeedMoreNursesresonatesdeeplywithme.Asacareeremergencyphysicianforover20yearsin
avarietyofsettings,Ihavewitnessedthechronicshortageofessentialstaff,servicesandequipment.
Fortunately,inmostcasesitdidnotresultindirectharmtothepatient.Butsometimesthingswentterribly

wrongbecauseofinadequatestaffingandequipment,andbadoutcomesresulted.
Ifhospitaladministratorshandsomecompensationwerekeyedtotheefficiency,patientsatisfactionand
outcomesoftheirinstitutionsemergencydepartments,Imconvincedthatstaffingandothervexingand
dangerousissueswouldberesolvedrapidly.
ToAlexandraRobbinsIcanonlysay:Yourworkisvital,andweneedyouandweappreciateyou.You
andyourcolleaguesarenotbeinggiventhetoolsandassistanceyouneedtodothejobright,andthisisa
disgracethathasresultedindirectandforeseeableharmtoourcitizensandtoournation.Wedeservebetter.
DAVIDLEMONICK
Pittsburgh
AversionofthisletterappearsinprintonJune2,2015,onpageA18oftheNewYorkeditionwiththeheadline:NurseStaffingandPatient
Safety.

2015TheNewYorkTimesCompany