Don’t be fooled by these stats about how many hours a nurse spends with a patient. It’s all a bunch of bulloney. Let me explain why.

Nurses are a crucial part of a patient’s hospital experience. And new findings posted online by the Massachusetts Hospital Association have opened a window into how much time nurses spend with patients at the hospitals in Boston’s western suburbs.

While the statistics are not meant to be used to compare institutions, association officials say, they are expected to give consumers a starting point to see which place may be the best match.

What they don’t tell the consumers is pretty sad…nursing “hours” are broken up into tiny bits and pieces of time- a few minutes here and there and maybe a block of time for personal care. Time spent doing patient related paperwork and similar stuff IS included in these bogus stats.

David Schildmeier, a spokesman for the Massachusetts Nurses Association, said his organization was opposed to the nurse staffing survey and did not participate in it.

The nursing group, which is both a union and a professional association, has a bill pending in the Legislature that would set limits on the number of patients assigned to nurses. The bill is opposed by the hospital industry, Schildmeier said.

Well that’s a helpful attitude for a union to have- just not participate in the surveys. Why? What do they stand to lose? ALOT. Trust me. State mandated ratios will not equal better care. It never has and never will. Hospitals are forced to lay off nurses and hire less educated care givers; management will use the minutes every non-hands on nurse devotes to any and all patients and COUNT these minutes as part of time spent…(these hands off nurses are doing paperwork, case management, nurse managers and the like.)

The newly posted hospital association’s report includes figures for the average number of hours spent with a patient, and the number of nurses and other caregivers working in different units at various times of the day.

The figures indicate that nurses in area hospitals generally spend about seven hours a day with patients in their care.

At Milford, nurses or assistants spend an average of 7.21 hours a day with each patient in the general medical and surgical unit.

For those who want to dig deeper, the data show that from 7 a.m. to 3 p.m., three to four registered nurses, one to two licensed practical nurses, and two unlicensed nursing assistants are on duty in the unit. The mix changes in the evening, with five RNs, no LPNs, and two assistants working until 11 p.m.; then three RNs and two assistants work the overnight shift.

Little notes of interest here: The RN’s and LPN’s do very little hands on care; it is the aides/assistants who deliver over 95% of that care. The nurses do assessments, write care plans and administer medications and treatments- all important but not actual hands on care. Often, in many states, even the med passes and treatments are now delegated down to the assistants (who have special training to do these tasks). All in the name of freeing up time for the nurses to spend with their patients. Yet, it doesn’t happen. I don’t know where they all go, but it isn’t anywhere near a patient. I’m not talking about where I work (where it is a 2:1 ratio); I’m talking about major medical centers here in NH and in MA.

A nurse or assistant spends 7.21 hours at the comparable unit at Beth Israel Deaconess Hospital-Needham, 7.16 hours at MetroWest Medical Center in Framingham, and 7.32 hours at Newton-Wellesley Hospital.

Julie Hehir, chief nursing officer at Marlborough Hospital, said the nurse staffing numbers are useful, but they don’t tell the whole story.

She said it’s important to look at nurses’ backgrounds and experience, ”and that varies day to day.”

Nurses and administrators also say each patient has unique needs, which can require individualized attention that may not be reflected in the averages.

”As a consumer, you like to know how well you’re staffed,” said Susan Primeau, 49, the nurse manager for the fifth floor at Milford. ”But it’s the quality of care that matters.”

Hospital officials also emphasized that staffing needs to be flexible. At Milford, the unit manager examines patients’ needs and other factors each day to determine the number of staff and the mix of personnel, said Cheryl Bonasoro, vice president of patient care services. The hospital calls in extra help as needed.

This is staffing based on census and acuity- the more complex needs of a group of patients usually require more staff.
From the point of view I have, it is the assistant who bears the brutal brunt of working short staffed. They are assigned more patients and are expected to get more done in less time; very rarely is an RN given an assignment. Even in the hospital settings. The other typical thing they do, when the census is down on one unit but higher on another is they “float” staff around. We’re expected to be able to go to work in another unit with patients we have no inkling about; each unit is different and has different rules and policy and procedure- it’s a nightmare and it’s a major sentinel event waiting to happen. Med errors, nursing errors occur most often during periods of short staffing.

It sounds simple: Just get more staff in. But, there are not extra staff to bring in anymore. Because of the backbreaking nature of nursing as a career, many leave the profession. Attempts have been made to bring in foreign trained nurses, but I highly advise everyone to stay the hell away from them and refuse care from them (it is your right). Nursing doesn’t pay well either and the work is brutal. We get forced to work an extra shift on top of the one we just did (mandated overtime)(sometimes several times a week); we are legally liable for the care we provide (we hold a license and can go to prison if we’re found guilty of neglect- intentional or not as well as the neglect of others). We are not always respected by people- patients and medical staff. It’s a tough job. Not to mention the daily ins and outs of our patients: disease, illness, codes, life and death situations present themselves to us all the time. Nurses have enough to deal with. Unions have no place in the art and science of care giving.