A Nurse’s Confession About Staffing And Infection Rates

This article was republished with permission from SCRUBS Magazine.

An NBC News article titled “Burned-out nurses linked to more infections in patients,” discussed the link between patient infection rates and their correlation to nursing staff workloads. Essentially, the higher the patient load, the higher the likelihood of infection rates in patients due to the nursing staff “cutting corners.”

There was a similar article on KevinMD in a guest post titled “Patient care suffers when nurses are overloaded with work.” The author, Dr. Linda Burke-Galloway, discussed the importance of the nursing workforce and implored readers to take physician and nurse burnout seriously, because it directly impacts the care of patients. She then listed some steps patients can take to help assess the possibility of patient overload.

I cannot disagree with the good doctor. Patient overload and understaffing places a great toll on each individual nurse, as well as the entire unit. The domino effect is undeniable if you’ve ever witnessed a hospital floor functioning while over capacity and understaffed. Other studies show understaffing can hurt nurses as well as patients.

It’s downright scary sometimes. I’m not just confessing this as a nurse, but also as a patient. Patients aren’t as naïve as you would think. They figure out understaffing and overcapacity fairly quickly.

Are corners cut? While I’m not outing anyone or admitting to anything, the obvious problem is choosing patient safety over proper sterility. Do you compromise patient safety to adhere to contact precautions and basic hand hygiene practices?

Taking the extra 15 to 90 seconds to wash your hands or gown and gloves is plenty of time for something “bad” to happen.

It’s choosing between preventing a deadly action that will immediately harm your patient versus an action that has the “potential” to infect your patient.

In that environment, it’s the immediacy of danger that wins every time.

Is it right? No. Is it wrong? No. But yes, it does exist.

And people wonder why nurses harp about inadequate staffing.

Like a broken record.

What do you think? Share your thoughts in the comments section below.


This article was republished with permission from SCRUBS Magazine.

8 COMMENTS

  1. Again, we nurses are put out n a situation where
    Where we must cut corners to meet to
    Time and staffing limits then penalized when
    Something goes wrong. I still love my patients
    But will soon leave the floor nursing can’t do
    This anymore, leave in pain and in tears too
    Often

  2. Computerized charting is scary. I am a computer geek. I see the caveats in the programs. It is too easy to point and click ; never truly comprehending what you documented. It starts with patient care! Good technique and safety. The SOAP note made the nurse identify and think through the issue. More computer does not mean better care, just stronger arguments for the attorney. When a doctor is in front of a computer, tests are ordered but no physical done, what kind of care is that? One has to look at the patient: my vet does, head to tail. Why doesn’t the same apply to humans? No short cuts please and please wash your hands. Retired after 35 years.

  3. I see it everyday, ratios of 7:1 of fresh surgical patients…no way excellence can be achieved as patients in the hospitals are complicated, many co-morbidities to deal with. Administration always says they are working on a plan to retain bedside Nurses. Reality is they don’t have a plan because money is the only thing that seems to count. Worse, when more is expected of Physicians, enforcement is put upon the RN with limited backup by Management and Administration. I seriously believe Congress should link MD reimbursement to hospital compliance. If they don’t do what needs to be done, RN’s shouldn’t have to chase them down. If the hospital compliance is not met, the MD doesn’t get paid. I envision fewer compliance issues within a couple nonpayment events!! Additionally, supply and demand being what they are, RN’s should make a lot more money. If you are going to ruin your health, you may as well get paid decently for it!! Thanks for letting me rant!!

  4. I recently was a patient in a major trauma hospital in my state. They had special protocols, like I got an antibacterial bath as soon as I got to the floor, head to toe, and BactraBan up my nose every shift. HOWEVER their protocols will do little good when I have nurses who have long hair touching me as they gave care, so I assume they also touched Mr. so and so in the previous room. I saw very little handwashing, they all just hit the foam on the way out and way in (sometimes). My old school may be showing but I think you need to stop and wash those hands occasionally at least! I also had to use the bedside commode and had to ask repeatedly for some way to wash my hands after wiping myself (not too coordinated either as my dominant arm was in a sling, immobilized, and I had broken ribs and a pneumothorax so moving was not my best talent). I finally had a nurse bring me a huge pump of foam, that was not sealed, was half full, and not telling who all had touched it before me. I settled as it was better than nothing! As soon as allowed up I was in the bathroom attempting to scrub my hands. I also never had another bath the entire 3 day stay. So all the protocols in the world will not beat infections when nurses are too rushed to do things right and when they are not trained in all aspect of cross contamination!

  5. Facilities blatantly understaff and if a problem occurs, it’s the fault of the nurse. I cannot stress this enough: Someday you, or someone you love more than life itself, will be in a hospital bed. Will understaffing be okay then? Take a peek into your local nursing home. This is YOUR future! Are the rules going to suddenly change for you? Nope. Too much “hard work” has gone into making sure that patients can’t get what they need.

    I did notice that when an internationally known person was coming into the hospital where I once worked that the PR people called the floor three times during my eight hour shift (that I know of) to make sure his room and his hand-picked staff were ready.

  6. Time is of essence, in today’s world of “computer” nursing, more emphasis and importance is focused on computer charting, the nurse’s most important task is to chart everything and anything on the computer, pt care is considered a secondary function of the nurse. This is so WRONG. But if a bedside nurse complains about this trend, she is labeled a “problem” because she doesn’t “like” the computer. This is also wrong, most of us nurses really care about our patient care and the quality of care. The IT folks, to include nurses who are on the IT committees, DO not do patient care and many have not ever done direct patient care. Changes are constantly made to “improve” care and each one takes the bedside nurse away from the bedside. We think the real reason changes are constantly made is to maintain jobs in IT which are so much easier than providing bedside care. Think about this concept, my peers in nursing. More nurses at the bedside is always a benefit to our patients, and research backs this concept up.

  7. As a seasoned nurse the 10 or 15 Seconds to wash my hands or don glove and gown are important in the long run. They are choosing the long term outcome over the immediate urgency. Usually the urgent is not as important as the long term effects.

    • GLad to see these issues being talked about. I have never felt this way about being a nurse. Just told my sons, I can’t go on doing this anymore.. Nurses are more interested in computer compliance than to give basic care..critical thinking? Who has time for that. Patient advocate? What is that. Empathy is out .. quality care a thing of the past….I can go on and on but I will say one thing, it’s scary.

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