The Cases of Negligence Due to Nurse Understaffing

Written by phyllis greene
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The Cases of Negligence Due to Nurse Understaffing
Nurse shortages affect quality of care (Image by Flickr.com, courtesy of Logan Ingalls)

Nurses often don't have enough time to properly care for their patients due to a shortage of nursing staff. "Care is literally being left undone," according to a report by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), an independent, not-for-profit organisation that accredits more than 17,000 health care organisations in the United States. The result is unnecessary injuries and even deaths in hospitals and nursing homes. Nurses and medical facilities are often charged with negligence for inferior nursing care due to understaffing.

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Statistics

Hospitals with inadequate nursing staffs tend to have higher rates of pneumonia, shock, cardiac arrest and urinary tract infections, according to research funded by the Agency for Healthcare Research and Quality.

Studies conducted between 1993 and 1998 found that for each additional surgical patient per nurse there was a 7 per cent higher likelihood of death within 30 days of admission, and a 7 per cent higher likelihood of failure to rescue patients in need of immediate help. Just one half hour of RN staffing per patient per day could reduce pneumonia in surgical patients by more than 4 per cent. And higher staffing at all levels of nursing was associated with up to a 25 per cent reduction in negative outcomes due to nurse errors and inattention.

Negligence

JCAHO describes negligence as a failure to use the same standard of care that a reasonable person would use under similar circumstances. Malpractice occurs when professionals act improperly or unethically. When nurses' mistakes cause patients to suffer injuries or death, lawsuits charging medical malpractice due to negligence often result.

Significance

Negligent acts by nurses can and do cause injuries and deaths. Nurses are on the front line of monitoring patients' conditions, but it's easy for them to miss the early signs of a medical problem if they are spread too thinly. It is common for overworked nurses to overlook signs of stress in patients and to commit errors when administering medications. They may use an improper dose, give the wrong drug, or give the right drug by the wrong method, such as intravenously instead of orally.

Charges of Negligence

A jury awarded the family of an elderly patient more than £0.6 million for negligent nursing care. Due to understaffing, the nursing home had allowed the patient to become severely dehydrated, lose weight and develop pressure sores. The nursing home's supervisors ignored ongoing complaints that nurses were understaffed and overworked. In fact, the facility was so understaffed that a maintenance man posed as a Certified Nurses Assistant during a state inspection.

In another case, nurse understaffing was blamed for the death of a woman after she underwent a routine hysterectomy. After surgery, she was put on a ward with only one registered nurse caring for 40 patients. The patient began bleeding internally, but the nurse failed to come to her aid in time. At the inquest into her death, a consulting gynecologist testified that the patient's bleeding had gone unnoticed due to the lack of nurses. The patient's surgeon told the inquest that there had long been concerns over staffing shortages at the hospital, but the coroner ruled the death was accidental.

Solutions

In 2006, the California attorney general brought criminal and negligence charges against the second largest nursing home chain in the state to force compliance with nursing staff requirements. Pleasant Care Corp failed to provide at least 3.2 hours of nurse staffing for each patient every day as required. Pleasant Care paid £0.8 million to the state in a lawsuit settlement in which the company pleaded no contest. California required the company to hire a compliance officer to ensure that each of its 30 nursing homes complied with state law.

Actions like these force medical facilities to increase nursing staff.

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