It's Not Just Nurses Anymore; Survey of Three Other Health Occupations Finds Patient Safety at Risk Due to Understaffing

4/11/2002

From: Janet Bass of AFT Healthcare, 202-879-4554 or jbass@aft.org

WASHINGTON, April 11 -- As the nation's hospitals deal with the crippling nurse shortage, a nationwide AFT Healthcare survey released today shows the situation is growing even more dangerous for patients because of seriously inadequate staffing levels in three other healthcare occupations.

Nearly 1,000 radiology technologists, respiratory therapists and certified nursing assistants were surveyed about current working conditions, the quality of patient care, and what changes should be made to retain and recruit people into their profession.

"Healthcare in America is getting to be like assembly-line work with a conveyor belt speeding out of control. The quality of patient care is suffering tremendously because of unreasonably high workloads, poor staffing levels and job stress," said AFT Healthcare Chair Candice Owley.

Asked what would be the most effective way to retain and recruit people in their professions, the respondents in the three groups overwhelmingly listed higher salaries, better health benefits and improved staffing levels.

"There must be safe workload limits, or it will be increasingly hard to guarantee that patients will be healed -- not harmed -- when they enter hospitals or nursing homes. But staffing levels won't improve unless these workers are treated with respect, and that means better salary and benefits," said Sandra Feldman, president of the American Federation of Teachers/AFT Healthcare.

AFT Healthcare is launching a "Set Limits -- Save Lives" campaign. Recommendations for safe staffing ratios for the three healthcare occupations will be issued in a few months after the current survey results are analyzed.

All three professions have severe shortages, according to the survey -- 77 percent of radiology technologists, 70 percent of certified nursing assistants, and 67 percent of respiratory therapists said there is a severe or moderate shortage.

In the survey, conducted by Peter Hart Research Associates, 302 radiology technologists, 308 respiratory therapists, and 302 certified nursing assistants were interviewed. Highlights of the survey:

-- More than 70 percent of each group of workers said quality of care has suffered because of increased workloads or poor staffing.

-- 58 percent of respiratory therapists, 46 percent of certified nursing assistants, and 37 percent of radiology technologists said patients might have been placed at risk because of the declining quality of care.

-- The top problems for all three groups of workers were inadequate staffing, not enough time to spend with patients, and low pay/poor benefits.

-- Asked what would be "very effective" to improve job satisfaction and to retain/recruit workers:

Certified nursing assistants: 84 percent said raising salaries (68 percent said they earn less than $20,000 annually), 83 percent said improving staffing ratios so each CNA is responsible for fewer patients, 68 percent said providing more training and continuing education opportunities.

Radiology technologists: 78 percent said raising salaries (47 percent said they earn less than $40,000 annually), 60 percent said providing performance-based bonuses, 55 percent said providing better healthcare and retirement benefits, 52 percent said improving staffing so each tech is responsible for fewer patients.

Respiratory therapists: 74 percent said raising salaries (54 percent said they earn less than $40,000 annually), 63 percent said improving staffing so each therapist is responsible for fewer patients, and 59 percent said providing better healthcare benefits.

-- 67 percent of respiratory therapists and 88 percent of certified nursing assistants said that mandated maximum staffing ratios should be established.

Respiratory therapists said they should be responsible for approximately: -- Five to 10 patients in a medical or surgical unit. -- Five to 10 patients in a non-ICU or telemetry unit. -- Three to eight patients in an intensive care or other specialty unit.

(Currently, 67 percent of respiratory therapists said they see more than 12 patients a day.)

Certified nursing assistants in hospitals said they should be responsible for approximately: -- Three to eight patients in a medical or surgical unit. -- Three to eight patients in a non-ICU or telemetry unit. -- One to six patients in an intensive care or other specialty unit.

Certified nursing assistants in nursing homes said they should be responsible for approximately five to 10 patients.

(Currently, 60 percent said they are responsible for as many as 20 patients each shift.)

An AFT Healthcare survey of registered nurses a year ago found that one in five RNs is considering quitting in the next five years because of miserable working conditions, especially understaffing.

Based on that survey, AFT Healthcare is recommending that the following patient-to-RN ratios be mandated:

Medical/surgical units -- 4:1 Post-anesthesia care -- 2:1 Intensive care /critical care units -- 2:1 Emergency -- 4:1 (2:1 for critical care; 1:1 for trauma) Operating room -- 1:1 Burn unit -- 2:1 Neonatal intensive care unit -- 2:1 Pediatrics -- 4:1 Intermediate care nursery -- 4:1 Step-down (non-ICU) / telemetry -- 4:1 Well-baby nursery -- 8:1 Specialty care/oncology -- 5:1 Postpartum -- 8:1 Telemetry (watching monitors) -- 5:1 Labor and delivery -- 2:1 Behavioral health psychiatric units -- 6:1

AFT Healthcare strongly supports legislation co-sponsored by Reps. Pete Stark (D-Calif.) and Steve LaTourette (R-Ohio) that would ban mandatory overtime except in emergency situations. Because of acute understaffing, healthcare workers are being forced to work overtime. This is causing a decline in the quality of patient care, higher probability of medical errors and job dissatisfaction.

------ AFT Healthcare represents more than 60,000 nurses and other healthcare workers. It is the healthcare division of the 1.2 million-member American Federation of Teachers.