Part 2: Are We Making Nurses’ Jobs Harder?
By Danielle Schroth

Nurses and Healthcare Reform: Nurses are on the frontlines of healthcare and often have the closest view of how healthcare changes impact patients. So what do nurses think about the way healthcare issues are being addressed during this 2016 presidential election? InCrowd conducted a microsurvey to ask them about the Affordable Care Act, impediments to quality patient care, and the candidates’ healthcare policies.  We are exploring nurses’ perceptions and reactions in a special 3-part blog series. In this second part, we cover impediments to quality patient care.

A number of factors  impact the level of care patients receive in clinics and hospitals. Often times, a nurse’s ability to deliver the highest quality care hinges on elements outside her control.  So we issued a microsurvey to 206 US nurses to better understand what they think are the biggest issues affecting their ability to deliver high quality care. The results left us asking, “Are we making nurses’ jobs harder?”

Increased Patient Loads, Less Staff

In part 1 of this series, we explored the impacts the Affordable Care Act has had on the frontlines. One outcome has been millions of new patients gaining healthcare coverage. So it’s not surprising that our survey found nurses describe increased staffing issues as a result. In fact, nearly 60 percent of nurses said that staffing problems were affecting the number of hours they worked, the way their time was being managed and, ultimately, the coverage and level of care they could provide for their patients.

This is especially true when nurses are forced to take on additional jobs. “No ancillary staff. RNs are cleaning rooms, mopping floors, never-ending search for supplies. So it’s difficult to give the kind of care we [want] to give with these types of barriers,” reported one emergency room nurse from Ohio.

Another recurring theme we heard was mandated nurse to patient ratios. These vary from facility to facility and can result in situations that are restrictive or badly managed. One nurse put it this way, Nurse-patient ratios need to be legally mandated because otherwise, hospitals will continue to overstress already stressed healthcare workers.”

Patients’ Mental Health Status

Patients’ underlying and often untreated mental health issues, the survey found, is one of the most difficult problems nurses are faced with managing. When mental health problems go unaddressed, providing other routine medical care becomes much more onerous. Such patients can become noncompliant and difficult to treat. When medical treatment is delivered, patients may need more time from nurses already stretched too thin. Close to 60 percent of nurses said that behavioral and mental health concerns should be a larger focus of the 2016 presidential campaign. “[There is] no access for homelessness, mental health, or drug and alcohol dependence,” stated a nurse from California, citing the need for “more programs for this growing population.”

Insurance and Affordability

One quarter of nurses surveyed called out insurance issues as one of the primary hurdles related to delivering medical treatment and care. Deductibles are so high that patients decline or refuse recommended procedures,” according to an obstetric nurse from California. “They get upset with us when they get billed. There is way too much discrepancy in who can have what.” Nurse respondents’ overwhelmingly said that a successful healthcare system should provide equal and quality care for every individual.

In our third and final installment of this series, we dive into nurses’ perceptions of the 2016 presidential candidates and what health care issues nurses think should be at the heart of this election.

Up Next Week: Nurses’ Perceptions of Healthcare Policies and the 2016 Presidential Election


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