By its nature, staffing emergency rooms is a very top priority. How else do we accomplish this critical work but with adequate staff to meet every and any contingency in the protection of patients?

Now, as it turns out, ER visits are increasing under the Affordable Care Act, putting more pressure on services and underscoring the need for appropriately staffing emergency departments. A new study in the journal Science was released in early January drawing upon samples of thousands of low-income people in Portland, Oregon. Its findings are very significant: those newly insured through Medicaid made 40 percent more visits to the ER than their uninsured counterparts.

This pattern, reported The New York Times recently, “held true across most demographic groups, times of day and types of visits….”

One reason put forward is tied to reduced costs under Medicaid. When services become less expensive, people use them more. Another reason for high traffic at ERs includes the increased complexity of medicine that only can be found in ERs. A family practice simply hasn’t the expertise or resources to match an ER.

There oughta be a law

Emergency care is not going away. Nor should it. As one doctor quoted in The New York Times article explained, “[T]here is only so much that prevention can do.”

Staffing ERs with appropriate, professional RN ratios is even more essential given these reported increases in patient visits.

Talk to just about every RN working in an emergency department – whether adult or pediatric – and you’ll hear the same concerns and stresses: too many patients, too few nurses. NYSNA voted to make passing a safe staffing law a key goal because patient care matters too much to let this stand.

As we go to press, RNs are preparing to meet with members of the New York State Legislature on February 15 at the Legislative Caucus in Albany that the Association of Black and Puerto Rican Legislators organizes. Every member of the State Senate and Assembly will be there – and they’ll be hearing from us about the urgent need to pass a safe staffing law.

Sign up now to join hundreds of fellow NYSNA members in Albany on March 26 to tell New York State legislators once again just how important safe staffing is – and to remind them that we won’t back down until there’s a law in our state.

Short-staffed and overloaded

09-Rose_Green_Elmhurst.jpg “We are always short-staffed, always, always. We are overloaded because other area hospitals have closed. There are shifts where an RN cares for 15 or 16 patients in the ER. On a good day you can have 10. What kind of quality care can you give to patients with that load? They put us in an impossible situation, running from patient to patient. We have to be very careful with our patients, but we are tired, burned out, checking, checking, despite the work load, so that we get it right.” –Rose Green, RN, Elmhurst Hospital

09-catherine_bogart.jpg “The ED treats 250 patients a day – adults and children – and eight-hour waits are not uncommon. We are on overload, it’s pretty chaotic. Ratios range from 5 patients per RN to 8; sometimes we are at 10 patients per RN. I’m sorry, but 10 to 1 can be extremely unsafe. Even 5 to 1 is difficult and can be unsafe. It depends on acuity. When another Poughkeepsie hospital closed down nearby, their patients were added to Vassar’s ED load. Recently our VP of emergency services announced a maximum  ratio of 10 to 1. We are overworked and exhausted.” –Catherine Bogart, RN, Vassar Brothers Medical Center