Not playing dead

April 2, 2011 -- Today the News-Press of Fort Myers ran a short item about a march and rally of nurses at the Florida Capitol two days earlier that was led by a St. Bernard. Actually, the Tallahassee march was organized by nurses affiliated with the National Nurses Organizing Committee (NNOC), a national nurses' union. The dog, Paxton, came with NNOC member Gail Ghigna Hallas, RN, PhD, who explains in the piece that the nurses were there to seek legislation requiring minimum nurse staffing ratios. The nurses and other hospital workers at the rally reportedly met with Governor Rick Scott and legislators inside the Capitol while Paxton "waited calmly outside." It's not clear if the rally would have earned the media attention without the novelty of Paxton's involvement, but in any case, the piece includes a surprisingly detailed discussion of the research showing that better nurse staffing saves lives and money. We thank the News-Press for this helpful article, Dr. Hallas for her quotes, and Paxton for leading the march.

The headline conveys what seems to be the most important point: "St. Bernard from Lehigh leads nurses rally in Tallahassee." The piece first explains that the "165-pound St. Bernard mascot from Lehigh led dozens of nurses" on the march, then "waited calmly outside the Supreme Court building while hospital workers and union organizers" met with state officials about "patient protection issues." The photos accompanying the piece also focus on Paxton.

But then the article offers some substance, relying mainly on quotes from Hallas, whom it identifies not only as Paxton's human but also as "Gail Ghigna Hallas, RN, PhD, author of No Other Medicine: Inside View of Corporate Healthcare Corruption in Hospitals and member of" NNOC. Hallas explains:

Studies show that improving ratios saves lives and money more so than trying to cut other fiscal corners. We're hoping to get legislation similar to what California has.

The article adds a quote from "Hedy Dumpel, RN, JD," the "National Director of Nursing Practice and Patient Advocacy for the California Nurses Association/National Nurses Organizing Committee." Dumpel says that California staffing ratios give nurses "the support and time they need to provide higher quality care." A press release reportedly says that proposed Florida reforms "would require minimum ratios by unit, with increased staffing when needed based on the severity of patient illness." The News-Press piece closes with a long quote from Hallas about the relevant research:

Research proves there's a significant need for such an approach. Cutting ratios to one RN per four patients could save 72,000 lives nationally (The American Journal of Public Health, August 2005) while another [study] found that up to 22,000 American lives are lost each year due to unsafe ratios (Journal of the American Medical Association, October 22, 2002). Other studies have linked everything from the rise of staphylococcus infections to the spread of pneumonia to unsafe ratios for direct-care RNs.

For a story that at first seems to be all about the novelty of a dog leading a march about proposed legislation, this is very helpful material. The article not only makes clear that research shows how poor nurse staffing takes lives, but it provides readers with information that should cause them should take the studies seriously. The piece identifies the major health journals in which the studies appeared as well as the publication dates, and it provides short descriptions of the key findings. An ambitious reader might even track the studies down based on this information.

The roles of Hallas and Dumpel in the piece are also very helpful. The item includes their educational credentials. And in their expert quotes, the nurses do not waste time on vague assertions that nurses are nice, helpful, or important. Instead, they focus closely on the points essential to showing why they believe the legislation they seek is needed:  nurses save lives by preventing specific adverse events, but they can't do so with excessive workloads. The piece even makes clear that what the nurses want are minimum ratios, addressing the confusion that sometimes occurs about whether such legislation would mandate one certain number in all situations.

Of course, the subject justifies far more detail than this item has. The piece might have said more about the studies, particularly more recent research showing the benefits of the specific ratios used in California. The item might have explained how nurses make such a big difference in patient outcomes. And it might have discussed the legislative debates surrounding staffing ratios, including the arguments hospital representatives often make that ratios are unnecessary, inflexible, or too expensive. But given the length of the unsigned story, it does a remarkably good job of conveying some key information about the importance of nursing. We thank all of those involved, particularly whoever had the inspiration to attract media interest with Paxton.

See the piece "St. Bernard from Lehigh leads nurses rally in Tallahassee," posted April 2, 2011 on the website of The News-Press (Fort Myers, FL).