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Elite panel issues massive report, urgent call to improve working conditions for nurses

November 5, 2003 -- Today Reuters and the New York Times ran passable initial stories about a major report issued by a panel of the National Academy of Science's Institute of Medicine, which advises the federal government on health care, urging reform to protect patients from the proven dangers of excessive nursing overtime and short-staffing.

Neither article adequately conveys the unusually comprehensive analysis or the sweeping calls for legislative and other change in "Keeping Patients Safe: Transforming the Working Environment of Nurses," which is over 400 pages long. Click here for the press release/summary and click here for the full text of the entire report.

Both Maggie Fox's Reuters piece and Robert Pear's lengthier Times piece focused on the report's call for limits on the hours nurses work and mandatory safe staffing ratios as critical steps in reducing adverse patient outcomes, as well as the nursing shortage. Commendably, Pear's story noted the report's description of how nurses detect and intervene to address lethal infections and major system failures, and the report's recommendation that nurses should be more involved in the management of hospitals and nursing homes in order to reduce errors. Fox's piece linked the report's call for limits on nurses' hours to the recent reforms limiting the hours medical residents may work each week. Both articles mentioned the report's citation of a study of two hospitals which found that nurses intercepted 86% of medication errors before they reached patients. The stories' coverage of the report also noted its focus on the shortage and short-staffing problems experienced by the nation's 2.3 million nursing assistants.

Ironically, the sources of supporting quotes in the Times piece appeared to reflect major media attitudes that are one of the major reasons inadequate resources have been directing to nursing. It appears that eight of the panel's 18 members are nurses, including Vice Chair and Michigan nursing dean Ada Sue Hinshaw, RN, Ph.D., and the study's director is a nurse. Only three panel members appear to be physicians. Panel Chair Donald Steinwachs, Ph.D, who dominated coverage, is a public health professor at Johns Hopkins. Obviously, nursing leaders--both on the panel and off--would be in the best position to comment on what the report means. Yet the Times ran quotes from three physicians but only two nurses, Hinshaw and Pamela Thompson, RN, MS, director of the American Hospital Association's nurse executive component, who appeared to be defending current nursing shift lengths. It could be argued that the physicians were needed to provide objective analysis. But would any journalist covering a report about critical problems in the medical profession have gathered more expert quotes from nurses than physicians?

See comments by Janice Reynolds regarding her concerns that Robert Pear's article blurred the words "nurse" and "nursing assistant."



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