Hello! Just sent out today’s e-mail to the doodlers.

Today, I talked to them about someone that I know is very, very important to all of you. Her name probably comes up in your daily conversations, right after the phrase, “What?! We’re short-staffed again?!”

I can almost hear how it enters the conversation: “Holy Linda Aiken, don’t people know that understaffing leads to increased patient mortality?!”

If that’s not what you say when venting about your three patient ICU assignment, or your fourth admission of the day, well then maybe you should start. Aiken’s body of research is exhaustive (meaning, I was exhausted by the time I finished scrolling through it), and it’s full of facts well deserving of a Google Doodle (and the million other awards she’s received).

Sure, screaming about how you deserve safe staffing to the supervisor is exhilarating, but next time, pull the Aiken card and drop some data about how it hurts patients.
___

To: proposals@google.com
From: Amanda Anderson RN
Subject: Why Nurses Need A Google Doodle: #RNgoogledoodle Innovator No. 5

Dear Google Doodle Team,

Hello! It’s Thursday! Hard to believe I’ve been writing to you for five days now. I’ve had dating relationships shorter than this one.

Today, I want to talk to you about an RN innovator who has given decades of work to an area that is incredibly important to every practicing nurse I know: Staffing. Linda Aiken, PhD, FAAN, FRCN, RN (whew!), currently works out of the University of Pennsylvania as the Claire M. Fagin Leadership Professor in Nursing. She also teaches Sociology, and serves as the Director of the Center for Health Outcomes and Policy Research there, so you can be sure that she’s smart. And most certainly innovative.

Aiken started writing about nursing shortages back in the ’80’s. She is one of the first nurse innovators to tie high ratios – when one nurse is expected to care for a large number of patients at a time – to things like increased patient mortality, complications, nurse burnout and turnover rate. The evidence is fairly near rock solid – her most recent study, conducted in multiple European countries, shows a 7% increase in 30-day mortality for patients each time a nurse is asked to care for an additional patient over the total of five, and a 7% decrease with each 10% of nursing staff that has a Bachelor’s degree.

I’m sorry, but that’s insane. A 7% increase in death?! Let’s say a nurse is assigned nine patients to care for (as often happens in countless American hospital units). Her patients have a 28% increase in their chance of dying in the hospital?! On the flip side, when patients are cared for in hospitals where 60% of nurses have a Bachelor’s degree, and only care for an average of 6 patients, they have a 30% decrease in mortality. Those are some pretty straight odds.

The New York Times published a review of this study a few weeks ago. You didn’t catch it? Maybe that’s because it was buried deep in the International Section, instead of on the front page, where it needed to be. This puzzles me. With millions of people in American hospitals on any given day, and only your fine state of California mandating a staffing ratio of 5:1, wouldn’t you think more people might be interested in this information?

I feel like it’s kind of similar to the GM debacle, on a much larger, less understood scale. GM had evidence of a problem, covered it up, and people died when they didn’t need to. How many hospitals are doing the same? Thanks to Aiken, we have scientific data tying unsafe staffing to unnecessary patient death, and yet, who is talking about the daily realities of this damage?

Have you ever tried Googling “How many patients does a nurse at ——- Hospital care for?” when looking for a place to send your mother for knee surgery? Zip results. I don’t know about you, but that’s the first thing I’d want to know. I don’t care how brilliant a doctor is, if there’s not enough “nurse” to care for his genius surgical work, you can be sure it, and the patient, will suffer. Thanks to Aiken, I can say that with certainty.

Years after Aiken started her body of work, staffing remains a real, daily problem that is undocumented by the majority of hospitals, and essentially unknown to the public. She has revolutionized the way the medical community and academia understand the problem. Without her innovative insight into the details of the nursing profession, her countless articles and books, and her continued drive for research, we’d just be a bunch of crabby, tired nurses complaining at the nurses station. With her work, we’ve got data.

Thanks for reading,

Amanda Anderson, RN

http://www.nursing.upenn.edu/faculty/profile.asp?pid=107
http://www.nytimes.com/2014/03/31/world/europe/nurse-education-level-affects-death-rates-study-says.html