Report: Nurse Understaffing Is Becoming More Deadly for Patients

Until Nurses Are Included in Reimbursement Models, Expect Them to Keep Leaving the Profession in Droves

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More than 90% of nurses in the nation’s 10th most populous state believe that understaffing is negatively affecting the quality of care they’re able to provide, according to a report recently released by the Michigan Nurses Association. 

The association interviewed 400 nurses in January. They said that worsening care quality has a serious and sometimes fatal impact on patient safety — the percentage of participants who know of a patient death being caused by nurses being assigned too many patients nearly doubled in past seven years. It grew from 22% in 2016 to 42% in 2023.

About a third of Michigan’s registered nurses are not working in the nursing field. The Michigan Department of Licensing and Regulatory Affairs’ records show there are 154,758 nurses with active licenses in the state, yet records from the U.S. Bureau of Labor Statistics show that only 102,480 are working as nurses.

Because of this, more than 70% of nurses working in direct patient care said they are frequently assigned an unsafe patient load. Nearly half said this happens during half or more of their shifts, and a quarter said this happens during almost every shift. 

The percentage of nurses who said their patient load is almost always unsafe has more than tripled in recent years — it was just 7% in 2016. 

Most participants think the understaffing crisis has little to do with a shortage of qualified nurses. About 80% of participants blamed the predicament on Michigan hospitals’ failure to improve working conditions and retain nurses.

A majority of nurses said that unsafe patient loads are the biggest obstacle preventing them from delivering quality care. Subpar care quality leads to negative patient outcomes, one of which is death. More than four in every 10 Michigan nurses know of a death being caused by unsafe patient loads, and 68% of participants know of an instance where a patient contracted an infection or experienced other complications.

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Medication errors are another negative result of nurse understaffing. Three-quarters of nurses said they are aware of a missed medication, wrong medication or wrong dosage being given to a patient because of exorbitant patient loads. Additionally, nearly 90% of nurses said they lack the time they need to educate patients and provide adequate information about discharge planning.

If hospitals don’t take serious and immediate action to tackle the staffing crisis, it will only get worse, according to the report. Less than half of nurses working in direct patient care said that they plan on staying in their current position over the next two years.

Participants suggested two measures to address the dangerous levels of nurses leaving the healthcare workforce. 

More than 90% of nurses support proposals to pass a law in Michigan called the Safe Patient Care Act, which would limit the number of patients that a hospital nurse can be assigned. Most nurses said this would lead to a significant improvement of care quality. 

They also said that fixed nurse-to-patient ratios could lead to better recruitment and staff retention. Three-quarters of nurses who work in direct patient care said they would be more likely to stay in their position if the legislation is signed into law, and about 40% of nurses who left their jobs said they would be more likely to come back.

Michigan nurses also recommended that hospitals eliminate mandatory overtime and offer retention pay.

Photo: gpointstudio, Getty Images

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