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Elizabeth Cooney is a health reporter for the Worcester Telegram & Gazette.
Boston Globe Health and Science staff:
Scott Allen
Alice Dembner
Carey Goldberg
Liz Kowalczyk
Stephen Smith
Colin Nickerson
Beth Daley
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Monday, February 26, 2007

Nurse staffing levels not the whole story, reader says

Liz Kowalczyk's recent blog item about a Massachusetts Hospital Association website that posts nurse staffing levels drew a skeptical response from a man whose wife spent much of last year in three hospitals.

"Anyone who thinks that even a majority of nursing hours are spent 'at each patient's bedside' is out of touch with reality," he wrote in an e-mail. "A good portion of the nurse’s day is spent in data entry, and God help anyone needing care in the hours near shift changes."

An MHA spokesman said in an e-mail that some nursing activities related to coordination of patient care might occur away from the patient.

"It's not unreasonable that a nurse is out of the patient room and away from the bedside to consult with other members of the care team, to review orders, to prepare medication, and yes, to document the care provided so that others can take care of the patient as well," said Paul Wingle, MHA senior director of communications.

The man, who declined to be identified, said his wife was 66 when she died in December of sepsis. She was treated at Emerson Hospital in Concord, UMass Memorial Medical Center's two campuses in Worcester and Saints Memorial Medical Center in Lowell. She also received care at a rehab hospital whose staffing levels were not included on the MHA website and at skilled nursing homes.

The nurse staffing levels were similar across the three acute-care hospitals, averaging around 8 hours per patient day on medical/surgical wards and about 15 hours per patient day in intensive care units, according to the MHA site. But those numbers don't tell the whole story, the e-mail writer said in an interview.

The care his wife received in intensive care units was great, he said, but in other units it varied, even within the same hospital. It appeared to him that nurses spend about 30 percent to 50 percent of their time with patients.

"The point is, the percentage of the nurses' time actually spent in care-giving is not what is posted. Those are total hours."

Posted by Elizabeth Cooney at 05:12 PM
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