Poorly trained or overwhelmed nurses are responsible for thousands of deaths and injuries each year in the nation’s hospitals, according to a Chicago Tribune investigation.
Since 1995, at least 1,720 hospital patients have been accidentally killed and 9,548 others injured from mistakes made by registered nurses across the country, the Tribune’s analysis of 3 million state and federal computer records shows.
“I wake up every day and hope I don’t kill someone today,” said registered nurse Kathy Cloninger. “Every day I pray: God protect me. Let me make it out of there with my patients alive.”
Mandatory overtime and 16-hour shifts have led to fewer nurses who are willing to work at the University of Illinois at Chicago Medical Center, where she has worked for seven years.
Last year, Cloninger accidentally over-infused an infant with liquid nutrients while rushing to reach another premature newborn in need of care. The baby, who received a 24-hour dose of nutrients in less than 30 minutes, suffered no permanent injuries.
Nursing Staffs Hurt by Cutbacks
The Tribune’s investigation found cases where patients were given overdoses of medication or vital care was delayed, sometimes for hours. It also found hospitals increasingly use part-time nurses from temporary agencies, who lack patient familiarity and training within specialties.
Nursing staffs have been the first target for cutbacks at hospitals where profits have been squeezed by managed care programs and falling federal Medicaid reimbursements, said Rick Wade, senior vice president for communications at the American Hospital Association.
The Tribune found that, since 1995, at least 119 patients have been killed and 564 others injured by unlicensed, unregulated nurses aides.
Aides, who earn an average of $9 an hour, are used to augment staffing but sometimes supplant higher-paid registered nurses. Under a cost-saving program in at least two Chicago hospitals, housekeeping staff assigned to clean rooms are pressed into duty as aides to dispense medicine.
One of the first lawsuits that targets corporate-level staffing decisions rather than individual negligence is the case of 61-year-old Shirley Keck, whose pleas for help went unnoticed until it was too late.
In February 1998, Keck was one of 41 critically ill patients on her floor at Wesley Medical Center in Wichita, Kan. When she started having trouble breathing, her daughter, 29-year-old Becky Hartman, ran to the nurses station several times for help, but no one was there.
“There was nobody around,” Hartman said. “I was raising my voice and getting angry. I was so frustrated.”
Her lawsuit alleged that lack of monitoring by nurses — caused by short staffing — led directly to the permanent brain damage Keck suffered.
The hospital agreed to a $2.7 million out-of-court settlement, but maintains that it was safely staffed.
Lack of Necessary Skills
The Tribune also cited several cases in which patients died after nurses performed delicate medical procedures without the necessary training, failed to detect internal bleeding and failed to help patients go to the bathroom.
A November 1999 report by the Institute of Medicine said medical mistakes kill anywhere from 44,000 to 98,000 hospitalized Americans per year.
That report also attributed the problem to basic flaws in the way hospitals, clinics and pharmacies operate. After the report, President Clinton said hospitals should agree to routine reporting of serious and deadly mistakes.
Later, another group of researchers issued a report that said the Institute of Medicine’s conclusions were exaggerated.
However, the Tribune’s findings are no surprise to the nurses themselves.
In testimony prepared for a national meeting on Monday, the American Nurses Association said there is a critical need for research that would explore the relationship of staffing levels and skill mix and the number of medical errors.