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Michigan nurses to lawmakers: staffing crisis is hurting patients

The Michigan Nurses Association says mandating maximum nurse-to-patient ratios would make patients safer. But every single hospital and health system in the state is opposed, an industry spokesperson said.
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The Michigan Nurses Association says mandating maximum nurse-to-patient ratios would make patients safer. But every single hospital and health system in the state is opposed, an industry spokesperson said.

Nikia Parker believes her friend might have survived in a hospital with more nurses.

At a hearing in Lansing earlier this month, Parker, an emergency department nurse and paramedic from Northern Michigan, described the death of a friend earlier this year, in the hospital where she works.

“After multiple encounters with both outpatient and inpatient facilities, I know there were times that he was cared for by nurses pulling far more weight than is safe,” Parker told lawmakers on the Michigan House of Representatives Health Policy Committee. “Nurses forced to ration their care, and inexperienced nurses who lacked support because their experienced coworkers were also drowning.

“I will always wonder how much that contributed to his outcome. I will never have peace in his death. And it will haunt me, and likely the people that cared for him, for the rest of our lives.”

Parker was testifying in support of the Safe Patient Care Act, a package of legislation that would set limits on how many patients a nurse can care for at a time. It would also create rules about how much mandatory overtime nurses can be forced to work, and would require hospitals to disclose their nurse-to-patient ratios to the public.

Supporters, including the Michigan Nurses Association, argue passing these bills would bring nurses who’ve left the field, back to the bedside. Parker says she’s one of them.

“Situations like this broke me. The moral injury became too much. I made the decision to take a 50% pay cut, to leave bedside nursing and become a paramedic full time. I still work one day a week in the emergency department, because despite the abusive environment, I just can't bring myself to completely walk away from the community I deeply care about when they're at their most vulnerable. But so many of my coworkers have left due to moral injury and we are burning out the few new nurses that we can convince to join the fight.”

But every single hospital and health system in Michigan has signed a letter opposing the legislation, arguing that a “one size fits all” solution would only increase the risk to patients.

Passing these laws won’t magically create more nurses to fill the thousands of current vacancies in Michigan, said Brian Peters, CEO of the Michigan Health and Hospital Association.

“Our hospitals know that right out of the gates, and certainly into the foreseeable future, we would be unable to meet the requirements of this mandate. And so the only way to avoid significant fines and penalties and reputational damage and all the rest, would be to go on diversion. To say there's no room at the inn. And in fact, to take hospital beds off line, either temporarily or in some cases permanently, decline to offer certain service lines, whether that's trauma care, or labor and delivery, or what have you.

“And so what that translates to, in very rapid fashion, is lack of access for patients, but particularly in rural communities of Michigan, and in the winter, when the next available hospital is a very long ways away. … So it is no exaggeration to say that patient access to care would be severely jeopardized by this legislation.”

Lawmakers will continue to debate the Safe Patient Care Act when they return to Lansing in 2024. And state Representative Betsy Coffia (D-Traverse City), one of the legislation’s sponsors, said she wants the hospital industry to come to the bargaining table.

“We already made an amendment, for example, for mass casualty events, based on feedback from the hospitals,” Coffia said. “But I would respectfully say to the hospitals, hard ‘no’ is not going to work here. This is such a real crisis that is directly impacting their patients, their workers and our constituents, that it's time to just stop saying ‘no.’”

Kate Wells is a Peabody Award-winning journalist currently covering public health. She was a 2023 Pulitzer Prize finalist for her abortion coverage.
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