The shortage of nurses in the United States has been an ongoing issue for over a decade. New federal data shows that the crisis is much bigger than previously thought.
Daily payroll records collected by Medicare from 14,000 nursing homes revealed that, over the past decade, these facilities had been inflating staffing levels of nurses and caregivers in reports sent to the government.
The practice stems from competition. The larger an institution’s staff is in relation to the number of patients, the higher the rating given by Medicare on its Nursing Home Compare website-an important factor in nursing home selection.
Until recently, these reports went unverified. In April, the government started using daily payroll reports to calculate actual average staffing ratings.
According to the new data, weekends are the worst staffed days at nursing homes.
The average facility had 11 percent fewer nurses and 8 percent fewer aides looking after patients on weekends than on weekdays. One resident told the New York Times that his facility turns into a “ghost town” on weekends.
The Centers for Medicare & Medicaid Services, the federal agency that oversees nursing home inspections, is working on making the ratings more accurate.
Patients’ general feelings of neglect are just the tip of the iceberg. The shortage of nurses in these living communities has serious consequences across the entire healthcare system. To list just a few:
- Overwhelmed nurses often forget to turn bedridden patients, leading to increased hospitalizations from bedsores.
- Short-staffing nurses also translates to more patient falls, late delivery of medication and even higher patient mortality
- Thinly stretched nurses burn out
- More code violations occur that can result in lawsuits
Nearly 1.4 million people are cared for in skilled nursing facilities in the United States. As more Baby Boomers reach retirement age (estimates show there will be 81 million patients in 2030), this number will only grow bigger.
As will the gaps in care.
Nursing homes and hospitals are struggling to recruit and retain employees. One of the reasons for this problem is that nursing schools have a hard time keeping up with the pace of demand.
In addition, hospitals tend to offer graduates better compensation.
Technology could easily solve the crisis in care.
Artificial intelligence is already assisting nurses around the globe. In Japan, for example, where the nursing crisis has reached even higher proportions than in the United States, the government turned to “Carerobos” as a solution. Japanese robots are literally taking the burden off human nurses’ shoulders by helping them lift and move patients. Some are equipped with sensors that alert the staff when a resident is in danger of falling out of the bed. Others, such as Sony’s Aibo robot dog, provide emotional support.
Carerobos are not cheap, but experts say the price will drop as these devices become mainstream.
The medical tech market abounds in more affordable options.
Amazon’s Echo devices and the Alexa app are becoming huge helpers to patients and nurses. Among other abilities, these digital voice assistants keep track of a patient’s health records and upcoming doctor appointments. They can even request medication refills from the pharmacy or call for help in cases of emergencies.
Telemedicine is another overlooked tool that can help cut down on unnecessary and costly trips.
Initially met with skepticism, virtual video consultations are on the rise in the United States. Major health plans such as Aetna, UnitedHealth, and Blue Cross/Blue Shield offer online visits via provider networks such as Doctor on Demand, Now Clinic, American Well or MDLive. For less than $5o per session, patients can see a doctor without needing to leave home or the nursing home.
Other tech innovations that can boost standards of care include:
- Health monitoring in the form of webcams, such as Cisco’s Video Surveillance Manager, which is basically a patient-sitter allowing for remote monitoring
- Devices for specific needs, such as high-tech silverware, that reduce hand tremors.
- Drug delivery devices such as bioresorbable stents are now able to release daily drug doses for weeks at a time and then dissolve without harming the body. More of this type of device would solve the problem of medication errors
Finally, one factor that could reduce crowding in retirement centers is collateral services such as concierge nurses. These nurses check on chronically ill patients who otherwise would be institutionalized in ICU or long-term care facilities.
Some providers rely heavily on technology such as real-time location systems (RTLS). This platform allows nurses to find the nearest hospital with offering the kinds of life-saving equipment a patient in distress might need. In nursing homes, RTLS tells caregivers where troubled patients are and provides the location of the nearest equipment needed, such as wheelchairs or crash cars.
Technology can help the nursing community reinvent itself and regain credibility. However, empathy makes nurses irreplaceable and helps patients recover faster. In some ways, technology can literally free up nurses’ hands, so they can tend to patients in a more meaningful way.