In Spain, SATSE, the largest trade union of nurses, had recently launched a citizens’ initiative calling for a law requiring that all hospitals limit the number of patients who can be treated at one time, in order to prevent errors in the provision of care due to understaffing. Under such a law, specific quotas would then further depend on the hospital settings, pathologies and other factors.
The objective of the citizens’ initiative is to gather at least 500 000 signatures in order to get a legislative proposal to be discussed in the Spanish parliament.
Research, even worldwide, reveals that:
1. there is a shortage of nurses in the healthcare provision
2. this poses risks for both patients and nurses: errors in care provision, accidents, stress-related conditions and even death of patients, with both morbidity and mortality being associated risks to this problem of understaffing
3. the increase in the number of nurses would eliminate these associated risks and that in the long term this investment in staff would be a prevention which would cost less than public healthcare expenditure for curing and reparation ex-post
In-house research conducted by SATSE further shows that the number of nurses needed in the Spanish public health system would need to be increased from 3.6 nurses per 1000 citizens to at least 5.5 nurses per 1000 citizens to even match the EU average. This equals 87.000 nurses missing in Spain, representing a significant shortage which has negative impacts on health and safety at work. What is more, more than 38% of Spanish nurses are more than 55 years of age – What will happen at when these nurses retire if the workforce is not replaced strategically and adequately on a rolling basis?
Research by Andrew Noblet shows that mentally and physically healthy workers achieve better results at work. Stress in the nursing sector is a great threat and a big source of loss for employers in the health sector. Investing in this sector would ensure savings and returns on the long run.
Both MEPs Javier Lopéz and Francesc Gambύs agreed that from an employment and public health perspective more social investment should be available and that European ageing population and the increasing needs of the elderly puts pressure on healthcare systems and the design of the healthcare provision, which should change to become more prevention-oriented.
MEP Javier Lopéz supported the initiative on ‘nurse staffing ratios’, mentioning four steps forward at the EU level:
1. a plead towards the governments of Spain and other Member States with similar challenges to seize the European Pillar of Social Rights and to ensure adequate employment conditions to all nurses in the system
2. an introduction of the topic at a plenary session of the European Parliament
3. a written question to all European stakeholders in the area of employment and public health as to what they think it should be done concerning an improved patient-nurse ratio
4. a network of more allies in the European Parliament to bring this topic to constituencies.
Francesc Gambús agreed that as a matter of healthcare provision the EU needs to rethink its health model and encourage more investments for the benefit of workers.
Esther Reyes Diez, affiliate of SATSE and President of the CESI’s internal members’ trade council on health services, said: “Both as a practicing nurse and as an EU citizen, I find it worrying that working conditions in the health sector are so bad. We cannot afford this situation in which both nurses and patients suffer. We need to act fast and to be responsive for the future.”
For SATSE President Manuel Cascos Fernandez this initiative is “a matter of patient safety and the law proposed is meant to guarantee more nurses in hospitals and health centers in order to achieve that. We need more quality in care.”
Alfonso Jesus Cruz, author of a study of SATSE on the situation of nurses, midwives and physiotherapists in the Spanish health centres, highlights the general consensus reached by in the research community that the healthcare sector needs more nurses. What is expected from the EU level is to set red lines on the maximum number of patients assigned by a nurse.
Through its health services trade council’, CESI encourages its member organisations to invest in campaigns to improve working conditions of healthcare providers and to provide information and training for their workers in order to better mitigate the risks in the workplace.
The topic of nurse staffing ratios will be debated at a forthcoming meeting with all health representatives in CESI’s trade council on May 23. The SATSE campaign could have a European dimension so that understaffing of nurses could be also addressed properly in those Member States which are dealing with it.
Picture: Ester Reyes Diez (second from left) with MEP Javi Lopéz (second from right) © CESI 2019