The Las Vegas Nurses Strike and Hospital-Acquired Infection

In Las Vegas, the SEIU nurses were recently locked out during contract negotiations (they're back to work now). The nurses don't want pay increases or better benefits, but a lower patient-to-nurse ratio. Universal Health Services, the for-profit hospital chain, claims the nurses are trying to expand the union membership. The nurses claim that they simply want to improve patient care. Regardless of the motives involved, there is one indisputable fact: having fewer patients per nurse decreases the likelihood that a patient will become infected while in the hospital.

I've blogged about nosocomial (hospital-acquired) infections before, but for those of you who are new to these parts, nosocomial bacterial infections kill at least 90,000 people in the U.S. annually (and that number is probably low). To put that figure in perspective, AIDS/HIV kills around 17,000 annually in the U.S., and breast cancer kills roughly 40,000 per year. That's right: five times as many people die from nosocomial bacterial infections as die from HIV. For every breast cancer death, there are two nosocomial infection deaths. And a major source of the antibiotic resistance problem is nosocomial infections: the fewer infections that need to be treated, the less antibiotics are used, reducing the selective pressure for antibiotic resistant bacterial strains.

UHS' policy ultimately stems from the externalization of the costs of crappy healthcare to insurers--if the hospitals bore the consequences of lousy care, including nosocomial infections, rather than shunting them off on the insurers (or Medicare and Medicaid), UHS would have an incentive to decrease the patient-to-nurse ratio.

One more reason why we need universal and national healthcare.

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