The Real Cost of Caring or Not Caring

Abstract

The unpredictable conditions, fast pace, and need for immediate decision making in emergency departments have some nurses questioning their ability to provide quality care to patients. 1 Baldursdottir G Jonsdottir H Iceland R The importance of nursing caring behaviors as perceived by patients receiving care at an emergency department. Heart Lung. 2002; 31: 67-75 Abstract Full Text Full Text PDF PubMed Scopus (59) Google Scholar In part because of the Affordable Care Act and the requirements imposed by the Department of Health and Human Services regarding Medicare and Medicaid reimbursement, facilities are increasingly focused on medical errors, quality of care, and the reduction of medical costs, particularly in the emergency department. 2 Frisse ME Johnson KB Nian H et al. The financial impact of health information exchange on emergency department care. J Am Med Inform Assoc. 2012; 19: 329-333 Crossref Scopus (177) Google Scholar The impact of these changes has all stakeholders examining the care given and the cost of that care at 3 different levels: the financial level (money spent), the physical level (patient outcomes), and the emotional level (satisfaction of the nurse and the patient). 2 Frisse ME Johnson KB Nian H et al. The financial impact of health information exchange on emergency department care. J Am Med Inform Assoc. 2012; 19: 329-333 Crossref Scopus (177) Google Scholar With greater than 40,000 nurses across the nation working in emergency departments and nurses’ salaries representing more than 50% of most hospital budgets, nurses’ salaries are an expense that hospitals review carefully when faced with economic pressures. 3 Pappas SH The cost of nurse-sensitive adverse events. J Nurs Admin. 2008; 38: 230-236 Crossref PubMed Scopus (53) Google Scholar The implementation of evidence-based practice places the cost of care that patients receive from nurses as one of the most valuable items paid for by health care consumers, with the rising cost closely related to the growth of the gross domestic product, which was 17.9% in 2011. 4 Fuchs V The gross domestic product and health care spending. N Engl J Med. 2013; 369: 107-109 Crossref PubMed Scopus (71) Google Scholar The awareness of health care spending by politicians and consumers supports the need for researchers to explore the real cost of care as it relates to nurses’ caring and the effect on patient outcomes and the health care system. Joan Buckley, Member, Nassau/Queens Chapter, is Assistant Professor Department of Nursing, Nassau Community College, Garden City, NY.