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ADVANCE Perspective: Nurses

What is the Price of Safety?

Published March 3, 2016 8:14 AM by Guest Blogger

In today's healthcare environment, workers are being asked to do more with less. See more patients in less time with fewer resources is a common refrain. As reimbursements grow harder to come by, hospitals are tightening their purse strings and looking for more cost-cutting measures.

Linda Boly, RN, an Oregon nurse with 34-years of experience, took a look at her hospital's time and cost-saving measures and said, this is not right. She told management she feared nurses were being made to rush through patient assessments at the price of safety.

This was not the first time Boly advocated for patients' and nurses' rights. Some of her story may be familiar to other nurses. She had been written up for failing to meet productivity quotas and for charting off-the clock. How many of you face similar unrealistic standards? Have you ever entered notes into an EMR after your shift because you chose to spend time caring for your patients instead of staring at a computer screen?

She also fought for Oregon's Nurse Staffing Law, action that got her deemed a "troublemaker." Using real-life examples from her hospital, she twice testified before the state legislature in support of the law. The Nurse Staffing Law mandates that committees made of nurses have the final say in staffing plans, among other safety measures. After her appearances, she began to be written up various infractions.

For speaking up to management about time constraints placed on nurses, Boly was fired in 2013. Two years later, after suing her employer for wrongful termination, a jury sided with her and she won $3 million in damages.

Of course, every nurse who is wrongfully fired might not have the same vindication. Then again, every nurse who questions the status quo might not lose their job. The question is, when you see something that threatens patient safety, what do you do? Do you bite your tongue and not rock the boat? Or do you take a cue from Boly and other nurse advocates and say, "This is not right."

Nurses must ask themselves, What is the price of safety? Standing up for the best interests of patients may come at a cost.

Danielle Bullen is managing editor of ADVANCE for Nurses. You can reach her at


Yes, the challenge of feeling like you need to rush through care is certainly a major hurdle and issue in the medical industry today. The answer lies in each individual's choice as to whether or not hey will give in to this pressure.

Franck Questoms, General - Dr., UNC October 3, 2016 3:35 AM
Charlotte NC

Long term care is getting very dangerous for the nurses and the residents. The faccility i work, staffs one nurse to 52 residents. One nurse to25 trach and vent residents. We seem like a step-down unit for the hospitals that will not keep their patients as long as they should. Except a step-down unit staffs one nurse to 5 patients. 25-50 patients with trachs , vents, some severe wound care, and extreme low immunities. We often have 7 or 8 IV ABT on one unit and 14 tube feeders with one nurse. Isnt there a safe patient staff ratio somewhere written as a law?

Kimberly, long term care - RN, NHC May 6, 2016 8:33 AM
Bristol TN

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