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Can Low Staffing Lead to Medical Malpractice?

Not enough staff is a common problem across many industries. As a consumer, it may take forever to get your server’s attention to ask for your bill or find an employee to answer your question in a home improvement store. However, when there are staffing problems in a medical facility, it can be dangerous or deadly. 

When there are not enough medical staff on hand to take care of patients, it can lead to serious injury or death. For example, when a patient in the hospital needs assistance to go to the bathroom, they can call for assistance. If they call and no one shows up, they may try and move around on their own. If the patient falls and suffers an injury, it may be the hospital’s fault for not responding to the patient’s calls. 

Understaffing accident injuries can be responsible for serious injuries in a hospital or clinic. If you think your medical injuries were caused by low staffing problems, it could be a case of medical malpractice. To find out more about your options, contact an experienced medical malpractice law firm to get more information. 

Understaffing as a Cause of Medical Injuries

Staffing problems in a hospital can increase the risk of serious injury, medical complications, or death. When there are not enough staff to attend to a patient and give them the standard level of care, if the patient suffers an injury, it may be a case of medical malpractice. It may be the fault of the hospital, clinic, or nursing home when there are not enough staff to provide proper care to patients. 

Most people think about medical malpractice as a single doctor making a mistake that causes an injury but sometimes it can be the hospital’s fault. A hospital can be liable for medical injuries for a number of reasons, including: 

  • Understaffing
  • Liability for an employee’s mistakes
  • Negligent hiring
  • Negligent training
  • Apparent authority errors
  • Negligent practices
  • Dangerous conditions

It’s not like hospitals are unaware they don’t have enough staff. Hospitals and care facilities know of the staffing problems but many of them have not taken the necessary steps to address hiring more healthcare workers. Hospitals may also have a problem with worker retention. The workers they do hire may leave the job because of stress, lack of pay, or to find work at a better place. One of the major causes of low staff is because of costs. 

A lot of hospitals and medical facilities are focused on profits over patients. A hospital company can save thousands of dollars every week if they hire just a few fewer workers. They may even take this number into account when deciding whether or not it is worth it even if a few patients are injured or die, as long as it saves them money. For injury victims who suffer an injury because of negligence, no amount of money may be worth their suffering

Slip and Fall Injuries and Not Enough Staff in a Hospital

A common medical accident that may be related to understaffing is slip and fall injuries. Many patients in a hospital have a fall risk because of medication, mobility, age, mental status, or other conditions that may impair their ability to move around unassisted. This is a common status in hospitals and facilities and workers are supposed to put fall prevention measures into place, including: 

  • Bed alarms
  • Lowered beds
  • Regular safety rounds
  • Locking bed wheels
  • Identify patients with high fall risk
  • Scheduled toilet and bathing
  • Make necessary items accessible for patients
  • Increased nurse-to-patient ratio
  • Grab bars
  • Communicate fall risk to staff

For example, if a patient with a bed alarm suddenly gets up to walk around, there is a risk that the patient will fall over and suffer an injury. The alarm is supposed to provide notice to the hospital, supervisors, and staff that they need to attend to the patient. If there are not enough workers to help the patient, the patient could end up wandering around until they slip and fall, suffering a broken hip. In this example, if the hospital did not do enough to keep the patient safe, they may be responsible for the patient’s injuries. 

Medical Staff in a Hospital

When you walk around a hospital, there are people all over the place. However, they all seem to be busy rushing off to somewhere or other. It may be impossible to know where to turn for help or who to ask for answers. According to one review, almost 20% of U.S. hospitals are critically understaffed. Staffing is based on facility policy and healthcare needs but some states are facing worse understaffing issues than others. 

It can be confusing for a patient in the hospital to get their bearings because it is an unfamiliar environment. There are so many types of healthcare workers in a hospital or care facility, that you may not know who is who. Some of the most common healthcare workers in a hospital include: 

  • Doctor
  • Registered Nurse (RN)
  • Nurse’s aide
  • Physician’s Assistant (PA)
  • Hospital administrator 
  • Midwife
  • Radiographer
  • Pharmacist
  • Physical therapist
  • Optometrist
  • EMTs
  • Medical assistants
  • Orderlies
  • Psychiatrists
  • Counselors

With so many healthcare workers in the same workplace, it can be tough for a patient to know who is doing what. Not knowing who was responsible for a medical injury is common in medical error cases. For example, when a patient is recovering from surgery, they may be visited by a dozen people in a single day. Unless the patient reads the worker’s name tag, they may not know whether they were being treated by a doctor, PA, nurse, nurse’s aide, or hospital staff. 

Nursing and Healthcare Worker Duties

One of the most common staffing issues in healthcare facilities is related to not having enough qualified nurses on hand. According to NurseJournal, nursing is the 3rd most in-demand job of any profession in the United States. With the country’s population living longer, the demand will likely continue to increase. 

What Medical Workers Do in a Hospital

There are a lot of healthcare workers who act as support staff in a hospital. Even if these workers do not have a medical degree or have not gone through a nursing program, they may still be responsible for performing important duties that keep patients safe and healthy. These employees may assist doctors and nurses in treating patients, monitoring patient safety, and providing care. 

Even non-medical workers in a hospital have a role in patient safety. There are hospital workers responsible for cleaning, providing food, delivering medicine, and security. If there is not enough staff to properly clean and sanitize the hospital and equipment, it can increase the risk of infection for patients. Hospital-acquired infections can be caused by a lack of proper hygiene procedures by administrators and employees.  

Low Staffing and Overwork

Another problem with low staffing is that the existing staff is often overworked and exhausted. Workers may be forced to take on additional duties, work extra hours, or come in on their days off to cover the workload. Overworked employees may be more likely to be inattentive, tired, distracted, and make simple mistakes. Lack of sleep and stress in medical staff can be dangerous for patients.

Federal Requirements for Nursing Home Staffing

Nursing homes often have staffing problems that lead to injuries for residents. Nursing homes need enough staff members to function, including working with patients, administrative needs, and custodial staff. Direct care staff in a nursing home may include: 

  • Registered Nurses (RNs)
  • Licensed Vocational Nurses (LVNs)
  • Licensed Practical Nurses (LPNs)
  • Certified Nursing Assistants (CNAs)
  • Dieticians

Healthcare workers have a lot of responsibilities in a nursing home that may be different from other hospitals. Nursing home residents can be wheelchair-bound, require mobility devices, or be bed-bound. Elderly patients who have difficulty moving and taking care of themselves may rely on healthcare staff for their daily needs. If there are not enough staff, the residents can suffer worsening health and injury. 

For example, if a patient is not able to get out of bed, laying on any side for too long can begin to develop skin ulcers or bed sores. If bed sores are not treated, they can lead to cellulitis infections, fasciitis, or gangrene. Bedsores are often a preventable condition as long as there are enough staff to help turn the patient, keep any wound areas clean, and monitor the patient’s skin health. 

According to the Kaiser Family Foundation, “Federal regulations require nursing homes to provide licensed nursing services 24 hours a day, with a registered nurse on staff for at least eight consecutive hours a day, seven days a week.”  

A study from the Centers for Medicare and Medicaid Services (CMS) recommended a minimum of 4.1 nursing hours per resident per day to prevent injury to nursing home residents. However, there is no federal requirement for the minimum number of staffing hours per resident. In most cases, the state law requirements for nursing staff time are more stringent. 

Washington, D.C. is the only place that has a minimum staffing requirement for nursing homes that exceeds the CMS recommendations. (4.16 hours per resident day). In Illinois, the total nursing staff hours per resident day total 3.83. In Maryland, the total nursing staff hours per resident is 3.06 hours per resident day. For Pennsylvania, the minimum total nursing staff hours per resident day is only 2.76. 

Chronic Healthcare Staffing Problems in the U.S. 

Understaffing problems in U.S. healthcare is nothing new. Understaffing is a complicated issue and is related to several factors that don’t provide enough nurses and health aides to meet demand, including: 

  • Private facilities trying to save money
  • Low pay for non-nursing staff
  • Stressful workplace settings
  • Violence against healthcare workers
  • Lack of investment in healthcare training

Not surprisingly, higher staffing levels are associated with higher care for nursing home residents. In 2022, “the National Academies of Science, Engineering and Medicine recommended minimum staffing levels, policies to ensure competitive wages and benefits, and improvements to staff training and opportunities for career advancement, among other reforms, as part of its comprehensive report to improve nursing home quality.”

Understaffed Facilities and COVID-19

The weaknesses of the staffing issues in healthcare were dangerously exposed during the COVID-19 pandemic. Many hospitals, nursing homes, and clinics were already operating on skeleton healthcare worker crews. As soon as these facilities lost a couple of workers because of infection or illness, there was no one else to take up their duties. A team of 5 nurses in a nursing home may have been forced to take on the workload of 20 employees. 

According to a study in the Journal of Advanced Nursing, “personnel understaffing and expertise understaffing jointly shape near misses, which are known to precede and contribute to accidents and injuries.” Not having enough staff on hand during COVID-19 increased safety workarounds, which resulted in near misses when mistakes were made. 

In some states, including Illinois, lawmakers required nursing homes to increase staff wages, with direct care staff wages increasing by $1.00 per hour by July 2020, and an additional 50 cents per hour by January 2021. 

The publication, “In a The National Imperative to Improve Nursing Home Quality: Honoring Our Commitment to Residents, Families, and Staff,” looked at nursing home care improvements in light of the COVID-19 pandemic. The authors found that “the way in which the United States finances, delivers, and regulates care in nursing home settings is ineffective, inefficient, fragmented, and unsustainable.”  

Talk to a Malpractice Lawyer After an Injury

Not having enough staff is not just a complaint about poor customer service. Unlike an understaffed restaurant, customers generally do not suffer injuries or die because of low staffing, like they might in a hospital, nursing home, or medical clinic. Medical staff are necessary for maintaining patient health and safety. When the hospital cuts corners or does not properly hire and train responsible staff, it can increase the risk of an injury. 

Call experienced medical malpractice attorneys who can look at your case, answer your questions, and help you understand your legal options to file a claim against a hospital, nursing home, or negligent doctor. Contact Gilman & Bedigian online or at 800-529-6162 for a free consultation.

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