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Profiles in Nursing
Linda Aiken's Research is Changing the Nursing Profession
The Magnet program for hospitals is directly related to Aiken’s work
Not surprising that Linda Aiken, Ph.D., FAAN, FRCN, RN, is listed among the 100 most influential people in healthcare for 2010. Very few nurses make the cut in Modern Healthcare’s annual list, but Aiken’s work in several pivotal areas make her hard to beat.
For one thing, she is the go-to source for information on the shortage of nurses — causes, consequences and possible solutions. She also heads the Center for Health Outcomes and Policy Research at the University of Pennsylvania. In addition, she is the only nurse on the editorial board of Health Affairs, the nation’s leading health policy journal. There’s more: she serves as co-director of the National Council on Physician and Nurse Supply.
First Stop: BSN
Nursing came somewhat as a fluke. Aiken says that what she really wanted to do was attend the University of Florida; while she had been interested in nursing for a long time, that career choice was less important. Still that initial step into a baccalaureate program was the single most important move she took and one that she encourages other potential nurses to explore.
Citing statistics that show only 20 percent of nurses go on to obtain an additional degree, Aiken says making that first degree a BSN opens up multiple career opportunities that are not otherwise possible.
In her case, further study led to recognition as a clinical nurse specialist in cardiac surgery. Later she obtained her doctorate in Sociology from the University of Texas.
Before she even had that first clinical job in nursing, Aiken saw the “disconnect between what nurses wanted to do and what was possible in a hospital organization.” And so for her an ongoing question has been: “How is the care in hospitals facilitated or compromised” by institutional structures?
The Link Between Patient Load and Mortality
In 2002, The Journal of the American Medical Association (JAMA) published her landmark research that studied 10,000 nurses in 168 Pennsylvania hospitals.
Her work showed the following: For each additional patient assigned to a nurse, 30-day patient mortality increased by 7 percent; failure to rescue rates rose by 7 percent; the odds of nurse job dissatisfaction increased by 15 percent, and the odds of nurse burnout increased by 23 percent.
Nursing Education and Patient Outcomes
By 2006, Aiken and her colleagues completed another major study, also published in JAMA, which showed that hospitals employing higher percentages of bachelor’s degree-prepared nurses had lower surgical-patient mortality than hospitals that staffed with fewer bachelor’s-prepared nurses. This study demonstrated that nursing experience, while an important factor in patient outcomes, is not as critical as nurse educational preparation.
Most recently, Aiken has completed a study of 225,000 nurses that contrasted patient well-being in California, which has mandated staffing ratios, with outcomes in two other states which do not, New Jersey and Pennsylvania.
The decision of the American Nurses Association to institute their signature Magnet program for hospitals is directly related to Aiken’s work. In a partnership referred to as “twinning,” Magnet hospitals in the United States now mentor institutions in developing countries to enhance care. Ever the visionary, Aiken would like to see the same thing happen with dysfunctional hospitals within the U.S.
Nurses in the Boardroom
She has, moreover, worked with the Robert Wood Johnson Foundation (RWJF) to increase the number of nurses in the boardroom of health organizations. Her background as a nurse “serves as a countervailing perspective to the more dominant focus on payment policies as motivators,” says the RWJF website.
Having seen nursing in many different countries and studied it extensively here, where does Aiken see the best environment for nurses? In the U.S. she says. Here the wages are the best, and despite many, many problems, so are the working environments.
Elizabeth Hanink, RN, BSN, PHN is a freelance writer with extensive hospital and community-based nursing experience.