Private nurses have been available for hire in hospitals for decades, markers of affluence much like household servants. Now, though, they are working in a different world. Shortages of staff nurses plague hospitals across the country. Even in those that are fully staffed, surveys have repeatedly shown, nurses are taking care of more patients and sicker patients than ever before, with far less time to nurse each patient assigned to them. Headlines repeatedly broadcast hospitals’ dangers, and patients generally know for themselves just how unpleasant a stay in one can be. Some researchers fear that worried patients and their families may begin to view private nurses less as a luxury than as a prudent and sensible precaution. But by hiring private nurses, they say, patients may simply be exchanging one set of problems for another, entrusting their care to nurses unfamiliar with a hospital and its routines and leaving themselves potentially vulnerable to mishap. There is no centralized data on how many private duty nurses and nurse’s aides, sometimes called ‘’sitters,” work in hospitals. Further, little consensus can be found among those in the business as to whether their services are increasingly in demand. Deborah Yanicelli, manager of the Manhattan office of Access Nursing Services, an agency that supplies private nurses to hospitals, often ones known for attracting well-heeled patients, says her volume of requests has increased considerably, up by perhaps 15 percent over the last four months. ”The reputation is that you’re taking a risk in the hospital,” she said. ”Some people with means just want to make sure everything will be O.K.” ”That market isn’t really growing like crazy,” Mr. Baiada said, in contrast to the demand for home care nurses for recently discharged patients, which is soaring. ”You’re in the hospital for such a short time now that you’re discharged before you can blink,” he said. Dr. Lorraine Mion, director of geriatric nursing at the Cleveland Clinic Foundation, said the demand for private nurses at her hospital was no different than usual. ”Still, it’s an interesting question,” Dr. Mion said. ”You can certainly see it happening someday.” Economic considerations may be blurring the picture: private nurses are expensive. Those who can afford them may frequent affluent hospitals where the perceived need for them is still not great. No insurance plans cover the cost, and hospitals will finance a private attendant only when a patient is at a high risk of life-threatening harm if left alone: an actively suicidal patient, for instance. Otherwise, the fee for a private nurse, which may run from $20 an hour for a practical nurse or aide to $75 an hour for an experienced registered nurse, must be paid by the patient or family.The money buys the confidence that a patient will not have to wait for the basics of nursing care, like help with eating or navigation to the bathroom. Bedbound patients will be repositioned frequently to help them avoid developing bedsores, and postsurgery patients will be reminded to do their breathing exercises.Private nurses supply extra pairs of hands to untangle intravenous lines and arrange pillows; they guard against falls and keep water pitchers full. They can clarify the purpose of new medications and review discharge instructions. But even when private nurses are highly experienced registered nurses, they generally cannot dispense medication, administer transfusions or chemotherapy, or write notes that become a part of the hospital record. These activities are the legal responsibility of the staff nurses, and hospitals will not allow them to be delegated. The result is that hospital and private nurses must collaborate in the patient’s care — an arrangement that may or may not work out. But the bad side, Ms. Laffend said, was that once her aunt was convalescing in a regular ward, she developed no rapport at all with the floor staff nurses, who may ignore and even resent patients who hire outside help. ”The sense you get from them is that if you don’t trust me, then all right, so much for you,” Ms. Laffend said. ”All in all, it was better for her psychologically to have someone there. If it was better over all, I don’t know.” Nursing scholars agree that private nurses may smooth over rough spots in hospital care, but at a cost.

Nurses themselves suggest that in the long run, a patient’s interests may be best served not by hiring private nurses, but if at all possible, working out a closer relationship with the hospital staff nurses instead. Read more