Report Sample on Mandatory Nurse Patient Staffing Ratios

Introduction

Mandatory nurse-patient ratios remain widely debatable among various vested stakeholders, including physicians, unions, patients, nurses, researchers, employers, nursing institutions, in different hospitals, and state and federal governments (Tevington, 2011). Proponents of mandatory nurse-patient ratios claim that the legislation will help regulate registered nurse (RN) staffing, reduce nursing shortages, enhance quality care, and improve career satisfaction and nurse recruitment (Tevington, 2011). According to Griffiths et al. (2020), better RN staffing will often result in a higher quality of patient care leading to reduced hospitalization. Healthcare facilities across the United States have growing caseloads of patients while only limited numbers of nurses are available to care for them (Tevington, 2011). As a result, the few nurses work for longer hours and hurrying through more patients in every shift.

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An American Nurses Association survey found that almost 54% of nurses had no sufficient time to spend on each patient; around 43% of nurses responded that they work longer hours (Stimpfel et al., 2020). California stage government directed all healthcare institutions in California to observe mandatory nurse-to-patient ratios from 2004; however, these ratios usually vary and depend upon patient care quality and conditions. Massachusetts recently enacted legislation necessitating mandatory staffing minimums in various states’ ICUs. Other states, including New York, are considering bouncing on the bandwagon. This paper discusses the issues of compulsory nurse-patient ratios, legal ramifications involved, and considerations necessary for the healthcare leaders and organization with the possible outcomes.

Current Situation

California was among the first states to mandate mandatory nurse-to-patient ratios in psychiatric and acute care facilities on 10 October 1999 (Serratt et al., 2011). California legislation sets a minimum number of nurses for each patient in neonatal nurseries, hospital operating rooms, and intensive care units. California’s bill AB394 directed the State Department of Health Services to set appropriate nurse-to-patient ratios (Serratt et al., 2011). California’s AB394 became the first step in a countrywide trend for inquiry of nurse-to-patient ratios. The minimum nurse-to-patient ratios setting can strengthen nursing education programs, improved patient care in hospitals, and an efficient nursing environment.

Although California remains the only state with mandated nurse-patient ratios, many other states have also proposed similar enactment. New Jersey Legislature established Bill A660 and referred it to the Assembly of Health and Senior Services Committee (Tevington, 2011). New Jersey Legislature introduced another identical bill, S963, and referred to the Senate Health, Human Services, and Senior Citizen Committee. These bills require specified minimum nurse-patient ratios in both ambulatory units and hospitals. They proposed a 1:6 ratio in medical-surgical units, the ratio was to be reduced to 1:5 after the first year, 1:4 for non-critical emergency rooms and in telemetry, intermediate care units, 1: 2 for trauma or critical patients, intensive care units, and burn units, and 1:1 for each unconscious patient.

These bills also try to incorporate some staffing committees’ fundamentals, such as staff nurse involvement. The continued interest in mandatory nurses staffing laws such as California’s AB394 and New Jersey’s A660 or S963 is linked with several critical concerns. Studies, including Griffiths et al. (2020) and Patterson (2011), have associated improved RN staffing with increased patient safety, quality of care, patient satisfaction, and decreased patient waiting hours.

Considerations

At first, legislation may not seem uncertain; however, it is an intense debate among healthcare policy specialists. Proponents maintain that mandatory ratios will lessen nurse exhaustion levels and stress and improve patient outcomes. However, opponents, including healthcare administrators and executives, express uncertainty for some of the reasons. They claim that a Mandatory nurse-patient ratio will bring with it increased costs. Most facilities will have to hire more nurses to comply with the law. Like in California, hospitals may be forced to raise nurses’ benefits and salaries to retain the nurses (Serratt et al., 2011). Therefore, already budget-strapped hospitals will need to redirect funds from other sectors. Besides, some healthcare leaders and organizations question whether the labor market has enough qualified nurses to satisfy these nurse-patient ratios in all healthcare facilities. Today, the average nurse’s salaries in California have increased to $100,000, including benefits, and the number of registered nurses grew by 125,000 when the law was put into action (Donaldson & Shapiro, 2010).

Some states have different statutes that challenge healthcare facilities to establish their own staffing plans and policies. Several healthcare institutions in these rules have successfully managed the competing strains involved with staffing issues by colluding with stakeholders to improve staffing programs that satisfy their community demographics’ specific needs.

Conclusion

In conclusion, while various states are adopting mandatory ratio laws, now is a convenient time for healthcare conductors and organizations to review their nurse staffing policies and consider appropriate moves. Modifications of those staffing programs may need an agreement with nursing unions.

References

Donaldson, N., & Shapiro, S. (2010). Impact of California mandated acute care hospital nurse staffing ratios: A literature synthesis. Policy, Politics, & Nursing Practice, 11(3), 184-201. https://doi.org/10.1177/1527154410392240

Griffiths, P., Saville, C., Ball, J., Jones, J., Pattison, N., Monks, T., & Safer Nursing Care Study Group. (2020). Nursing workload, nurse staffing methodologies and tools: A systematic scoping review and discussion. International journal of nursing studies, 103, 103487.
https://doi.org/10.1016/j.ijnurstu.2019.103487

Patterson, J. (2011). The effects of nurse to patient ratios. Nurs Times, 107(2), 22-5. https://www.semanticscholar.org/paper/Large-city-hospital-%E2%80%93-A-%26-E-1-%3A-3-%2B-in-charge-%2B-1-%3A/48c091882cc67ffa0f6eba066f90265481395516?p2df

Serratt, T., Harrington, C., Spetz, J., & Blegen, M. (2011). Staffing changes before and after mandated nurse-to-patient ratios in California’s hospitals. Policy, Politics, & Nursing Practice, 12(3), 133-140. https://doi.org/10.1177/1527154411417881

Stimpfel, A. W., Fatehi, F., & Kovner, C. (2020). Nurses' sleep, work hours, and patient care quality, and safety. Sleep Health, 6(3), 314-320.
https://doi.org/10.1016/j.sleh.2019.11.001

Tevington, P. (2011). Mandatory nurse-patient ratios. Medsurg Nursing, 20(5), 265. https://search.proquest.com/openview/7fb2f4d034bc2efca42490c3ba1259f7/1?pq-origsite=gscholar&cbl=30764.