When most people go into the hospital, they expect to receive quality medical care and leave a few days later on the path to a full recovery. Most of them don’t anticipate poor care,including everything from slow response times to medication errors.
According to some nurses, the fact that many hospitals are understaffed is actually putting patients in danger. Although healthcare facilities are reporting a nursing shortage, thanks to a lack of properly trained nurses or the funds to hire an adequate number of nurses, a growing number of nursing organizations are calling on the government to legislate minimum staffing ratios.
In 2004, California was the first state to enact such laws, and since then, 15 additional states and the District of Columbia have passed laws regarding minimum staffing levels in hospitals. But few have gone as far as to establish specific, mandatory ratios, citing the nursing shortage and the increased costs associated with such measures. Despite the objections, nurses all over the country in every specialty have been fighting for staffing ratios for several reasons.
MORE NURSES MEAN BETTER OUTCOMES
When arguing for mandatory ratios, nurses point to statistical evidence showing that having more nurses on the floor decreases the likelihood of adverse events and improves the quality of patient care. A 2011 study sponsored by the AFL-CIO indicated that after the mandatory staffing ratios were passed, the likelihood of a patient death was significantly decreased, and the actual number of surgical deaths and deaths due to complications after hospitalization, such as pneumonia also decreased measurably. Nurses point to these findings as evidence that having an adequate number of nurses caring for each patient allows them time to completely care for each patient; they are also able to notice and address potential problems quickly.
STAFFING RATIOS MEAN HAPPIER NURSES
Despite the vast majority of nurses reporting a great deal of satisfaction with their career choice, burnout is still a significant problem. When a single nurse is charged with caring for a number of gravely ill patients, the stakes are high, and many nurses work long hours with limited breaks or “down time.” Supporters of ratios argue that when hospital units are adequately staffed, nurses are able to confidently do their jobs and take the mental breaks that are necessary for excellent care. Nurses in states with mandatory ratios report greater satisfaction with their work; it’s not uncommon for nurses in these states to seek additional education as well, such as enrolling in an online RN to BSN program.
SICKER PATIENTS NEED MORE CARE
Our population is aging, and the acuity of patients of all ages increases all the time. Diseases and conditions are more complex than ever, with many patients dealing with chronic conditions that require advanced care. Changing diseases and treatment protocols require advanced training and education or experienced nurses. While many healthcare facilities have shifted some responsibilities to technicians or other professionals, those lower-level providers cannot provide the same level of care as an experienced nurse. Nurses argue that with minimum ratios, experienced nurses will always be the ones providing the bulk of patient care.
MORE NURSES EQUAL LOWER HEALTHCARE COSTS
While nurses acknowledge that mandatory staffing ratios will marginally increase hospital staffing budgets, they also point out that adequate staffing will lower healthcare costs overall, primarily because adverse events such as pressure ulcers, patient falls, pneumonia and infections are less likely to happen when nurses aren’t spread too thin. For example, a study by the Agency for Healthcare Research and Quality found that pneumonia increases treatment costs by almost $30,000, while pressure ulcers cost nearly $8.5 million per year to treat — costs that could be significantly reduced by mandatory staffing ratios.
NURSING RATIOS WILL HELP END THE NURSING SHORTAGE
According to the National Nurses Organizing Committee, in the years since California’s law was enacted, the number of licensed RN’s in California has increased by more than 100,000, and applications to nursing school have also increased. They argue that the ratios make nursing a more attractive career option for new nurses, and that the ratios force hospitals to hire more nurses. With the Bureau of Labor Statistics predicting the need for more than a million new nurses in the next decade, anything that can be done to ease the shortage is important, supporters argue.
Not everyone is in favor of nursing ratios; many hospitals and healthcare systems claim that the laws increase healthcare costs and do not measurably improve patient outcomes. That is not stopping nurses though, who are working in states around the country to protect both their profession and their patients.
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