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Nurse to patient ratio is probably one of the most talked about issues in nursing. And apparently, it’s also one of the most common reasons why nurses leave the profession. When an institution suffers from short staffing, bad things start to happen. Nurses become grumpier and the quality of care they deliver decreases. Infections increase and patients stay longer in the hospital. These things don’t only affect nurses and patients; they can be bad for the health institution, too.
The Problem Worsens
There are tons of things that force nurses to hang their nursing caps
and just quit work. Bullying, burnout, and poor working conditions are
probably some of the reasons you are already familiar with.
These things easily make one out of five fresh nurses quit the
profession within their first year of getting a license. One out of
three, on the other hand, quit within the first two years of starting
work.
With more nurses quitting work, most
institutions require nurses to take longer shifts, reduce their off days
and take on more patients than necessary. One good reason is that
institutions don’t see hiring more nurses as cost-effective.
In reality, however, they actually end up spending more in addressing
the poor outcomes of short staffing and poor nurse-patient ratio.
What Is The Correct Nurse-Patient Ratio?
The American Nurses Association advocates for a legislative model
wherein nurses have the autonomy to create a staffing plan that will
meet the demands of their units and patients. This approach allows for a
staffing plan that’s flexible and can be adjusted based on the
following:
Number of admissions
Minimum number of nurses
Staffing level advised by specialty nursing organizations
Number of discharges and transfers
The level of education, training and experience of the staff
The intensity of patient needs
Unit geography and availability of technology
Patient numbers
Availability of ancillary staff and other resources
In determining staffing ratios, it’s a good idea for institutions to
sit down with their nurses as they are the people who are in direct
charge of patient care. They have a realistic view of what goes on in
each unit and what problems they encounter.
What Does The Law Require?
In California, there are clearly and legally defined minimum nurse to
patient ratios that are supposed to be maintained at all times. For
example, for Intensive/ Critical Care, one nurse should only care for
two patients. The same ratio applies to Neonatal Intensive Care, Post
Anesthesia Recovery and Labor and Delivery. A 1:1 ratio applies for the
Operating Room and Trauma patients in the ER.
Apart from California, there are 14 other states in the country that
legally address nurse staffing. Seven of these states legally require
hospitals to have staffing committees that will take charge in creating
staffing plans and policies. This includes OH, OR, CT, NV, WA and IL.
Just recently, Democratic State Senator Mike Skindell reintroduced a
bill that mimics the California law on safe staffing. It mandates a 1:1
nurse to patient ratio in certain areas of the hospital as well as
prevents nurses from being overloaded and overworked.
The bill prohibits mandatory overtime as well as the use of cameras to
substitute for nurses. It also prohibits the layoff of supporting
personnel and practical nurses.
Why Does Proper Nurse To Patient Ratio Matter?
Proper nurse to patient ratio doesn’t only help achieve clinical improvements but it also offers economic benefits.
Here’s what adequate staffing can provide:
Decreased patient care cost related to readmissions from poor outcomes
Reduced medication errors
Decreased length of patient stay
Increased patient satisfaction
Reduced patient mortality
Safe staffing has also been found out to increase chances of stroke
survival. When there are enough trained nurses, patients have a better
chance of getting over the aftermath of stroke.
In the study, the addition of one trained nurse per 10 beds can reduce
patient death after a month by as much as 30%. After a year, chances of
death goes down by 12%.
What Can You Do?
Short staffing can be hard to deal with, particularly if you’ll be
dealing with the actual institution you are working for. There are,
however, a few things you can do to advocate safe staffing while staying
employed.
Use the SBAR method in communicating your ideas
The SBAR method simply refers to Situation, Background, Assessment,
Response. It’s a technique you can use to discuss staffing issues with
the management. You can start with your immediate superior since most
institutions follow a chain of command. Assess the response you get and
find out the next best person you can talk to in order to get a better
response.
Join nursing organizations
There are a couple of nursing organizations and groups that advocate
for nurses’ rights. If you happen to belong to a union, make sure that
your group is respectfully and positively working with your employer to
avoid any conflicts that can affect the nurses in your institution.
Update your skills
As short staffing continues to be a problem, you should be more
consistent in updating your training and improving your skills. This way
you’ll be able to provide the best care to your patients despite your
poor working conditions. It will also put you in the best position
possible to advocate for your rights as well as your patients
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