Nurse to patient ratios: Leaders have their work cut out for them

When it comes to nurse to patient ratios, it’s not just about numbers.

Leaders, assessing how to ensure you have the best nurses in the right numbers rendering the best care to your patients is something you take very seriously. Advocating for the needs of your nurses is something you take just as seriously. Right now is the perfect time to think again about how to do both.

Good nurse to patient ratios is a goal the nursing profession has worked on from its earliest days. But for too long, we’ve struggled with the numbers.

The work involved in establishing the right nurse to patient ratios, measuring their impact on safety and quality, and finding ways to pay for them have been topics of unending discussion and debate — and not just in nursing.

Experts from other healthcare arenas, as well as the government, have weighed in on the issue and made their voices heard. With California leading the way, more than a dozen states now have laws requiring nurse to patient ratios.

Many research studies on nurse to patient ratios have been conducted, with one after another demonstrating improved outcomes in the presence of adequate ratios and negative outcomes in their absence.

Questions and differing opinions

Nursing professionals believe adequate staffing numbers are at the heart of care quality and patient safety. Many, but not all, in the profession believe mandated ratios might be the way to uniformly ensure this.

The topic leads to many questions such as:

  • What are the best measurements and instruments to use in coming up with nurse to patient ratios?
  • Must everyone measure acuity the same way with the same instruments?
  • Are there variables that might call for different measurements from organization to organization?
  • Must everyone have uniform ratios in similar patient populations, or can they differ from state to state?
  • How many organizations have the staff needed to meet uniform ratios or have the budgets to pay for them?

The consensus in leadership is that patients deserve to be cared for by nurses with manageable assignments, and nurses deserve assignments they can safely handle. There are standards in place based on the premise that like ratios equal like care quality.

Many of us tend to focus on the numbers, but are they proof of better outcomes or just predictors?

There are many variances among patients with similar diagnoses. And all patients and all care units are not alike. So should they use the same staffing ratios?

And what about differences in staff skill levels, education and experience?

These are the questions that continue to prompt study and research.

Advocacy: What you can and must do

Nurses have always been good at collaborating with and for one another, and we must continue to advocate for both patients and staff. Nurse to patient ratios and schedules are linked to patient safety, but they’re also linked to the staff safety. Illness, absenteeism, stress, fatigue and burnout are just some of the negative outcomes of inadequate staffing nurses deal with.

Staffing is under continued scrutiny, and ratios are …read more

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