Nurse to patient ratio: how much is simply too much?

One of crucial topics discussed in the sphere of nursing is the increasing nurse-to-patient ratio. Overall, nurses across the country are being asked to take care of more patients at one time, and individual states or health care facilities are having to cope with this growing problem.

In most states, individual health care facilities have the flexibility to set their very own standards for secure staffing. Currently, 14 U.S. states have adopted some type of secure staffing laws (American Nurses Association, n.d.). However, in 13 of those states, laws only require the implementation of a general rate management plan, not regulation. California, an outlier, became the primary state to pass a law mandating a mean nurse-to-patient ratio in 2004 (Mark et al., 2013). Their standard is a mean of 1 nurse for five patients in medical-surgical wards.

Although California is the one state with such laws, increasingly more states are realizing how vital a secure nursing workforce is to each patient care and nursing success. In recent years, there was a brand new wave of support for state and federal minimum staffing levels for nurses. Research has shown advantages for each nurses and patients in California within the years after the state law went into effect, and lawmakers in Pennsylvania and Massachusetts have also recently considered codifying minimum standards for nurse staffing.

Why is the nurse-to-patient ratio vital?

A balanced nurse-to-patient ratio can result in many positive outcomes. Nurses, patients, and even healthcare facilities have found success using a secure nurse staffing method.

Nurses

When nurses have fewer patients to take care of at one time, they report higher levels of job satisfaction. A study published by the AFL-CIO labor union found that, unlike nurses studied in New Jersey and Pennsylvania, California nurses felt their workload was reasonable and led to raised care (AFL-CIO: Department of Professional Workers, 2011) . They also reported receiving appropriate support services, resembling nursing assistants. They even had time for brief breaks during their shift.

When nurses are deprived of this support and feel that unreasonable expectations are placed on them, they might experience a phenomenon called nursing burnout. According to RN Network, in 2018 as many as 62 percent nurses experienced symptoms of burnout (Cornwall, 2018). Nurses affected by burnout find it tougher to supply high-quality patient care and infrequently report strained work relationships.

Patients

The quality of patient care declines because the variety of patients under a nurse’s care increases. A study published within the journal found that unsafe staffing levels “are associated with increased mortality” of patients (Needleman et al., 2011).

In addition to the chance for the patient, satisfaction can also be vital. Where nurse-to-patient ratios weren’t well balanced, patients reported seeing nursing staff and facilities working poorly. A study published within the journal found that patients’ thoughts about hospital care were related to nursing staffing and quality of care (Aiken et al., 2018).

Hospitals

It may not seem to be it, but hiring more nurses can actually be profitable for healthcare facilities. A study published within the journal found that employing more nurses and lower nurse-to-patient ratios shortened patients’ hospital stays and helped save on medical costs (Dall et al., 2009).

As mentioned above, quality nursing care also improves the general perception of the hospital facility, in addition to outcomes for patients. The higher the nursing care, the higher the perception of the power.

What you may do about keeping your staff secure

Even in an adequately staffed hospital, there could also be days when the nurse-to-patient ratio is unbalanced. The nurse could have called in sick or seen more patients than usual. In each cases, a better nurse-to-patient ratio means nurses face the challenge of caring for more patients. We spoke to a pediatric nurse with years of experience who explained how drastic the divide is between a manageable nurse-to-patient ratio and a high ratio.

“When you have a small number of patients, you will likely have time to perform a full battery of vital signs and systems checks, administer all medications, and inquire about any requests or needs before leaving each patient’s room,” said Dawn D., RN. “When you have a larger number of patients, you have to decide what has the highest priority; Which patient needs your attention first?”

You probably won’t have any influence on the nurse-to-patient ratio in your facility. That’s why, based on Dawn, it is vital to play as a team.

“It’s rare for every nurse on your shift to have difficult patients,” she said. “When you see a co-worker struggling to keep up, offer to help. In turn, your co-workers will likely do the same for you when you have a busy day.”

There are also other ways to make an impact outside of the hospital setting. Nurses are playing an increasing role in policy as more states listen to the impact of nurse-to-patient ratios. In Tennessee, Tennessee Nurses Association formed a political motion committee (PAC) called the Tennessee Nurses Political Action Committee (TNPAC) to assist lobby the state legislature for nursing improvements. They also provide members with legislative updates as health care and nursing industry bills are passed through the Tennessee General Assembly. As a person, you may educate elected officials and lift awareness of nursing issues in your community, in addition to take a leadership role in your state’s nurse association.

Actively looking for solutions to the rising nurse-to-patient ratio could make a difference in your hospital and your community. If you should take a leadership role and make a positive impact, enroll at King University today online RN to BSN program. Our Christian faith-based program will teach you strategies to develop into a greater nurse so you may provide higher care to your patients. With transfer credits, you may complete this program in as little as 16 months, and with our online format, you may achieve your educational goals while balancing your busy life.

AFL-CIO: Department of Professional Workers. (2011). The impact of nurse-to-patient ratios: Implications of California’s nurse mandate for other states. Downloaded from https://dpeaflcio.org/programs-publications/issue-fact-sheets/impact-of-nurse-to-patient-ratios-implications-of-the-california-nurse-staffing-mandate-for-other-states/

Aiken, L., Sloane, D., Ball, J., Luk, B., Rafferty, A., & Griffiths, P. (2018). Patient satisfaction with hospital care and nurses in England: an observational study. (1). doi: 10.1136/bmjopen-2017-019189

American Nurses Association. (n.d.) Nursing staff. Downloaded from https://www.nursingworld.org/practice-policy/nurse-staffing/

Cornwall, L. (2018). RNnetwork’s 2018 Portrait of the Modern Nurse study. Retrieved from https://rnnetwork.com/blog/rnnetwork-2018-portrait-of-a-modern-nurse-survey/

Dall, T., Chen, Y., Seifert, R., Maddox, P., & Hogan, P. (2009). Economic value of skilled nursing.(1). doi:10.1097/MLR.0b013e3181844da8

Mark, B., Harless, D., Spetz, J., Reiter, K. and Pink, G. (2013) California minimum nurse staffing laws: results from a natural experiment. (2). doi: 10.1111/j.1475-6773.2012.01465.x

Needleman, J., Buerhaus, P., Pankraz, V., Leibson, C., Stevens, S., & Harris, M. (2011). Nursing staffing and mortality in an inpatient hospital setting. (11). doi: 10.1056/NEJMsa1001025