State-Mandated Nurse Staffing Levels Alleviate Workloads, Leading to Lower Patient Mo - page 3

by herring_RN 8,900 Views | 29 Comments Guide

As mandated by State law, the California Department of Health Services requires acute care hospitals to maintain minimum nurse-to-patient staffing ratios. Required ratios vary by unit, ranging from 1:1 in operating rooms to 1:6... Read More


  1. 0
    Nothing is perfect. It is good to work for fines and all that can be done to improve patient care.

    Meanwhile our ratios continue to improve nursing care.
    State-Mandated Nurse Staffing Levels Alleviate Workloads, Leading to Lower Patient Mortality and Higher Nurse Satisfaction

    As mandated by State law, the California Department of Health Services requires acute care hospitals to maintain minimum nurse-to-patient staffing ratios. Required ratios vary by unit, ranging from 1:1 in operating rooms to 1:6 on psychiatric units.

    The legislation also requires that hospitals maintain a patient acuity classification system to guide additional staffing when necessary, assign certain nursing functions only to licensed registered nurses, determine the competency of and provide appropriate orientation to nurses before assigning them to patient care, and keep records of staffing levels.

    To assist with compliance, the legislation made grants available to hospitals and provided funding to college and university nursing programs to increase the pipeline of new nurses.

    The legislation has increased nurse staffing levels and created more reasonable workloads for nurses in California hospitals, leading to fewer patient deaths and higher levels of job satisfaction than in other states without mandated staffing ratios.

    Despite initial concerns from opponents, the skill mix of nurses used by California hospitals has not declined since implementation of the mandated ratios. ...

    http://innovations.ahrq.gov/content.aspx?id=3708
  2. 2
    Hospital nurse staffing ratios mandated in California are associated with lower mortality and nurse outcomes predictive of better nurse retention in California and in other states where they occur.

    Implications of the California nurse staffin... [Health Serv Res. 2010] - PubMed - NCBI
    lindarn and tewdles like this.
  3. 6
    Once again, nurses have no one to blame for allowing hospitals to break the staffing ratios.

    You have 16 patients, which means that you need four nurses, but you only have three because some one called in sick? Assign the three nurses and inform administration that four patients do not have a nurse. Do not give the other nurses five patients. When the four patients call for their nurse, you inform them that you were not given enough nurses and administration will not call in another nurse. Therefore, they have NO nurse today. Give them the administrations phone number, the CEO, hospital attorney and law firm, and also the local TV news station and paper, and you will see how fast you get adequate staffing.

    Nurses are letting them get away with it. Period. Reject a 5th patient. Period. They are breaking ratios because you let them. If you have not unionized yet, what are you wating for? To win the lottery?

    Nurses need to, "just say NO"!

    JMHO and my NY $0.02.

    Lindarn, RN, BSN, CCRN
    Somewhere in the PACNW
    sneeds, brandy1017, kabfighter, and 3 others like this.
  4. 3
    Short staffed nurses and million dollar administrators...I wonder why our outcomes are in the toilet?
    sneeds, lindarn, and herring_RN like this.
  5. 0
    sounds great to refuse the fifth pt- but that means then the nurse with the assignment going off with no one to report to is going to be mandated then, as, im sure, the upper levels know that we "can't abandon our patients"
    What if you/me are that nurse that day??

    They know they've got us all by the "snarkles"

    I would love it though if the media was brought in. Might be worth losing the job over
  6. 2
    The charge nurse gets report on everyone. Refuse mandatory overtime. Call administration and get the DON to come and take care of patients. After all, they are nurses, if in name only.

    Until nurses start to REFUSE, we will forever be taken advantage of. Again, start to contact the media, and get the public involved. The squeaky wheel gets the grease.

    JMHO and my NY $0.02.

    Lindarn, RN, BSN, CCRN
    Somewhere in the PACNW
    sneeds and tewdles like this.
  7. 4
    What many nurses do when their hospital violates the law: [COLOR=#003366]http://www.nationalnursesunited.org/...nsemar2309.pdf[/COLOR]

    The same information in a different format: [COLOR=#003366]http://nurses.3cdn.net/dfe19c41cd5c7a4ad3_nim6bxw3p.pdf[/COLOR]

    In my experience and that of friends hospitals do staff to the minumum ratio. They often fail to provide additional staff for higher acuity and/or do not provide an RN to take report and take over your assignment when you go on a meal or rest break. Where we are united they do the right thing for a while and then try again.

    Nurses do get press:

    Protestors say Glendale Memorial Hospital plans to lay off 41 employees - Glendale News-Press

    Kaiser nurses picket in Vacaville, Vallejo over staffing issues - The Reporter
    Last edit by herring_RN on Feb 7, '13 : Reason: typo
    sneeds, tewdles, Esme12, and 1 other like this.
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    Unfortunately, in today's society of gluttony and greed.....the hospitals and their million dollar NON MEDICAL CEO's can no longer be trusted, nor have the morality, to make decisions on behalf of the patients. Profit margins, exclusive benefits, huge bonuses have replaced caring about the patients while touting "satisfaction" surveys as the "Gold Standard". Most consumers of healthcare think that because they are "satisfied" with all the bells and whistles means that they are getting good care.

    Years ago when I started...we had huge patient ratios. I know that the patients are "sicker" but I remember on nights, on a surgical floor there was 2 RN's, 2 aides, and maybe an LPN (IF the acuity was high) for 32 patients on nights. ON post op night #1 to 4 were brutal with all the NGT's, drsgs, and all patients had multiple drains. All chole's were open, all hysts were open. Multiple JP's and T-tubes were the norm.....not the exception. 12 pateints for drsgs, pain meds IV's and IV antibiotics.

    We worked so hard as a profession at proving that staffing with RN's/LPN's meant healthier patients, shorter stays, and less complications. What happened to all that evidence? What happened to direct patient contact and care? What happened to primary care nursing?

    There was a time I would not have supported nurses unionizing/collective bargain. Now, I believe it will be the only saving grace.
    sneeds, tewdles, laborer, and 5 others like this.
  9. 2
    Me too. There are too many safety violations, labor law violations and incompetence in management...unions are essential for advocacy for healthcare workers and ultimately quality patient care.
    sneeds and herring_RN like this.
  10. 2
    The world of for profit health care, where profit matter more than patients.
    sneeds and herring_RN like this.


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