Mandating nurse to patient ratios

[GGLynnRN, ASN, BSN, RN]

Hi! I was curious to hear opinions on mandating nurse to patient ratios. Do you think this may be part of the solution in reducing nursing shortage? Do you think it would improve care and prevent burnout? Interested and open to views from all nursing specialties. Please give reasons for your opinions. Thank you.

[LibraNurse27, BSN, RN]

I am in CA, the only state with mandatory patient ratios. I think it makes a huge difference in preventing the terribly unsafe situations described on all nurses, like 4:1 ratio in ICU or 14:1 in Med/Surg. In my experience it prevents the worst of the worst, but doesn't make things perfect because management finds ways to cut other resources.

For example we often did not have a unit clerk so were expected to answer the phones and call lights, do all the paperwork, etc. We had no CNAs, no transport, sometimes no RT. We were always supposed to be "in ratio" but in reality we wouldn't be when 2 nurses had to leave the floor for extended time periods to bring bed bound/monitored pts to CT or MRI. But, I heard some hospitals in CA have the ratios and the support staff. I think it is still better than no ratios, because I bet some places have crazy ratios and still don't have other resources! It is definitely worth fighting for. 

P.S. There have been studies indicating lower patient mortality rates when safe ratios are in place. Makes sense! More time with each pt gives the nurse time to review incoming labs, thoroughly assess pts, check on them more often, and give better care in general = )

[GGLynnRN, ASN, BSN, RN]

Thank you for responding! Do you find having the ratio and not having unit clerks, RTs and CNAs just as stressful? I definitely think a ratio is a step in the right direction, and believe it will eventually spread across the United States-may take years, but nurses are having more and more duties put upon them and I do not foresee that ending.

[GGLynnRN, ASN, BSN, RN]

I too have read studies showing lower patient mortality rates with lowered nurse to patient ratios. I have had to hit the ground running beginning of shift right after “an update hand off”. I like to read the history, orders etc and reasons for admission. When my unit is getting slammed with admits, and I have not had time to learn about them, that is running somewhat blind IMO. Especially when we have to hurry up, get orders and get them on unit. I know this will happen, lately-it is every day. I find staffing matrices infuriating because we and patients are all numbers and more is placed on nurses and techs. I know there are budgets, but patients are sicker and sicker.

[LibraNurse27, BSN, RN]

I also worked in another state and had 7 patients on days for med/Surg and up to 9 on nights. I found it more overwhelming than California. We did have CNAs who were awesome and ran the whole shift, but not enough of them. In an ideal world nurses and patients would not be numbers as you said, and we would have enough nurses on the floor PLUS enough support staff.

I can’t imagine a business telling its employees there is no receptionist and to please do the job of the receptionist in addition to their own job and for no extra pay! Imagine if that happened in an office setting. 

[OUxPhys, BSN, RN]

It's part of the solution. Other part's are pay, work/life balance, benefits.