Metaparadigm of Nursing-Does Safe Staffing Save Lives?

In 2004, California became the first state to establish minimum nurse-to-patient staffing requirements in acute-care hospitals. As a nursing student, the debate whether mandated or non-mandated Nurse to client ratio in the clinical setting is not an easy topic to explain.


There are many arguments surrounding this health care issue. With the coming age of the "baby boomers" many analyst predict that the current method of Nursing care ratio and current number of available nurse's in the US will not meet the coming demand of clients. It has been estimated that, "by 2025, the United States may need 500,000 more registered nurses than it has."(Gever, 2009) Many argue that with a balanced client to nurse ration, there would be better quality nursing care, less medical errors, and greater retention and satisfaction of experienced RN's.

According to the ANA (American Nurses Association) they claim that the current method of client to nurse staffing has an effect on the current overall American nursing shortage. Many of the issues presented by the ANA include significant relationships between workload stress and fatigue, lower nurse-to-patient ratios, higher levels of reported dissatisfaction and burnout, too little time spent with clients, hospitals having difficulty keeping experienced nurses on staff, as well as retaining new graduates. The ANA also states that the number of new graduate nurses who leave within the first year is as high as 50% of new hires. The ANA also reports that nearly 50% of US hospital nurses report job dissatisfaction and high burn rates.

Do I feel that all states should have some type of nurse patient ratio? I feel that as a nurse PCT's and CNA's should be staffed accordingly. Many times have I observed RN's with 5 to 7 patients and expected to do total care on these clients without any assistance. Situations like these are very burdensome and disheartening to veteran Nurses. The answer to this question really doesn't matter what I think, but rather what action each State Legislature takes. According to the Code of Federal Regulations (CFR), 42 Code of Federal Regulations (42CFR 482.23(b) requires hospitals certified to participate in Medicare to "have adequate numbers of licensed registered nurses, licensed practical (vocational) nurses, and other personnel to provide nursing care to all patients as needed". (ANA, 2008) Each state has its democratic process of handling its internal issues. In Florida it's up to our Legislature to act upon whether this act be amended into the states constitution. Currently the Florida Legislature has not adopted a set staffing ratio for Nurses; however, The American Nurses Association (ANA) and State Nurses Associations are promoting legislation to hold hospitals accountable for reliable nurse staffing plans.

Works Cited

ANA, Initials. (2008, June). Improving the quality of care for millions of americans. Retrieved from

Gever, M. (2009). Improving the quality of care: the continuing debate over nurse-patient ratios. National Conference of State Legislatures, 30(535), Retrieved from

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