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Nurses in California: Nurse Patient Ratio

Hello, I am a nursing student in Florida. My husband is in the air force and we are both originally from California, so after I graduate with my RN and my husband gets out of the air force we are going to be moving back to California where all our family is. My teacher had mentioned that nurses in California had a max of 4 patients per shift. Is this true? I couldn't find anything about it on the internet. Is this only for certain units? Thanks for any info :)

Pangea Reunited, ASN, RN

Has 6 years experience.

It's especially tough for new grads to find work in California. What area will you be moving to? Med/surg ration is 1:5. I'm not sure what it is in other areas.


Specializes in Vents, Telemetry, Home Care, Home infusion. Has 43 years experience.

There are MANY threads + posts at allnurses regarding California nurse -patient ratios --use our search engine spyglass at top of page to locate. Allnurses guide Herring_RN has written extensively on this topic

Here are a few of these numerous threads:

What is the nurse-patient ratio where you work?

California RN-staffing ratio law is threatened.

15 Years of California's Nurse to Patient Ratios!

State-Mandated Nurse Staffing Levels Alleviate Workloads, Leads to Lower Patient Mortality

Nurse Patient Ratio -has article links re benefits: save patient lives and cost effectiveness

Ratio requirements:

California RN Staffing Ratio Law

CA Board of Health: Nurse-to-Patient Staffing Ratio Regulations

Edited by NRSKarenRN

Ive heard that. Thankfully, I will work here for about 1-2 years as an RN before we move back. San Diego area. I am also bilingual so I think that will help. Gotta learn medical Spanish though.

herring_RN, ASN, BSN

Specializes in Critical care, tele, Medical-Surgical. Has 48 years experience.

Here is more information about our ratios:


Here are some peer reviewed research studies showing that staffing ratios safe lives and are cost effective:

Hospital Nursing and 30-Day Readmissions Among Medicare Patients With Heart Failure, Acute Myocardial Infarction, and Pneumonia

Medical Care: January 2013

Improving nurses' work environments and staffing may be effective interventions for preventing readmissions. Each additional patient per nurse was associated with the risk of within 30 days of readmission for heart failure (7%), myocardial infarction (9%), and pneumonia (6%). In all scenarios, the probability of patient readmission was reduced when nurse workloads were lower and nurse work environments were better.”

State-Mandated Nurse Staffing Levels Lead to Lower Patient Mortality and Higher Nurse Satisfaction

Agency for Healthcare Research and Quality, September 26, 2012

The California safe staffing law 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.

Nurse Staffing and Inpatient Hospital Mortality

New England Journal of Medicine, March 17, 2011

"Studies involving RN staffing have shown that when the nursing workload is high, nurses' surveillance of patients is impaired, and the risk of adverse events increases." "… We found that the risk of death increased with increasing exposure to shifts in which RN hours were 8 hours or more below target staffing levels or there was high turnover. We estimate that the risk of death increased by 2% for each below-target shift and 4% for each high-turnover shift to which a patient was exposed."

Implications of the California Nurse Staffing Mandate for Other States

Health Services Research, August 2010

The researchers surveyed 22,336 RNs in California and two comparable states, Pennsylvania and New Jersey, with striking results, including: if they matched California state-mandated ratios in medical and surgical units, New Jersey hospitals would have 13.9 percent fewer patient deaths and Pennsylvania 10.6 percent fewer deaths. Because all hospitalized patients are likely to benefit from improved nurse staffing, not just general surgery patients, the potential number of lives that could be saved by improving nurse staffing in hospitals nationally is likely to be many thousands a year,” according to Linda Aiken, the study's lead author. California RNs report having significantly more time to spend with patients, and their hospitals are far more likely to have enough RNs on staff to provide quality patient care. Fewer California RNs say their workload caused them to miss changes in patient conditions than New Jersey or Pennsylvania RNs


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