Nurses rally for national law mandating ratios for patient care in hospitals

DLS_PMHNP, MSN, RN, NP · Dec 31, 2009

....hospitals require nurses to develop treatment plans that assess the individual needs of a patient. The groups said that these plans are flexible, unlike mandated ratios, and allow for nurses to adjust staffing for patients whose conditions suddenly change.

This is the way it should ALWAYS be... However.... acuity levels continue to rise and we continue to drown. There is MUCH more to staffing levels than "ratios." I wish our hospital admins understood the concept of "acuity levels". They don't seem to give a rat's ass that pt safety is continually compromised with their ridiculous staffing models.

I'm so glad our union contract negotiations begin next week. This is on our front burner.

Great article, thanks for sharing.

Diane ,RN

Not_A_Hat_Person, RN · Dec 31, 2009

I'd like to see mandatory ratios for LTC nursing.

allnurses Guide · Dec 31, 2009

I'd like to see mandatory ratios for LTC nursing.

Me too. Federal regulatione are woefully unsafe.

It's like they were written for walking, talking patients who can feed themselves and need minimal care.

xtian0143rn · Dec 31, 2009

about 8 yrs ago when i went to australia, my sister in law works in a hospital kitchen and when we went there, their nurses has pickets and rallies going on and said they were fighting for nurse patients ratio and one of the demands they were asking is to have 1:4 ratio if the nurse gets more than 4 he/she is entitled for additional payment or sort of like a professional fee, i wonder if that would happen here i'll be happy to work in LTC where i have 15-20 sometimes more patient, though tired atleast well compensated.

ky_grl82 · Dec 31, 2009

When I started looking into nursing I was so shocked that there were no legal ratios for patients to nurses. I used to work in a daycare center and there are manditory ratios there to make sure the children are kept safe such as 10 2-year-olds to one teacher (which is way too many, let me tell you). I am not a nurse yet but I am sure I will find out that I will still feel that ratios should be manditory.

nerdtonurse?, BSN, RN · Dec 31, 2009

The hospitals locally have started saying (to head off any calls to our senators, I guess) that if they get mandated nursing staff, they are going to cut everyone else, including the cleaning crew. I wonder if they did that in California? If you're from California or somewhere else where they had the mandated ratios, did the hospitals kick out the secretaries, techs and cleaning staff?

Lacie, BSN, RN · Dec 31, 2009

Florida is also working on manadatory staffing ratios and I was shocked to see the FNA is "against" this proposal. People wonder why I am not in this association lol. They need mandatory staffing ratios for all aspects of nursing not just hospitals. They need them for LTC and chronic Dialysis units also. There are no state mandates in florida for dialysis whic leaves alot of room for continued abuse and it gets abused over and over.

nminodob · Dec 31, 2009

I am a Calif nurse. Yes, when layoffs come around the CNAs are cut. This is because there are no laws protecting them. Of course, this makes our job harder. But think about it: if there were no staffing ratios in place and the economy got worse, administration would cut these same "ancillary" workers AS WELL AS nurses. And how would working conditions be then? - Higher ratios as well as no "ancillary staff."

Another point is that with the laws denying facilities reimbursement for pressure ulcers and falls, it will hit the administrators in the pocketbooks if they don't keep the environment clean and uncluttered and properly staffed with nurse assistants. Not to mention the push for "magnet" status - hospitals that aspire to this credential will never cut housekeeping to the point where the facility looks trashed!

In the end, these claims I believe are false and just administrator's tactics to weaken nursing's resolve to better their profession.

nicurn001 · Dec 31, 2009

The three Arizona groups issued a joint statement in response to the rally, saying in part: "Ratios undercut the skills, knowledge and experience of nursing professionals. Ratios are inflexible numbers that do not take into account individual patients’ needs and different levels of acuity and complexity among patients."...

Acuity tools are also inflexible numbers , that are created arbitrarily by individual hospital groups . They are used to maximize the patient load of individual nurses , whilst at the same time minimizing the number of nurses needed upon a floor.

Acuity tools are ( at least in the hospital I work in ) used in conjunction with the ratios law . For example on the Telemetry floor the ratio is 1 Nurse to a maximum of 4 patients per assignment .So even if the hospitals acuity tool says that the level of care would allow 5 patients in the assignment , the assignment cannot be changed to 5 ,because then it would be out of ratio . Conversely , if the patients acuity increases , then the number of patients in the assignment is reduced ( even if the administration is tempted to ignore it's own staffing tool , the prospect of a litigants attorney finding that the assignment was overloaded according to their own tool , keeps administrations honest ) .

So the arguement given by the three Arizona groups is poor ( almost as poor as my english at the moment , worked last night and my brain is running on fumes at the moment )