Nurse To Patient Ratios

allnurses Guide · Aug 7, 2013

Nurses union to file ballot question asking voters to limit number of patients

The state's largest nurses union intends to ask voters to do what the Legislature has refused to do: establish statewide limits on the number of hospital patients assigned to each nurse. ...

... The union believes workload limits are a pivotal issue now that hospitals are under growing pressure to control the cost of care. Some have laid off nurses or not replaced those who have left their jobs. The union's campaign urges patients to "just ask . . . how many patients is your nurse caring for today?'' ...

... Each hospital would be required to develop a "patient acuity system'' that would describe circumstances under which specific patients would require more intensive nursing care, such as the use of specialized equipment.

Nurses involved in the ballot initiative said the number of patients that nurses are expected to care for now varies widely among hospitals. Nurses may not have time to sit by a dying patient or adequately educate a patient before discharge about medications and follow-up appointments-a lapse that can lead to an expensive hospital readmission.

"That education involves a lot of one-on-one time,'' Kelly-Williams said. "It will save health care dollars to ensure patients are taken care of the right way the first time.'' ...

... Nicholas disputed the union's assertion that hospitals have too few nurses. The hospital association runs a website that lists each acute care hospital and the number of nurses and other staff assigned to different units. She said this provides a high level of transparency for patients about their nursing care.

"There is nothing to fix there,'' she said. ...

http://www.bostonglobe.com/lifestyle/health-wellness/2013/08/03/mass-nurses-union-file-ballot-question-asking-voters-limit-number-patients-per-nurse/NFW7GUcADcf1mUTp9UPc3O/story.html

TaylorMaidRn · Aug 16, 2013

I love seeing non-clinical personnel make decisions for a hospital on what would be best for their patients regarding nurse-patient ratios! Makes perfect sense? :roflmao:

allnurses Guide · Aug 22, 2013

lindarn · Aug 22, 2013

I will again state my beliefs about staffing ratios. In Washington State, TEACHERS decided how many students were safe for one teacher to handle in a classroom. Therefore, TEACHERS have the power, and authority to decline to add more students to their classroom, if they are at their max number.

Also, if there is a student who has special needs, what ever that special need might be, that student is counted TWICE. If the maximum number of students a teacher can have is 25, if they have a special needs student, that child is counted twice. That reduces the maximum number of actual students that a teacher can have in his/her, classroom to 24.

That is because it was determined that special needs students will need more assistance from the teacher, and it is necessary to reduce the number of regular students in the teachers' classroom, so the teacher has time for the other chidren as well. Imagine that!! Special needs (aka acuity, in the medical world), take more time to care for that someone who does not have exceptional needs!!

Why is that not a concept that hospital administrators want to understand? No one ever died because they could not do long division, or diagram a sentence. Patients all over are suffering due to nurses being overworked by having too many patients to be responsible for, in hospitals, and especially, in nursing homes.

THAT is the point that nurses need to make to the administrators. Notice that Hospitals and nursing home owners are big proponents of, "Tort Reform". In other words, they want to limit how much patients can recover in malpractice suits. Yet, they want to punt the responsibility for patient safety to nursing, who they want to take as many patients as they can push on them, regardless of how safe it is. Then if/when, something goes wrong, they do not hesitate to throw the nurse under the bus, and make him/her, the fall guy for policies they cannot change or control.

JMHO and my NY $0.02

Somewhere in the PACNW

allnurses Guide · Aug 22, 2013

Boston Globe editorial:

Nurse ratios shouldn't be set by law-or the ballot box
August 22, 2013
...The union's plan would impose legal limits on the number of patients a nurse could care for in various hospital settings: no more than four on regular medical or surgical floors and a maximum of two in critical-care units. In emergency departments, the ratio would vary from one to three patients per nurse, depending on their conditions. Hospitals would be forbidden from meeting those staffing levels by reducing other members of the health care team.
In other words, the ballot question would lock hospitals into rigid requirements not just for nurses but for other medical staff as well. Hospitals would be subject to a $25,000 fine for each day they failed to comply with the law. ...
... The nurses' association has been pushing mandatory staffing ratios for more than a decade. It's telling that, despite the Legislature's heavily Democratic makeup, such a law has never made it to a governor's desk.
It's a particularly bad idea now.
As health care reform goes forward, there will be a need for flexibility and creativity in the way hospitals deliver care. Imposing strict nurse-to-patient ratios and big penalties for their violation is counterproductive.
In that light, it's noteworthy that the American Nurses Association does not support mandatory ratios. ...
... Legislators should stand firm against this effort by the nurses' association. And if the group does take the issue to the ballot, voters should be wary as well. ...
http://www.bostonglobe.com/opinion/editorials/2013/08/22/nurse-patient-ratios/c9uuJvLbM3klZLcxicW0bM/story.html

allnurses Guide · Aug 22, 2013

Nurses in New South Wales, Australia demanding safe staffing:

Nurse-patient ratios on conference agenda
NSW nurses are set to step up their demands for more workable staff-patient ratios at the state's hospitals during their annual conference in Sydney.
... Last month, thousands of nurses from 180 NSW hospitals voted during a state-wide strike to launch a fresh round of industrial action in their fight for patient-staff ratios.
NSWMA general secretary Brett Holmes says the issue will be front and centre at the conference, particularly when NSW Health Minister Jillian Skinner delivers an address on Friday morning.
"The ratios we are seeking will, at a reasonable cost, bring a greater level of stability and reliability to such situations and improve patient experiences and outcomes across the public health system," Mr Holmes said. ...
http://news.ninemsn.com.au/national/2013/08/07/11/16/nurse-patient-ratios-on-conference-agenda

allnurses Guide · Aug 27, 2013

Nurses have good reason to fight over staffing ratios

August 26, 2013

As a registered nurse for 25 years working in a community hospital south of Boston, and an active member of the Massachusetts Nurses Association, I was enraged by your Aug. 22 editorial "Nurse ratios shouldn't be set by law-or the ballot box."

Nurses have been fighting for safe staffing ratios for a long time. We feel that taking the issue to the people of the Commonwealth is a way to get this done. We have many accounts of unsafe staffing conditions at hospitals in Massachusetts, and now that the for-profits have moved in, the situation is only getting worse.

Staffing has been squeezed in a vise grip, and patient loads are dangerously excessive. Our initiative is even more critical for patients in light of health care reform, as we see the health care landscape ever-changing. Patients are being put through the grinder, only to be discharged too soon and then readmitted...

http://www.bostonglobe.com/opinion/letters/2013/08/25/nurses-have-good-reason-fight-over-staffing-ratios/WO0EdHyFfrq5Bi1e3pg90O/story.html

allnurses Guide · Sep 5, 2013

Safe Patient Limits Ballot Initiative Certified by Attorney General Measure will Protect Patients and Improve Care in Massachusetts Hospitals

Thu Sep 5, 2013

As hospitals focus on profits, patients are being put at risk because they are sharing their nurse with too many other patients, resulting in costly and dangerous medical complications and readmissions

CANTON, Mass., Sept. 5, 2013 /PRNewswire-USNewswire/ -- The Patient Safety Act today received certification from the Massachusetts Attorney General's office. The Patient Safety Act will dramatically improve patient safety in Massachusetts hospitals by setting a safe maximum limit on the number of patients assigned to a nurse at one time, while also providing maximum flexibility to hospitals to adjust nurses' patient assignments based on the specific needs of the patients. ...

http://www.reuters.com/article/2013/09/05/mna-ballot-initiative-idUSnPNDC74854+1e0+PRN20130905

allnurses Guide · Sep 17, 2013

New South Wales, Australia:

Nurses join forces to fight health cuts
... "Nurses from hospitals across the region, including Shellharbour, Shoalhaven and Wollongong, have been out in force collecting signatures and the community response has been overwhelming," Ms Tilden said.
"Across the Illawarra more than 1500 signatures have been collected, which will go towards the state target of 100,000 signatures. We need at least 10,000 signatures to get the issue debated on the floor of Parliament."
Ms Tilden said the introduction of ratios in 2010 for major metropolitan public hospitals in NSW, including Wollongong, had been a great advance for patient care.
She said there was no reason why those ratios should not be extended to regional and rural hospitals where nurses were forced to deal with five or six patients at once.
"We are campaigning for a ratio of four patients to one nurse in general wards, and three to one in emergency departments, across the state," she said. "It's about safety for patients, and safety for nurses."...
Nurses join forces to fight health cuts | Illawarra Mercury

allnurses Guide · Sep 18, 2013

Great Britian

Hospital wards should publish ratio of staff to patients every day, say MPs
MPs on health committee say hospitals must make 'commitment to open and public accountability for staffing records'
Hospital wards should publish the ratio of staff to patients daily to ensure that fundamental standards of adequate care are met in the NHS, an influential parliamentary committee recommends.
In its first assessment of the Francis review of the Mid Staffs scandal, in which patients endured appalling care in an NHS hospitall, MPs on the health select committee say the health service must change the "culture which tended to prioritise the smooth operation of the system above safe and effective care of patients".
The report says that as an urgent first step, GPs and NHS England - the groups that pay hospitals to treat patients - should force NHS trusts to establish appropriate staffing levels on every ward and then publish daily the ratio of patients to staff....
... Labour'sAndy Burnham, the shadow health secretary, said "one report after another has highlighted the importance of safe staffing levels in the NHS, yet more than 5,000 nursing jobs have already been lost since the election. David Cameron must intervene and provide a guarantee to patients that all hospitals in England will have enough staff to provide safe care."...
http://www.theguardian.com/society/2013/sep/18/hospital-wards-ratio-staff-patients-mps

allnurses Guide · Dec 7, 2013

Massachusetts Nurses Seek Public Support for Minimum Staffing Ratios in Hospital Care Units

Frustrated by the legislature's failure to enact a safepatient-staffing bill and citing changes brought on by health reform, MNA/NNU has launched a campaign to get the Patient Safety Act on the November 2014 ballot.

The ballot initiative would give Massachusetts registered voters the opportunity to effect policy change to ensure patients receive the necessary care, said MNA President Donna Kelly-Williams.

In addition to mandating minimum staffing ratios, the measure would require hospitals to be transparent about their financial holdings and to limit CEO salaries to ensure that taxpayer dollars are dedicated exclusively to patient care, the unions said on their website.

On Sept. 5, the state's attorney general certified the initiative as having passed constitutional standards and thresholds required for inclusion on the ballot. Once the Secretary of State develops the official petition language,the unions will need to collect 70,000 signatures to have the initiative placed on the ballot.

The ballot initiative coincides with the Committee to Ensure Safe Patient Care's "Just Ask" campaign encouraging members of the public, whenever they or their loved ones are admitted to a hospital, to ask how many patients their nurse will be caring for that day....

http://prod-admin1.tmg.atex.cniweb.net:8080/preview/www/2.3305/2.3443/1.366321