I am a nursing student in Leadership class. My group has to write a persuasive paper topic "mandated nurse-patient ratio." I live in California, where we have mandated nurse-patient ratio. On the surface, we think the ratio is a good idea, but our professor does not agree with us. After some research, we learned some set backs about the mandated ratio. We are also required to interview nurses. The problem is that we mostly got a positive response about the ratio, and we are supposed to be writing a paper against it. Many people we interviewed said that it is important to have it mandated. We need more opinion on this. Do you suggest other method of ensuring reasonable patient loads if it is not mandated? We propose our thesis that it should not be mandated (it can serve as a guideline but should not be mandated).
All input is appreciated! By sharing your opinion, the input will be used for our paper, kind of like an informal interview.
You should be able to find a plethora of studies showing a link between increased patient mortality rates and increased patient loads. More patients, less staff = poorer outcomes. Also many studies out there that show increased patient loads are linked to disatifaction among nurses and increased burnout rates...which means more turnover and turmoil for staffing. It's a viscous cycle. As long as big money is running healthcare instead of modest profits and truly patient-centered care I only see this issue getting much worse!!
Well this situation has gone from bad to worse folks. Mandating levels r a joke if there is no one to cover the next shift u r stuck or no one is there during ur shift and no one can be mandated from off going shift then u divide up those patients. A normal 5 to 1 ratio went to 11 to 1 and madness. Yes levels r great if honored and staff licensed staff to cover it is also necessary cause an aide is awesome and looks great when they r in the ratios keeping the numbers down but no help at the med pass time and assessments or new orders and heaven forbid someone tank. Once 9 months pregnant I called a code on my patient to get help with another patient of mine being coded and no one to help me sad but true and necessary. Answer: higher pay for the whole team u pay for what you get a simple thank you from the bottom line gods in the office eating their warm delicious lunch on an empty bladder. Showing me u r working on staff and will do what it takes to fix this cause hey I eventually get to leave while my patient is at the mercy of the bottom line for their care.
I did Google it. Nothing has happened with this bill since May.
Skimming over it, I didn't see anything that would discourage hospitals from cutting down CNA staff, transporters, etc. I could see some improving the ratios, but giving more for nurses to do to make up for it.
The bill is dead in committee, and the probability of being passed is now 0%.
What kind of leadership class is that? Real nursing leadership should be trying to teach you guys to be pro nurses and not pro corporation. I think your teacher drank the cool aid. As one of the comments brilliantly said: you don't know what you getting yourself into. The only reason nursing rations exist is to protect nurses from greedy corporation who want to maximize their profits by making nurses work like slaves
Not having mandatory ratios is what corporate hospital USA loves to hear. With that on board they can load nurses with as many patients as they want to a unsafe and unproductive level. I cannot believe your teacher is against mandatory ratios. Maybe because she is not on the floor anymore. Thank god for California mandatory ratios. I feel sorry for other states specially these redneck republican states which like to grill their workers to death. Please don't write a paper like that. Don't shot yourself on the foot!
Specializes in UR/PA, Hematology/Oncology, Med Surg, Psych.
Bet that instructor has been away from the bedside for a very long time. Probably a BSN that didn't do much nursing practice, then went on for her MBA.
Specializes in Critical care, tele, Medical-Surgical.
The bill is dead in committee, and the probability of being passed is now 0%.
For now you are probably correct. I think now is the time for nurses to learn as much as possible about ratios and begin planning to educate people, especially members of Congress.
The first time our California safe staffing bill was introduced it didn't get out of committee.
After educating the public and our legislators and campaigning for those who voted for it or incumbents promising to vote for it it passed both branches of the legislature twice. It was vetoed by the governor.
Then we elected a committee of bedside nurses who interviewed each candidate for governor and asked just one question, "Will you sign this bill?"
Only one said, "I probably will."
We worked on his campaign. We made sure he knew nurses were working on his campaign.
After he was elected and the bill passes thousands of nurses went to the capitol and chanted, "Sign the bill!"
CNA's 12 Year Campaign for Safe RN Staffing Ratios
I thought a persuasive presentation would present the positive side of why the mandate is needed?? As BrnEyedGirl posted, we use to do patient acuity levels to justify staffing. This did work to a certain degree, unfortunately, the acuity levels did not reflect admissions or discharges which take up a lot of nursing time. The acuity scales were timely to do and I guess staffing did not get changed anyway, so they were done away with. There should be studies you can access that discuss preferred staffing ratios and relate this to positive patient outcomes. That would be a persuasive approach. Good luck!!! And, just because your professor is against the mandate does not mean it would not have positive effects. You just have to prove it will. Perhaps her approach is that the negative effect is on the budget for staffing. I have worked in acute, subacute, home health and recently returned to the hospital environment. This same hospital where I worked 7 years ago had the Progressive Care and Intermediate Care units combined, acuity levels were not addressed at all. I would have 6-7 patients who were a mix of Progressive and Intermediate care type patients. It was a bear, and I could never get everything done for these patients it was just too much. Now that I have returned to this same hospital they now only give 4 IMC or PCU patients as an assignment. So something changed the way staffing was done. Acuity levels do matter. Perhaps looking at outcome measurements would help.
icuRNmaggie, BSN, RN
1,970 Posts
Twenty years ago hospitals had a Charge RN and it was 1:5 on M/S and 1:2 in ICU.
There was absolutely no need for a rapid response team because the care was good.
I see it the lack of safe ratios for what it really is and that is the American Hospital Association playing Russian roulette with human lives.