Running a hospital in the current fiscal environment is a challenge for the employers and the government. One of the most difficult issues they need to face is what would be the proper number for the minimum staffing ratios in nursing. They believe mandatory minimum staffing ratios would limit their ability and creating inflexible staffing management, increasing the cost, make the hospital suffering financial burden (Schultz, 2013). The purpose of setting up staffing ratios is to give each nurse an appropriate amount of patients to follow so they can make sure to provide the patients’ health safety and have the best outcome as possible (Huston, 2014). Minimum staffing ratios matter and it may affect the hospital’s operating status if the hospital does not set the minimum staffing ratios appropriately.                                                                                                                                      On one hand, some states legislatures and the United States Congress plan to pass laws to mandatory hospital nurse to patient staffing ratios in order to improve the working conditions in hospital and provide quality care to patients (Welton, 2007). They believe minimum staffing ratios can help the nurses relieve their overloaded work, to avoid putting too many patients on too few nurses. The American Nurse Association (ANA) conducted a survey of over 200,000 RNs and 54% of those nurses felt they didn’t have enough time with the patients and overtime increased with 43% of the nurses’ working extra hours because of inadequate staffing (Huston, 2014). This creates a lot of pressure for the nurses because they have to face a lot of responsibility and have to be prepared for the patients. Some people believed that if they do set minimum staffing ratios, it could promote patient safety and to achieve desired patient outcomes. The positive effect could occur and nurses could be more focused in providing the best care and treatment for the patients. Not only that, the use of standardized ratios provided a more consistent approach than acuity-based staffing. In other words, these ratios could work more easily and the nurses wouldn’t have problems with the health care system. A confirmed minimum staffing ratio could make hospitals operate regularly.

            The ratio seems to make hospitals work properly because this ratio showed improvement in nurse staffing. In California, the nurse: patient ratio was among the lowest of any US state. California had a huge nursing shortage due to market based decisions on hospital care, thus caused California having the worst RN staffing. Furthermore, this issue turned out to be chaos for the patients because that would mean they could lose confidence with them and it could make the state of California in jeopardy. Luckily, the California Nurses Association (CAN) tried to resolve this conflicting issue and made the final mandated ratios in 2003. The results have stated that the staffing conditions are improved at 68% of the hospitals and 59% were generally in compliance with the requirements of the law (Buchan, 2005). The use of these ratios boosted the path to success and patients can slowly gain back the confidence for the nurses’ care and treatment. If these ratios are used, the other hospitals in the United States could possibly be beneficial like California.                                                                                                                                Without the setting of the minimum staffing ratios, the hospital could be in jeopardy. A study was made of 799 hospitals in 11 states, and in conclusion, they found a higher prevalence of infections, such as pneumonia and urinary tract infections, failure to rescue, and shock or cardiac arrest when the nurses’ workload was high (Needleman, Buerhaus, Mattke, Stewart, & Zelevinsky, 2002). Another study investigated the relationship between staffing levels at 168 Pennsylvania hospitals in 1999 and mortality rates of selected surgical patients. The final statement was that each additional patient a nurse assigned, there was a seven percent increase in the likelihood of dying for a patient under that nurse’s care (Aiken, Clarke, Sloane, Sochalski, & Silber, 2002). Both studies proved that if the ratios are not set, the patients have more chance of dying and could make the other patients in the hospital scared and wouldn’t want a nurse to take care of them. With these ratios are set, the nurses wouldn’t have to work as stressful as before, would get an adequate amount of patients and could have the ability and the potential of taking care of these patients, even the patients are more infirm and need more complex care. However, if not, the public health system could be affected like no one would go to the hospital and it could cause the nurses unemployed (Buerhaus, Donelan, DesRoches, & Hess, 2009). Setting these ratios is a necessary for the nurses which can make their job more manageable.

            On another hand, to maintain the minimum staffing ratios, hospitals and health systems need to face tremendous concern with the increasing costs to hair more nurses. To maintain the minimum staffing “at all times” may make the hospital in jeopardy to shut down. Even the American Nurses Association, the most powerful institution for the profession nurses, opposes staffing ratio bills because minimum staffing can make understaffing problem. Passing a law to mandatory the staffing ratios is not the right way to solve the problem, instead of this, hospital administrators should work together with nurses to create proper staffing plan (Schultz, 2013).

            In conclusion, the patient-to-nurse staffing ratios setting are important to patients, nurses and hospitals. I suppose there is an appropriate ratio for nurses to works with, but mandatory staffing ratios make staffing management inflexible and potential inefficient and will increase the cost to pay overtime and agency nurses. We need more researches to find one or more options which can effectively improve staffing level and patient’s outcome, and also can be accepted by hospital administrators and government. Ignore nursing staffing issues now may cause additional legislative changes in the future to increase nurses needs and reduce adverse patient outcome (Stanton, 2004). So, minimum staffing ratios in nursing matter and it can affect the nurses’ and hospitals’ future, nurses and hospitals need to face this challenges toghther.

References

Aiken, L. H., Clarke, S. P., Sloane, D. M., Sochalski, J., & Silber, J. H. (2002). Hospital nurse

staffing and patient mortality, nurse burnout, and job dissatisfaction. JAMA, 288, 1987-1993.

Buchan, J. (2005). A certain ratio? The policy implications of minimum staffing ratios in

nursing. Journal Of Health Services Research & Policy, 10(4), 239-244.

Buerhaus, P., Donelan, K., DesRoches, C., & Hess, R. (2009). Registered nurses’ perceptions of

nurse staffing ratios and new hospital payment regulations. Nursing Economic$, 27(6), 372-376.

Huston, C. J. (2014). Professional Issues in Nursing (3 ed.). Philadelphia, PA: Lippincott Williams & Wilkins.

Needleman, J., Buerhaus, P., Mattke, S., Stewart, M., & Zelevinsky, K. (2002). Nurse-staffing levels and the quality of care in hospitals. New England Journal of Medicine, 346, 1715-1722.

Schultz, D. (2013, April 24). Nurses Fighting State By State For Minimum Staffing Laws – Kaiser Health News. Retrieved from http://www.kaiserhealthnews.org/stories/2013/april/24/nurse-staffing-laws.aspx

Stanton, M. W. (2004, March). Hospital Nurse Staffing and Quality of Care | Agency for Healthcare Research & Quality (AHRQ). Retrieved from http://www.ahrq.gov/research/findings/factsheets/services/nursestaffing/index.html

Welton, J., (September 30, 2007) “Mandatory Hospital Nurse to Patient Staffing Ratios: Time to Take a Different Approach” OJIN: The Online Journal of Issues in Nursing. Vol. 12 No. 3, Manuscript 1. DOI: 10.3912/OJIN.Vol12No03Man01