Does Nurse-to-Patient Ratio Legislation Help Patients?

Floyd has made substantial staffing cuts since January because of the accounting mistake announced at the end of last year. Nursing and all other departments except administration have been working with much fewer personnel and continue to struggle with working harder with less.

Even though the financials appear to be improving in the past 2 months, the Administration is talking about further cuts in order to reach this artificial goal of a certain FTE/adj. occ. bed.

This number cannot be calculated with any accuracy and there is no real standard to compare. We have seen this number change so often, no one can give a rational explanation of how it is calculated or what the standard is to compare with. These numbers continue to come from the same department that gave us our financial data for the past 3 years and we have seen the accuracy of that.

Further cuts are a mistake as patient care has already suffered.

Floyd has historically been the premier hospital in southern Indiana and with its heart center; we should be setting the standards and not always playing catch-up.

In an effort to improve patient care at hospitals many states are considering the implementation of nursing ratio laws. These laws would require specific nurse-to-patient ratios be maintained by hospitals at all times.

The specific ratios would differ by hospital departments but would be legislatively mandated. Nursing ratio legislation is currently being considered in the U.S. House, U.S. Senate, Florida, Georgia, Hawaii, Illinois, Iowa, Missouri, New York, Oregon, Pennsylvania, Rhode Island, Vermont, and West Virginia, but so far only California has implemented nursing ratios.

It all began when California’s law was passed in 1999 under Governor Gray Davis. The implementation of ratios began January 1, 2004 and was considered a great success by California nursing groups. The implementation of planned increased standards (lower ratios), scheduled for 2005, was frozen until 2008 by Governor Schwarzenegger as an emergency action due to the predicted high costs to hospitals and severe nursing shortage, but several California courts, however, upheld the legislation and the tougher standards were enforced.

According to the Department of Health Services nursing ratios had an estimated cost of $442 million in 2004, and $652 million for 2005 once stricter standards were in place. The estimate for 2008 and beyond is $956 million annually. An estimated 5,000 additional nurses are required statewide to meet the guidelines; a difficult proposition in the midst of a nationwide nursing shortage.
The California Nurses Association (CNA) claims that ratios have been successful in creating a safer working environment in hospitals. They believe that creating a safer and more pleasant work environment for nurses will attract trained nurses who have left the profession to go back to work.

They also assert that nursing ratios are necessary to protect patient safety and help eliminate the dangers associated with patient overload. There is a strong link between improved nurse-to-patient staffing and lower rates of medical errors and patient deaths.

As with any legislation, it is only as good as the overall plan and implementation. Standards are necessary to help minimize errors and improve patient care, but it comes with a cost. Legislating standards without a plan to fund the additional cost will result in more hospitals failing financially.

Floyd should be the leader in this endeavor of creating workable standards that promote patient care and safety. The nurse to patient ratio in California is 6:1 on Med-Surg units.

Waiting until it is mandated once again puts us in a position of following rather than leading. Is this what we want?? It is what we are getting with the current mindset of our administration.