Effects of Man d Nurse-Patient Ratios Man d nurse-patient ratios in the Unites s have prompted a lot of deliberations and debates among the members of the healthcare community. Since California passed the Safe Staffing Act of 1999, many discussions for and against this issue have been brought to the healthcare forum. Proponents of the mandate have enumerated various benefits of this legislative imposition that have benefited patient care and have improved the lives of nurses in the United States. These proponents have argued that as regards patient care, fewer patients assigned to each nurse ensure better care and attention. Nurses are able to focus their attention on fewer patients. They are able to concentrate on their patients’ needs, safety, and individual care. In a study submitted to the Alabama Nurse Journal, it was established that the mandated nurse patient ratio has managed to improve patient safety and has also improved the quality of care given to patients. There has also been a decrease in mortality rates, lesser medical errors, and decreased rates in pneumonia, thrombosis, urinary tract infection, gastrointestinal bleeding, shock, and pressure ulcers. Hospital stay was also shorter for patients.
Many hospitals in America argue that the mandated nurse-patient ratio cuts into a large part of the hospital budget. They argue that increasing staffing costs will eventually reduce patient access to healthcare. According to them, this mandate does not take into account the individual needs of the patient or the skills and characteristics of the nurse or the hospital. They also argue that hospitals are very much committed to providing quality patient care while still utilizing safe staffing levels, however, they feel that legally imposing nurse-patient ratios does not ‘allow for fluctuations in the supply of nurses and does not account for new technology’ introduced into healthcare (Lewis, 2005). Hospitals declare that mandated nurse-patient ratios are inflexible impositions on healthcare. Hospitals are forced to finance the obligatory increase in nursing staff and in the end, they may not be able to afford this cost. Hospital closures may follow.
Nurses’ associations have a mixed reaction to this mandate. Some associations support the mandate, declaring that their lives have greatly improved. They are less stressed due to the decrease in their caseloads. Some unions have declared that this mandate has helped improve patient safety and has increased the job satisfaction of nurses. Nurses are now able to take day-offs and are not required to render mandatory overtime during busy work days. Before this mandate, nurses have been known to render mandatory overtime and work long busy shifts. This has raised safety concerns for the patients who are saddled with bleary-eyed exhausted nurses. However, some nurses and nursing associations opine that this mandate may be seen by hospitals as the future standard, that what is applicable today may be seen as applicable tomorrow even when circumstances change. They also argue that this mandate does not take patient acuity into consideration. Some nurses in the ICU feel that taking care of just two very sick patients can take up all their time, and they feel that during these times, more nurses may be needed. There are also other times when a nurse in the medical-surgical unit may be taking care of five patients who are not very sick. These situations imply that indeed a greater flexibility in the ratio may be needed. However, nurses and most nurses’ associations believe that a mandated nurse-patient ratio may just be the nudge that hospitals need to hire more nurses. They agree that this may be the ‘only choice in a system where hospitals currently hold nearly autocratic power in staffing decisions’ (Bartolomeo, 2001).
The important point that many nurses, hospitals, and nurses’ associations put forth is that there is a need to mandate a nurse-patient ratio for better patient care and improved job satisfaction. The question on the ideal and correct nurse-patient ratio is a crucial question that needs critical research and analysis. The need to balance cost of staffing and the economic viability of hospitals need also to be taken into consideration. All in all, the ultimate end of improving the quality of patient care is the bottom-line that all nurses and hospitals should aim for at all costs.
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