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The Imbalance of Nurse-Patient Ratios: What Can be Done to Even Things Out?

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Did you know that there isn’t a nationally suggested or implemented nurse-patient ratio? I’ll repeat – there is no national or federal law or mandate that regulates how many patients can be assigned to nursing staff at any given time. At this time, there are 14 states that have placed laws into effect to help correct nursing staff problems; However, California is the only state that currently has laws in place to regulate this shortcoming. This shortage in regulation indicates a severe lacking in this problem being addressed – but what can be done?

Imbalance of Nurse to Patient Ratio

This is a problem that often seems too big to be solvable. But, it’s not.

Let’s chat about the imbalance of nurse-patient ratios and what can be done to even things out. This can definitely be viewed as a crisis of sorts and absolutely warrants more discussion and attempts at solution. A statement backed up by National Nurses United reporting up to 685 patients per day are dying from preventable errors in hospitals.

The Problems that Improper Staffing Causes

When there are too many patients per nurse, it can lead to some serious problems – and not just for the nurses. Take a look at what the American Nurses Association says:

“Inadequate nurse staffing levels by experienced RNs are linked to higher rates of patient falls, infections, medication errors and even death. As a result of massive reductions in nursing budgets, combined with the challenges presented by a growing nursing shortage, fewer nurses work longer hours and care for sicker patients. This situation compromises care and contributes to the nursing shortage by creating an environment that drives nurses from the bedside.”

In short, by not having stricter guidelines in place regulating nurse-patient ratios, it causes a toxic, stressful, and unhealthy environment for all involved.

The Imbalance of Nurse to Patient Ratios: What Can be Done to Even Things Out?

A Law in the Works

In May of 2019, there was a proposed legislation to help put an end to this understaffing problem. The “Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act was reintroduced for approval. One of the backers of the bill, house representative Jan Schakowsky stated:

“This National Nurses Week, I am proud to once again reintroduce the Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act with my friend Senator Brown,” said Rep. Schakowsky. “Safe staffing levels save lives. Numerous studies have shown that safe nurse-to-patient staffing ratios result in higher quality care for patients, lower health care costs, and a better workplace for nurses. This bill will improve the health of patients by improving nursing care—establishing minimum registered nurse-to-patient ratios in hospitals, protecting the rights of nurses to advocate on behalf of their patients, and investing in training and retaining nurses to address the nationwide nursing shortage. It is past time that we act on the evidence and give nurses the support they deserve, and put patients over profits. I will continue to partner with nurses across the country in promoting this bill and fighting to end dangerous staffing.”

This bill is currently in the first stage of legislation and review with congress. Unfortunately, it is projected to have a 3% chance of approval, but it is an important step taken to address this gigantic issue.

How Nurses and the Medical Community Can Help

It’s easy to feel helpless when you’re up against a problem this large, but rest assured there are things nurses and the medical community can do to make a difference. Consider the following:

● Push for and implement inclusive and cohesive staffing plans within your hospital. Hospital administrators should regularly seek input from nurses on the floor, be ready to adjust the minimum nurse requirements according to patient intakes, compare reports to help with predicted needs, and consider the type of care needed and equipment being used at any given time when determining staffing needs.

● Nurses often feel overwhelmed and unheard. Consider joining and actively contributing to your state nursing association. This is a great way to add your voice into the conversation.

● Write senators and legislators about the problems you’re facing and what you think will help.

● Nurses and physicians should keep track of and document situations in their hospitals that they feel could have been avoided with better access to care. It’s always easier to prove a point and seek change with examples.


King University Online, Nurse to Patient Ratio: How Many is Too Many?


Nurse.Org, Nurse-Patient Ratios and Safe Staffing: 10 Ways Nurses Can Lead the Change


AMSN, Question: What is the suggested nurse/patient ratio and the suggested CNA/patient ratio for a medical-surgical floor?


Healthcare Dive, Fight for mandated nurse-to-patient ratios heats up


National Nurses United, RNs Applaud Reintroduction of Federal Safe Staffing Bills Mandating Nurse-to-Patient Ratios


Capsol Team

Capsol Team



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