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One-to-four patient ratio is required in antepartum, postpartum, pediatric care, and in the emergency room, telemetry, and other specialty care units.One nurse for every five patients is required in medical-surgical units and one for every six in psychiatric units.“ANA and its Constituent & State Nurses Associations (C/SNAs) in the states are promoting legislation to hold hospitals accountable for the development and implementation of valid, reliable, unit-by-unit nurse staffing plans.These staffing plans, based upon ANA's Principles for Nurse Staffing (member login required), are not mandated ratios.They also take the position that any nurse-patient ratio and staffing plans must include the following recommendations: While legislators may have the power to push through legislation pertaining to patient safety and nurse staffing mandates, it is clear that those with the greatest stake in such decisions be brought into the conversation. Democratic State Senator Mike Skindell reintroduced the Ohio Patient Protection Act (Senate Bill 55) , a legislative attempt to impose restrictions on the number of patients for whom Ohio nurses can safely care for.The bill mandates that a one-to-one nurse-patient ratio would be imposed for patients in the ICU, OR, trauma, critical care, as well as for unstable neonates and patients needing resuscitation.“Safe staffing” is a frequent rallying cry by nurses and non-nurses alike, but what does that really mean and does it make patients and nurses safer? 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.
That doesn't make sense and frankly is very difficult to adhere to," she adds.This rigid ratio is one of the reasons that ER waiting times can be lengthy—especially if there is an unexpected surge of ER patients because of a car crash."Hospitals do the best they can to predict how many nurses they will need during different parts of the day and staff accordingly," Emerson adds."We know 90% of our nurses support and desperately want it," he says.The association in 2008 hired a polling organization to survey patients who had spent time as inpatients "and 30% said safety was compromised because nurses had too many patients." De Ann Mc Ewen, an RN and member of the California Nurses Association board of directors, says the ratios have helped reverse the number of nurses exiting from the profession over the last decade because of burnout.
The subject of nurse-patient ratios comes up often in nursing circles, and can often be a topic of discussion in state legislatures around the United States.