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The Government Contemplates Nursing Staff Ratios

Nursing ratios are very important. When I worked in IL, I once had to take 3 critically ill patients. I had never been so busy at work in my life and I constantly felt as though I was way behind. I was very scared of possibly missing something. There simply was not enough of me to pay very close attention to each patient.

There were a few nights on med-surg that I took 9-10 patients, mostly fresh post-ops. That’s a lot of patients. And that was over 10 years ago. Even in the last decade it seems like patients have been getting more and more complicated what with their chronic medical problems.

Here in California, there’s a law protecting ICU nurses in particular; it says that we can only take 2 patients in ICU. Even if they require a lower level of care and are overflow from full med/surg units, even if they have transfer orders – if they are physically in ICU, they are to be 1RN:2pts. California has been moving towards staffing ratios on transitional care units and med-surg floors as well.

There’s a bill that’s been introduced – the Registered Nurse Safe Staffing Act of 2007 (HR 4138). It would provide a staffing system that has input from nurses who give direct patient care. This is a very good thing. It is something that we do in my ICU all the time and I can’t imagine it any other way.

PixelRN has also written about this issue, perhaps a bit more eloquently than I. WashingtonWatch.com provides information on the current status of the bill and a wiki where you can put forth your arguments for or against the bill. There’s even a link on their sidebar where you can write to your state representative. I plan on doing so right after posting this. They don’t know if you support it if you don’t tell them! They all have email; it’s very fast.

There have been more and more regulations lately from JCAHO, the most recent and notable being those which state hospitals will not be reimbursed for care related to preventable complications such as pressure ulcers and UTI’s. We do the best we can with what we have. More nurses = more care = less complications.

This is one regulation from the government that actually makes sense. I’m so glad it’s been taken to a national level. We really need to get behind this bill.

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My hospital management says that IF the ratio legislation goes into effect, we will lose nursing assistants, secretary help, and all sorts of control over unit decisions, such as how breaks will or will not occur. They want us to write our representative saying we don’t want ratio requirements. The med surg ratios is STILL 1:9 on nights here in IL. There has been no talk about a flex nurse to cover when a nurse leaves the floor. I’d like to hear: before and after experiences with mandated ratio legislation. Ca nurses, please fill me in ???



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Alltop. I don't know how I got there either.


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  • profileI am Gina. I have been a nurse for 15 years, first in med/surg, then CVICU, inpatient dialysis, CCU and now hospice. This blog is about my experiences as a nurse, and the experiences of others in the healthcare system - patients, nurses, doctors, paramedics. We all have stories!

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