New York Times Examines Debate Over Nurse Staffing Ratios
The New York Times today examines the nation's nursing shortage and the debate between hospitals and nurses over how many patients nurses can safely care for at one time. According to federal statistics, the number of registered nurses working in hospitals increased to 1.3 million in 2000 from 1.1 million in 1988. But 13% of hospital nursing jobs nationwide remain unfilled. Nurses say they must care for too many patients and are subject to "onerous working conditions," leading many to seek jobs outside of hospital settings. In addition, hospitals have cut other staff members and now require nurses to carry out more tasks, increasing their work load. The Times reports that the staffing "battle" between nurses and hospitals is "making its way through the courts" and state legislatures as nurses push for minimum staffing ratios. California nurses filed a lawsuit this month against Tenet Healthcare, the nation's second-largest for-profit hospital chain, alleging that they were forced to work through meals and breaks without pay because of staffing shortages. In January, California officials approved minimum nurse staffing ratios at the state's hospitals. The new standards, scheduled to take effect next year, require one nurse for every four pediatric patients, one nurse for every five patients on medical-surgical floors and one nurse for every one patient in operating rooms and emergency departments. Similar staffing measures are being considered by legislatures in Florida, Iowa, Kentucky and Massachusetts.
Hospital executives are opposed to mandated ratios, saying they are "not useful" because hospitals differ in the type of patients they treat and need the flexibility to move nurses between departments. They also say that ratios do not address the underlying problem: too few nurses willing to work in hospitals. "Legislating that you have so many nurses doesn't mean that nurses can appear," Pamela Thompson, executive director of the American Organization of Nurse Executives and a spokesperson on nurses' issues for the American Hospital Association, said. But nurses say that minimum staffing levels might prevent incidents like the January death of a patient at a liver transplant unit in a New York hospital, in which the state Health Department concluded that the unit was "inadequately staffed with nurses and physicians in charge of providing the necessary care for 34 transplant recipients and donors" (Abelson, New York Times, 5/6).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.