Staffing Ratios — The Wrong Formula for Patients and Nurses

Source: NJ Spotlight
My nursing career has spanned many decades. I’ve served in the Navy on a hospital ship, cared for patients in hospital ICUs and emergency departments, led healthcare quality and patient-safety programs, and earned my doctorate degree in nursing practice from Rutgers University. Patients have always been my No. 1 priority — followed by my fellow nurses in a very close second.
So it was eye-opening to hear from Peter Buerhaus, a professor of nursing and leader of the Center for Interdisciplinary Health Workforce Studies at Montana State University. He spoke recently at a conference at the New Jersey Hospital Association on the nursing workforce of the future. With legislation pending in Trenton that would mandate rigid nurse ratios in hospitals, Buerhaus says such mandates have no proven connection to improved patient care. Not only that: They devalue nurses.
Ratios freeze the quantity of nurses and decrease the flexibility to allow the unit’s high performers to work to the full potential of their skills. There is no conclusive evidence that ratios improve patient outcomes, but there is plenty of documentation that ratios increase healthcare costs. And perception-wise, ratios send a message that nurses are one-size-fits-all. For a profession that ranks consistently as the most trusted and admired in the public eye, that’s demoralizing.
A larger problem of the ratio debate is that it diverts the attention of nurses, healthcare executives, policymakers, and other leaders from much more pressing concerns in healthcare. They should be focused on issues such as the uneven growth in the supply of registered nurses (with New Jersey, especially vulnerable to a future shortage) and the healthcare needs of an aging population. That focus — looking forward, not backward — is the right one for both New Jersey nurses and the people they care for.
Nurses are problem solvers, and this recent conference also featured several New Jersey nurses who had proactive, constructive ideas for improving the workplace to promote the very best in patient care. Many of them are working under a pilot project of the Organization of Nurse Leaders, which is developing a model of nurse empowerment giving staff nurses a greater voice and decision making roles in their workplaces.
“We’re all looking for a healthy environment for staffing, and this has brought that to us,” said an operating room nurse from Jefferson Stratford Hospital. “If we’re not healthy and happy, our patients won’t be healthy and happy.” And a critical-care nurse at Lourdes Health System says: “Every nurse is a leader, and we all must work together on one goal: patient and staff satisfaction.”

By Aline Holmes, DNP, RN, Senior Vice President of Clinical Affairs for the New Jersey Hospital Association and program co-leader of the New Jersey Nursing Initiative, a Robert Wood Johnson Foundation program.

NEWTON: "Foodstock" donations boosts local food pantries
Hillsborough Elementary Schoolers Cut And Donate Their Hair