Bill Being Considered To Establish Better Patient To Nurse Ratio

Nursing professions are among the highest demand fields available for new college graduates. There is always a need for qualified, professional LPNs and RNs in hospitals and other medical care facilities like nursing homes. The nurse to patient ratio in these long-care facilities is often so high that it's unsafe and sometimes leads to neglect.

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Quality care comes from time spent with the patient, and many nursing homes just don't have the staffing to allow nurses the time to visit patients for more than a few minutes at a time. A new bill, known as the Safe Staffing for Quality Care Act, or NYA08580, passed by the State Assembly of New York attempts to change that.

Proposal Of The New York Staffing Bill

With a new bill being proposed to the Senate of New York, nursing homes and hospitals in the state would have to implement a minimum nurse-to-patient ratio. Centers would be required to submit a plan for their staffing to the Health Department. In addition, nurses will be allowed to refuse to work in facilities where the minimum staffing hasn't been fulfilled. Supporters of the bill believe that the quality of care would improve with a lower staff to patient ratio.

The bill is not expected to pass the senate. This is partly due to the opposition of the Coalition for Safe & Affordable Care and the opposition of a group of nursing home administrators, insurers, and hospital administrators. All the opposers say that imposing regulations will disrupt teamwork and deny flexibility in nursing homes and hospitals, thereby undermining care decisions.

Looking At The California Model

California was the first state in the country to implement a required nurse-to-patient care ratio in 2004. It was done to keep nurses on the job and improve mortality rates among patients requiring complex care. The bill required a nurse for every five patients in surgical units and oncology, one for every three patients in labor/delivery and one nurse for every two patients in ICU.

In 2006, Florida passed similar legislation requiring a registered nurse to be in the operating room during every surgical procedure. The legislature also created a minimum staffing requirement for nursing homes. However, this model does not require a nurse to be linked with a certain number of patients, only that the nursing home should have a certain number of nurses on staff.

Comparing The Ratio Solution: Does it Work?

The Department for Professional Employees (DPE) recently conducted a study that compared California with two other states that don't have minimum nursing requirements (as of 2006), New Jersey and Pennsylvania, to determine whether the minimum nurse-to-patient ratio implemented in California is working.

The results of the study were impressive, particularly in the area of nurse satisfaction. In California, 73% of nurses felt that their workload was manageable, compared to 61% in Pennsylvania, and 59% in New Jersey. During surgical procedures, California experienced a mortality rate that was almost 14% lower than New Jersey and 10% lower than Pennsylvania. These statistics alone indicate that California is doing something right by implementing a required ratio of nurses to patients.

New York Statistics

To determine if passing a bill requiring a minimum nurse-to-patient ratio would benefit the patients and nurses of New York, it is helpful to know where the nursing homes currently stand regarding the quality of care.

In 2006 the Attorney General of New York published a report on the staffing levels of New York nursing homes. The purpose of the report was so that families could make an informed decision when considering nursing homes for their loved ones. The research revealed that 98% of the homes in the state would not meet the standards required by a comprehensive federal (CMS) study for the quality of care. Seventy percent of the homes would not meet staffing standards set in Florida, and 38% wouldn't meet California standards.

The passage of the Safe Staffing for Quality Care Act would vastly improve patient care by increasing the number of nurses available to assist patients during critical periods of the day when injuries are likely to occur (getting up to use the restroom, bath time). Statistics have shown that passing the bill would be in the best interest of the patients if not nursing home administrators or insurance agents.

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