That's right. Today we'll do a deep dive into the topic of safe staffing ratios for nurses. This topic is frequently a point of negotiation for nursing unions and is commonly referenced as a contributor to nursing burnout. While the demands of nursing will be weighty no matter what, the number of patients a nurse is responsible for during their shift can allow them to find a safe balance or equilibrium or cause them to be stretched too thin, which can result in distressing consequences for both patient and nurse safety. As hospitals and healthcare facilities grapple with staffing shortages, achieving optimal staffing to ensure positive patient outcomes is at the forefront.
Let's take a look at what states have laws and mandates in place for nurse-to-patient ratios and then review steps for what your facility can do in creating staffing plans that include safety precautions for patients, the well-being of your nursing staff and provide the flexibility necessary for the ebb and flow of patient intake.
Which States Have Mandatory Staffing Ratios
- California is the only state in the country that has established minimum nurse-to-patient ratios specific to each hospital unit by law. Other states have laws or regulations that address staffing by mandating periodic public reports of staffing or staffing committees. Logically, the percentages vary by department or division.
- Massachusetts has also mandated a 1:1 nurse-to-patient ratio for all intensive care units.
- Connecticut, Minnesota, Nevada, Ohio, Oregon, Rhode Island, Texas, and Washington must use staffing committees that include membership of at least 50% clinical nurses.
- Illinois, New Jersey, New York, Rhode Island, Vermont, and Washington must produce staffing reports to the public either periodically or upon state request.
- In Georgia, a bill was introduced to the house, HB 11, "Safe Patient Limits Act" to address the topic but was unsuccessful.
What Are Safe Nurse-to-Patient Ratios?
Safe staffing ratios: The American Nurses Association (ANA) has created a bundle of free resources to guide nurse staffing, including an eBook, a webinar, and more.
National Nurses United recommends the following for safe staffing:
- Medical/Surgical: 1:4
- Emergency Room: 1:3
- Intensive Care: 1:1
- Psychiatric: 1:4
- Rehabilitation: 1:4
- Labor and Delivery: 1:2
- Pediatrics: 1:3
Staffing Plan Suggestions
Keep in mind that when you make the well-being of your nurses a priority, you can make gains in patient safety and nurse retention. Instead of waiting for your state to create mandates or laws around staffing ratios, be proactive and create safe staffing plans. Here are our suggestions for achieving optimal staffing of your nurses.
- Ask for and accept input from your direct-care nurses. Your nursing staff wants to be valued, they want to be able to do good work, and they want to be heard. By accepting input from a few chosen nurses, you can meet the abovementioned needs and receive valuable insight into patient safety when creating a staffing plan.
- Create a staffing plan formally. Ensure the appropriate clinicians are matched with patients who will best benefit from their skills for each shift. Make it specific to each unit, and standardize the level of care after working out the kinks over a short period. Accounting for patient understanding, level of expertise in your nursing staff, and patient admission numbers will likely mean you need flexibility in your staffing strategy.
- Utilize per diem nurses to account for patient intake fluctuations and nurse call-offs. Traditionally, healthcare facilities have turned to PRN clinicians for assistance in times of crisis or obligate their full-time nursing staff to be available for a certain number of PRN hours or shifts per month. Utilizing PRN staff as a strategic resource to meet patient fluctuations and staffing issues with nurse call-offs is a logical and affordable step for facilities.
- Re-evaluate overtime policies. Are your nursing staff feeling overworked? Consider PRN staff instead of mandatory overtime to relieve your hardworking team without compromising patient care.
- Re-evaluate your nursing model of care. How is it working for your staff? Do you need to make changes?
How to Find Qualified PRN Staff
Nursa, the healthcare staffing app, sources a large talent pool of CNAs, LPNs, RNs, and other allied healthcare workers who are often already part of your community. You'll save yourself and your facility money, time, and energy using Nursa. Here's how it works.
- Download the Nursa app.
- Register your facility with Nursa.
- Post your PRN shifts for each clinician type.
- Review PRN shift applicants.
- Hire clinicians for shifts.
Nursa is not a subscription service, nor do we set a minimum or maximum number of shifts for your facility. You use Nursa only when you need PRN staff. Nursa is free to download and free to post shifts. You'll only pay for completed shifts.
Nursa does most of the staffing paperwork for you: Nursa verifies all licenses and conducts background checks.