Delay In Nurse Staffing Ratio Mandates Will Only Provoke Strikes!

Posted by Melanie Aiken on

The nursing profession has numerous struggles that nurses face on a daily basis.  The top five issues nurses face at work are staffing, long hours, work place hazards, work violence and bullying/harassment.  Nurses have advocated for safer staffing ratios for years and as it stands in 2019 the only state that has mandates for patient to nurse ratios is California.  This historic win sponsored by the California Nurses Association took 13 years in the making and have been in effect since 2004.  The hospital industry have been trying to overturn the law ever since.


Unless you have been living under a rock, you have heard and seen the notice to strike by nurses all over New York City on April 2, 2019.  Thirteen thousand nurses from NY City’s largest hospitals have voted yes to strike.  The strike date has been withdrawn due to negotiations between the New York Hospital Alliance and the union New York State Nurses Association (NYSNA).  Nurses are frustrated and exhausted mentally and physically due to poor staffing ratios.


As a nurse it is evident how unsafe having disproportionate nurse to patient ratios can be.  A study found “Ninety percent of nurses say they don’t have the time to provide adequate comfort and emotional support to their patients and patients’ family members, and 86 percent of nurses say they can’t spend as much time on patient education as would be ideal.”  Having mandates for patient nurse ratios is one way to combat this issue.  The California Nurses Association worked diligently to ensure the passing of the bill.  Many nurses in other states were given a glimmer of hope and thought many more states would soon follow.  



There are currently two national bills that are pending review in the Senate and the House which may effect change. The Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act (S.1063) (Brown) This requires acute facilities to provide registered nurse staff based on acuity of patients provided that minimum nurse-to-patient ratios for each unit are met at all times.  Registered nurses will have the right to act in the patient’s best interest and as their advocate.   The Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act (H.R.2392).  This bill suggest that nurses who are put in unsafe situations may object to an assignment if it violates the minimum ratios or if nurses are unequipped by education or experience without jeopardizing the nurse’s license or compromise patient safety.  The bill states hospitals may not penalize the nurse for making a decision to refuse an unsafe assignment however, the nurse should ensure patient safety is foremost.




There are many pros and cons of the proposed nurse patient ratio act.  Many in favor of enforced patient ratios state that it will improve patient care quality.  One con to proposed nurse patient ratio is that it may limit patient care access and limit the hospital’s patient volume.  Another con is that the hospitals will have to make significant cuts to critical programs such as mental health programs.  Community hospitals may not be able to absorb the cost and be forced to close.  The fact that having mandates for nurse patient ratios may affect hospitals bottom line may be the reason why many states have not swiftly followed suit.  However, this begs the question, is the hospital’s bottom line more important in relation to patient safety?


Nurses are leaving the profession sooner as a result of burnout and feeling obligated to take unsafe assignments in fear of being penalized.  As nurses we must support these bills in order to effect change and join nursing associations that are committed to fighting for the cause.


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