Nursing Notes

June 29, 2010

Nurse to Patient Ratios: The Lucky Few

Here is a follow-up on the article I posted from the NY Times “Is There a Nurse in the House?”  This is from the SEIU Blog and is a very good complement to the original article.   Please read below and let me know what you think.  Do any of you readers sit on your hospital’s Staffing Committee?  If so, tell us about your experiences please.



A recent NY Times editorial — “Is there a nurse in the House?” — hit a nerve with me, and probably many other registered nurses around the country. I rarely see a piece in the paper that is so on point about the challenges professional nurses face providing healthcare to our patients.

The editorial, by Theresa Brown, RN described nurses as first responders and the first providers to act in crises. And yet, as Brown notes, even though research proves that thousands of patients die unnecessarily in hospitals where there are too few nurses to provide care, most hospitals around the country continue to cut nursing staff as a cost-cutting measure.

It doesn’t have to be this way. Patients at Allegheny General Hospital (AGH), a level one-trauma center, where I work in Pittsburgh, PA are among the lucky few in this country. We union nurses sat down as equal partners with management and negotiated safe nurse to patient ratios into our SEIU contract for every department in the hospital. Our facility is definitely not the norm. Outside of California, where SEIU was instrumental along with other nurse unions in winning legislated staffing ratios, there are no requirements for safe staffing ratios. In fact, most hospitals in the rest of the country force nurses to accept overloaded assignments that risk patients’ lives on a daily basis. But, as I said, it doesn’t have to be this way.

When nurses have the time to professionally monitor our patients, we identify the smallest changes in a patient’s condition and thereby prevent complications that might otherwise lead to death. We provide the care that eases pain and reduces fear.
When nurses have too many patients on a shift, that level of attention is impossible to maintain; and patients lie in wait and at risk.

Patients in hospitals where nurse to patient ratios are in place, are free from central-line infections and other hospital-induced complications; they are rarely harmed by medication errors; they learn about their medications from nurses who have time to teach them; and they can go home healthier and prepared to live in a state of wellness rather than returning to the hospital sicker than ever just a short time later.

There is no reason why every single hospital in this country cannot model its nursing practice after Allegheny General Hospital in Pittsburgh and frankly, patients in this country cannot wait for it to happen hospital by hospital. Our hospital has had its financial challenges, but nurses and administrators kept working together, focusing on the mission of providing the highest quality of care to the community it serves.

As healthcare reform is implemented and quality care is incentivized, the healthcare industry is finally shifting its attention to quality standards for care. The only way for hospitals to achieve those standards will be to adopt nurse to patient ratios. However, hospitals are notorious for resisting the obvious. That’s why I agree with Theresa Brown that nurse to patient ratios must be mandated by law in order to give every patient in this country the care that our AGH patients in Pittsburgh receive.

It seems to me that patients in New York, or Louisiana, or Alaska might want that kind of nursing care, too. As a nurse I think they deserve it. As a leader of nurses in this country I will fight for it and I hope the rest of the nurses in this country and our patients will stand with us to support the staffing ratios bills from Congresswoman Schakowsky, HR2273, “Nurse Staffing Standards for Patient Safety and Quality Care Act of 2009”; and Senator Boxer, S1031, “National Nursing Shortage Reform and Patient Advocacy Act”. The research leaves no doubt. You are safer in my hands when I have the appropriate number of patients.

Cathy Stoddart, RN, BSN is the Chair of the Nurse Alliance of SEIU Healthcare Policy & Politics Committee and a staff nurse at Allegheny General Hospital in Pittsburgh, PA

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1 Comment »

  1. […] Nurse to Patient Ratios: The Lucky Few « Nursing Notes […]

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