StudentShare
Contact Us
Sign In / Sign Up for FREE
Search
Go to advanced search...
Free

Mandated Staffing Ratios - Essay Example

Cite this document
Summary
This essay "Mandated Staffing Ratios" discusses Acuity-based staffing, hospital staffing ratios that are usually determined by the administrative staff of a facility. They are also determined by the health care system to which the hospital is affiliated…
Download full paper File format: .doc, available for editing
GRAB THE BEST PAPER93.8% of users find it useful
Mandated Staffing Ratios
Read Text Preview

Extract of sample "Mandated Staffing Ratios"

? Man d Staffing Ratios Man d staffing ratios Introduction Different hospitals have been adopting different nurse staffingsystems depending on different factors. Ratio staffing involves specific RN-to-patient ratio. For instance, 1:2 is a ratio whereby one nurse is assigned to two patients. It has been the core supportive element of RN staffing, but it is rigid because it does not allow for acuity. In October 1999, California was the first state to enact mandatory staffing ratio legislation, which requires minimum, specific, licensed nurse-to-patient ratios for all acute care hospitals (Zimmermann, 2002). This legislation was sponsored by the California Nurses Association. The peak of a nurse’s concern over adequate staffing reached the public, and forced staffing changes for the better. Other states followed suit, introducing bills pertaining to staffing initiatives in their state legislatures. Minimum ratios for critical care units were already in effect (Perrin & McGhee, 2008). These included hospital, intensive care units and operating rooms. Initially, management of hospitals could staff nurses across units in a flexible manner. A controversy arose regarding the effectiveness of the mandated staffing ratios legislation. This essay analyses the merits and demerits of mandated staffing ratios compared to acuity-based, flexible matrices established, through collaborative governance processes. Discussion Mandated staffing ratios are said to limit hospitals’ flexibility in staffing. They prevent management from customizing staffing levels to patient needs. Besides, technology advanced hospitals may have difficulties in substituting technology for nurses appropriately. Opponents of the mandated staffing ratios have expressed their fears that the minimum staffing ratios would become the average staffing ratio, as hospitals may be tempted to reduce their staffing to the lowest level required by the legislation (Perrin & McGhee, 2008). The legislation is not empirically supported because previous data of staffing for best practices hospitals does not uniformly indicate that hospitals which are rated highly for quality of patient care have richer staffing than other hospitals (Perrin & McGhee, 2008). Therefore, critics of mandated staffing ratios argue that it is not clearly evident that legislating staffing ratios enhances patient care. In Massachusetts, the Massachusetts Nurses Associations argues that the safe RN staffing bill in California is working, though they cannot demonstrate that patient outcomes have improved. Negative consequences have not occurred for the health care system, and a positive effect has been seen on the nursing profession from the mandated ratios (Perrin & McGhee, 2008). There had been no hospital closures in California. In addition, hospitals did not find it as tedious as they estimated, to meet the staffing ratios for the two and half years since the staffing ratios came into effect (Perrin & McGhee, 2008). Proponents of the mandated minimum ratios claim that RN staffing had fallen behind the needs of the increasing severity of hospitalized patients, and higher RN ratios will increase patient safety and quality of care (Feldstein, 2013). They also argue that minimum legislated ratios will not become the maximum, but rather the best hospitals will exceed such standards and the worst will be forced to stop assigning eight or more patients to the medical surgical nurse (Dunham-Taylor & Pinczuk, 2010). They believe that failing to set minimum standards will not be impossible because of the shortage, but rather poor staffing is a cause of the shortage, and will continue until staffing is fixed. Another drawback of the mandated staffing ratios is that staffing levels are determined by the government, away from the bedside. Given that it is only the hospital management that understands health care requirements in its units, it is controversial for the government to determine staffing levels, when the government officials do not have the slightest idea of hospital units. Also, mandatory staffing ratios represent a legislation that will take long to achieve the needed changes because they must go through legislation (Zimmermann, 2002). The minimum levels may become the standardized maximum for most hospitals, leading to deterioration in patient outcomes in hospitals and units where patients are many. It may be difficult to achieve an agreement concerning what the optimal staffing level should be, among various nursing organizations. Also, the government assumes that a nurse is a nurse. Therefore, it bases the staffing ratios on mere numbers. This may be a misguided focus because the emphasis should be on patient outcomes, and not on mere members. It should be noted that having mandated staffing ratios does not guarantee the outcome of adequate staffing because staffing needs can change instantly, as a patient rapidly deteriorates. As far as different nurses are concerned, staff characteristics such as experience level, influence the patient load that a specific nurse can handle adequately differ significantly (Zimmermann, 2002). Besides, ratios may increase hospital costs (Feldstein, 2013). The mandated staffing ratio denies nurse managers freedom to increase the number of nurses working on their units. This leads to loss of flexibility to move nurses around a hospital as the administration sees fit (Gordon, 2006). It should also be noted that the cost of compliance with legislative mandate may be excessive. Furthermore, ratios may prevent managers from staffing units with a suitable mix of inexperienced and experienced nurses. Any legislated minimum is likely to become the maximum for most hospital facilities. Nurses are likely to lose their control of their practice, and there may not be enough nurses to meet ratio requirements once the ratios are enacted. Only some hospitals have let RNs provide more care to fewer patients. Instead, they have directed them to give less care to more and sicker patients, as workloads have increased (Gordon, 2006). Opponents of the mandated minimum ratios are vocal about the ineffectiveness of this approach. They argue that nurse-to-patient ratios are counterproductive to evident-based decision making, and are inappropriate as a staffing methodology for the complex phenomenon of patient care. Ratios assume that care is constant within each level of care, despite the length of stay, skill mix, care delivery model, cost, competence and geography of the unit (Dunham-Taylor & Pinczuk, 2010). The assumption contradicts what is known about patients by nurses that patients can all be very different, require very different interventions and have a variety of holistic needs, as much as they may be residing within the same unit. Therefore, adoption of inappropriate standards by units can result into a continuous cycle of unfulfilled expectations. Some leaders may lower current effective RN staffing to the required minimum, hence reducing the quality of patient care. The legislated minimum in rural areas may be ineffective, as well as, trauma settings that have an extensive variety of patient care requirements (Dunham-Taylor & Pinczuk, 2010). This may lead to failure to rescue patients by nurses, where one nurse should attend to a large number of patients. Therefore, unplanned negative patient consequences occur. Mandated staffing ratios do not consider the range of patient care acuity and fluctuations in daily care. It is assumed that nurses are always available. Unfortunately, minimum ratios could become the maximum ratios. The staffing ratios reflect the differing skills of nurses, and may force closure of hospital beds in the annual budgeting process. In addition it devalues the role of nurse critical thinking and judgement. The mandated staffing ratios assume a manufacturing model is appropriate for patient care, which is never the case. It removes staff accountability from the organization and transfers it to the government. it is imperative to note that patient care is widely varied in required hours and caregiver skill level (Dunham-Taylor & Pinczuk, 2010). In acuity-based, flexible staffing, units plan their staffing and make staffing decisions in each and every shift on the presumption that all of their beds will be full with the typical level of acuity (Zimmermann, 2002). Patient characteristics, staff and the system are other factors that affect staffing. Acuity-based, flexible staffing considers historical average patient acuity and offers incentives for nurses to return to continue providing health care. It is simple to regulate specific numbers. In addition, it alleviates nurse stress in short term and increases nurse satisfaction (Dunham-Taylor & Pinczuk, 2010). It improves patient safety outcomes. It should be noted that traditionally, nurses support equal numbers of patients assigned to each nurse, regardless of activity. Conclusion In flexible, Acuity-based staffing, hospital staffing ratios are usually determined by the administrative staff of a facility. They are also determined by the health care system to which the hospital is affiliated. In acuity based system, a patient’s health status and needs are rated to help determine staffing levels. Given that individual patients’ health status and needs can differ broadly, mandated staffing ratios may be ineffective. Also, each hospital is different in terms of the population served and organizational variables (Wunderlich, Sloan, & Davis, 1996). An acuity-based staffing is closely aligned with changing needs of the patient and gives credit of time for patient which is never considered (Mensik, 2012). Given that mandated staffing ratios have many demerits, and that flexible acuity-based staffing has numerous merits, staffing should be based on patient needs. This enables facilities to manipulate ratios by moving patients to units that have higher ratios, when nurses are not available. References Dunham-Taylor, J., & Pinczuk, J. Z. (2010). Financial Management for Nurse Managers: Merging the Heart with the Dollar. Sudbury: Jones and Bartlett Publishers. Feldstein, P. J. (2013). Health Care Economics. New York : Cengage Learning Press. Gordon, S. (2006). Nursing Against the Odds: How Health Care Cost Cutting, Media Stereotypes. Ithaca: Cornell University Press. Mensik, J. (2012). The Nurse Manager's Guide to Innovative Staffing. Indianapolis: Sigma Theta Tau International Press. Perrin, O. K., & McGhee, J. (2008). Quick Look Nursing: Ethics and Conflict. Sudbury: Jones and Bartlett Publishers. Wunderlich, G. S., Sloan, F. A., & Davis, C. K. (1996). Nursing Staff in Hospitals and Nursing Homes: Is It Adequate? Washington, D.C: National Academy Press. Zimmermann, P. G. (2002). Nursing Management Secrets, Issue 974. Philadelphia: Hanley & Belfus Press. Read More
Cite this document
  • APA
  • MLA
  • CHICAGO
(“Mandated staffing ratios: legislated minimum RN staffing rations vs Essay”, n.d.)
Mandated staffing ratios: legislated minimum RN staffing rations vs Essay. Retrieved from https://studentshare.org/nursing/1485291-mandated-staffing-ratios-legislated-minimum-rn
(Mandated Staffing Ratios: Legislated Minimum RN Staffing Rations Vs Essay)
Mandated Staffing Ratios: Legislated Minimum RN Staffing Rations Vs Essay. https://studentshare.org/nursing/1485291-mandated-staffing-ratios-legislated-minimum-rn.
“Mandated Staffing Ratios: Legislated Minimum RN Staffing Rations Vs Essay”, n.d. https://studentshare.org/nursing/1485291-mandated-staffing-ratios-legislated-minimum-rn.
  • Cited: 0 times

CHECK THESE SAMPLES OF Mandated Staffing Ratios

Evidence Base Research: Impacts of High Nurse to Patient Ratios

There is a substantial amount of evidence based research that highlights that patient outcomes are poorer, infection rates go up, and failure to rescue increases when nurse to patient ratios are high both in telemetry and surgical units.... At my hospital, nurse to patient ratios have been increased for telemetry nurses to 6 to1, and for medical surgical nurses, 7 to 1.... This paper aims to present research that consolidates the need to have suitable nurse to patient ratios, and also which highlights the lack of standardization in the methodology through which nurse to patient ratios are decided....
8 Pages (2000 words) Research Paper

The Possibility of Nursing Shortages

But is is true that patients will receive better care, with fewer medical errors under a system of precise nurse-patient ratios?... Over a dozen states are now considering some form of mandate that will enforce specific ratios of nurses for every patient under the hospital's care, it is worthwhile to examine critically the available research on the balance between caregiver and patient.... ?? PROS More nurses equals better care; in order to ensure the best possible patient outcomes during hospitalization, nurse-to-patient ratios must be mandated by law....
9 Pages (2250 words) Research Paper

Mandating Nurse-Patient Ratios

Considering, various reports it has been ascertained that with the implementation of California -Mandated Staffing Ratios, there has been a massive increment in the overall job satisfaction degree deciphered by the nurses along with an acceleration in the quality of patient care (Aiken, Sloane, Cimiotti, Clarke, Flynn, Seago, Spetz & Smith, 2010; Abood, 2007).... Thus, aligning the strategies of enforcing nurse-patient ratio with the California –Mandated Staffing Ratios will assist me in developing a detailed plan for influencing the state's legislature to attain greater effectiveness in this context....
3 Pages (750 words) Essay

Practicum Management Assignment

These proponents have argued that as regards patient care, fewer patients assigned Effects of Man d Nurse-Patient ratios Man d nurse-patient ratios in the Unites s have prompted a lot of deliberations and debates among the members of the healthcare community.... They also argue that hospitals are very much committed to providing quality patient care while still utilizing safe staffing levels, however, they feel that legally imposing nurse-patient ratios does not ‘allow for fluctuations in the supply of nurses and does not account for new technology' introduced into healthcare (Lewis, 2005)....
2 Pages (500 words) Essay

Nurse-to-patient Ratio Staffing

State-mandated safe-staffing ratios will be important to ensure both patient and nurse safety.... Does the nurse to patient staffing ratios affect the hospital performance positively or negatively?... Legally mandated nurse to patient ratios is a controversial topic in healthcare.... Mandating ratios is one attempt to ensure that a nurse workload does not exceed the needed level for adequate patient care (Conway, 2008).... However, these essential ratios are not without consequences....
9 Pages (2250 words) Research Paper

Nurse to Patient Ratio Policy

t is clear from different books and articles present that the issue of mandatory nurse to patient staffing ratios is not new to the healthcare system.... different aspects of the nurse to patient staffing ratios led to higher patient mortality, nurse dissatisfaction, and even medical errors.... It also tried to reduce the nurse to patient ratios that existed at the time, which were associated with negative outcomes among the patients and loss of nurses (Sloan & Chee-Ruey, 2012)....
5 Pages (1250 words) Coursework

Mandated Staffing & Working Hours for RN's

The study mentioned above, along with other examples, reinforces the view of the NMONE, that Mandated Staffing Ratios is not the solution to better working conditions and better patient care.... 'Proposed minimum, nurse-to-patient staffing ratios, such as those enacted in many U.... In a 2004 to 2006 study of mandatory nurse staffing ratios in California, results indicate that mandates did not improve patient care.... A system that bills the patient based on the level of care required, separately from other services, may allow the mandatory staffing ratios to improve conditions for patients and nurses alike....
3 Pages (750 words) Essay

How Have Mandated Nurse Staffing Ratios Affected Hospitals

The author of this paper "How Have Mandated Nurse staffing ratios Affected Hospitals" has analyzed the findings of interviews held with two practitioners regarding the issue of financial implications of nurse understaffing in the home health agency.... Statistically, studies have demonstrated that 'about 45 percent of new nurses leave their first hospital jobs within two years of graduating from nursing school – and inappropriate nurse staffing levels are unlikely to encourage them to remain at their first hospital of employment' (Sanford, 2010, p....
3 Pages (750 words) Assignment
sponsored ads
We use cookies to create the best experience for you. Keep on browsing if you are OK with that, or find out how to manage cookies.
Contact Us