Mandatory Nurse Patient Ratio - Essay Example

"Mandatory Nurse Patient Ratio" is an engrossing example of a paper on care.
It is mandatory for hospitals to observe the nurse-patient ratios in California (Hwang, 2009). This was after it passed California Assembly Bill in 1999. It defined the minimum specific and numeric nurse to patient ratios in all the hospitals in California. In the medical-surgical unit, the ratio is 1:6 and it is supposed to reduce to 1:5 after the first year. Behavioral units also apply this ratio. In the step-down units, the ratio is 1:4 and this ratio is the same in telemetry, intermediate care units, and non-critical emergency rooms (Tevington, 2010). In the intensive care units and burn units, the ratio is 1:2. The patients are in critical condition and thus they need more care and assistance. The post-anesthesia units also use this ratio. The patient-nurse ratio in patients under anesthesia is 1:1. The proposed ratios have progressed to various states in the United States. About 17 states have adopted the mandatory nurse-patient ratio legislation. New Jersey adopted this legislation in 2010.

History

In the early 1990s, a decrease in healthcare financing and the restructuring of the system led to a decrease in the number of licensed caregivers in hospitals and an increase in the number of unlicensed caregivers (Bergman, 2003). The patient acuity also increased and the length of patient hospital stay decreased. On October 10, 1999, California Governor Gray Davis signed Assembly Bill 394 that required all hospitals to meet a fixed patient-to-nurse ratio (Bergman, 2003). This was due to the increase in the number of patients per nurse in 1994.

 Effectiveness of the legislative regulation to support a positive nursing environment

Research conducted on hospitals in California revealed that the nurses in these hospitals are paid more wages compared to other nurses in the industry (Hwang, 2009). This improves the motivation of the nurses and thus they attend to patient needs more effectively. In addition to this, because the nurses are not overworked, they perform better in their profession and thus they get more time to interact with their patients and this improves the patient-nurse relationships.

Ineffectiveness of the legislative regulation to support a positive nursing working environment

Research conducted on Californian hospitals has revealed that after this bill was passed, hospitals started to force the workers to work overtime since hospital management felt that they paid their nurses more wages for less effort (Tevington, 2010). This is because the number of patients that the nurses could attend to had reduced.

Controversial aspects

There are controversial aspects of the patient-nurse ratio to the nursing profession. The nursing profession expects that all the nurses offer their patients maximum care in order to improve their safety (Tevington, 2010). This ratio aims at reducing the number of patients that a nurse can attend to and in some instances; nurses refuse to take care of extra patients. The healthcare organization also incurred more costs since the healthcare management was forced to hire more nurses to take care of the patients. The healthcare organizations also incur more costs in training the nurses (Hwang, 2009). To the consumers, the bill ignored several aspects such as incorporating the length of stay of patients, patient acuity, and treatment length.

Editorial Comments

I believe the legislated patient ratios are an effective way to manage the nursing workload. This is because a nurse will be able to know the number of patients whom he/she is to attend in a day and thus he will be able to manage his/her efforts appropriately. I think the responses to the mandated ratios in California are positive. Other states have adopted this idea and they are implementing them in their hospitals. There are additional issues that have arisen since this legislation was enacted. Governor Arnold Schwarzenegger tried to oppose this law in 2005 but the public defeated him in court.