Safe Staffing Legislation

Mandating nurse staffing ratios is one, albeit controversial, way of approaching staffing in patient care areas.  The American Nurses Association has been outspoken on this issue, calling for legislation mandating staffing plans and ratios.

A recent American Nurses Association (ANA) survey of almost 220,000 RNs found that 54% of nurses do not have sufficient time with patients, 43% have been working extra hours because of short staffing, and 20% reported that inadequate staffing affected admissions, transfers, and discharges.

Legislation to aid in staffing plans and ratios has been discussed on both the state and federal level. Currently, 15 states (CA, CT, IL, ME, MN, NV, NY, NC, OH, OR, RI, TX, VT, and WA) plus the District of Columbia have enacted legislation or adopted regulations to address nurse staffing.  Of these states,  seven (CT, IL, NV, OH, OR, TX, and WA) require hospitals to have staffing committees to address staffing plans and policies, one state (CA) requires the minimum nurse-patient ratio to be maintained at all time, and five states (IL, NJ, NY, RI, and VT) require public disclosure or reporting.

In a statement on its website, ANA says that it “supports a legislative model in which nurses are empowered to create staffing plans specific to the unit and patient population and to which healthcare facilities are held accountable.” In this type of model (rather than mandated fixed ratios), which is not a “one size fits all” approach, ANA says that hospitals would have the flexibility to develop staffing plans that fit their particular institutional and patient needs. Mandated ratios can be inadequate depending on severity of patient illnesses, experience and training of nursing staff, technology, and nurse support services, all of which can change with little to no notice.

For more information on legislation pertaining to nurse staffing and details on the laws in your state, visit ANA’s Nurse Staffing Plans and Ratios page.