Let’s be honest: nurses have their limits. Though many can provide superhuman levels of care, that doesn’t mean nurses can endlessly juggle patients without a loss in quality. In fact, high nurse to patient ratios negatively impact the healing process.
The reality is pretty harsh. Patients are at a higher risk of infection, greater complications, readmission for the same ailment, and even death when nurse to patient ratios get out of hand. Healthcare facilities feel serious strain when the ratio is out of whack. Worst still, that imbalance is the norm rather than the exception.
What’s being done to rectify the disparity? Some states have passed legislation to regulate nurse-to-patient ratios: California, Connecticut, Illinois, Minnesota, Nevada, New Jersey, New York, Ohio, Rhode Island, Texas, Vermont, and Washington have each taken their own action. Michigan is fighting to enact legislation and New Mexico, North Carolina, Maine, and Washington D.C. have made separate attempts in the past. The problem with all of those separate attempts is that they have equivocal results for native and travel nurses.
The question is: would a clearly defined national nurse to patient ratio sort out this mess or just cause greater complications?
Where It All Began
Nursing shortages have existed in the United States since the 1960s with relative consistency. There are some who predict that we might see a nursing surplus in the future, but others argue that we’ve only ever seen nursing surpluses as a result of recessions.
Regardless, the percentage of time over the past 55+ years that we’ve seen an out-of-control ratio was enough for the federal government to address this public health issue with federal regulation in 2011. But the way they wrote this public health regulation has made the situation intractable ever since.
All of the trouble comes down to one word: “adequate.” The regulation states that any hospital certified to participate in Medicare must “have adequate numbers of licensed register nurses, licensed practical (vocational) nurses, and other personnel to provide nursing care to all patients as needed.” That’s incredibly vague and has led to a wide range of interpretations with few similarities.
Disparity Breeds Varying Results
There is little concession about what “adequate” means between the states that have chosen to acknowledge the issue. Seven states only require that each hospital appoint a committee to decide staffing plans and policies without mandating the exact ratio. California mandates a strict minimum nurse to patient ratio. Massachusetts passed a law that is specific to the ICU, requiring a 1:1 or 1:2 nurse to patient ratio depending on the stability of a patient’s health.
For travel nurses, the varied nurse to patient ratio means that certain states are going to have a much higher, consistent demand than their neighbors. California and Massachusetts will consistently have an unquenchable need for travel nurses. Other states like Washington or Illinois will depend on each specific hospital’s staffing policies.
In general, states without regulated nurse to patient ratios don’t need travel nurses any less. There just aren’t any institutionalized rules to hold hospitals accountable to a level of quality that patients and nurses desperately need. However, there is a grassroots movement focused on changing that.
A Possible Solution
National Nurses United is advocating for a national nurse to patient ratio to address the growing demand for nurse practitioners, nursing assistants, and other nursing staff. One of their main goals is to encourage safe staffing conditions that benefit both nurses and patients across the country. They point to California as a victory for quality care in the United States and believe that it’s only the beginning.
Two bills have recently been proposed in both the Senate and the House with the objective of creating a minimum standard that benefits hospitals, nurses, and patients alike. It would do away with the hodge podge ruling and create an amenable standard nationwide. And of course, travel nurses will be able to pursue a wider array of opportunities as every state gets in line with this commitment to quality.
Want to get involved? You can send a letter to Congress compelling them to take action on either of the two bills. And if you want to stay current with all the latest news that relates to travel nurses, it’s time to register with Travel Nurse Circles. We provide our members with news, resources, and tools that can help them easily navigate their next travel nurse job search.
Plus, those nurses who register with Travel Nurse Circles before December 10th, 2015 will be entered into a $1,000 sweepstakes. Act now because time is running out.