Nurse to Patient Staffing Ratios – Care Example

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"Nurse to Patient Staffing Ratios" is a perfect example of a paper on care. Nurses are charged with the main responsibility to improve health care quality by patient safety strategies and interventions. Quality health care is the key concept under which the safety of patients prevails. However, deliberations of compulsory ratios of nurses to patients is still a largely controversial issue among nurses, physicians, patients nursing organizations, and vested stakeholders as well as state and federal governments (McCue, 2008). It is evident that nurse staffing impacts patient outcomes and this links nurse staffing directly to patient safety and nurse retention.

Therefore, a specific, regulated, and guaranteed staffing of nurses will result in better care and lessen work burdens for nurses while increasing job satisfaction. This paper will demonstrate that when there is a maximum number of patients that may be assigned to a nurse, the patients will benefit from greater safety and receive improved quality of care. Patient care quality and safety are not only a direct function of the nursing workforce’ s experience but also their number (Cimiotti, 2012). Therefore, in the same sense, the maximum number of patients that nurses can deliver quality, competent and safe health care must be considered.

That is because such consideration will ultimately impact both patient outcomes and nurse satisfaction. The reliability of this concept is that once the working environments for the nurses are improved, it will attract new nurses and even those licensed but not present or actively working in the field of nursing. Then, with more nurses in the fraternity, it is possible to achieve the optimum ratio and deliver quality services (Bootman, Cronenwett & Bates, 2006).

The ultimate beneficiary will be the patient since the standards of the services will inevitably improve. Inappropriate staffing will only shift the balance in the ratio and make the difference between quality health care and insufficient health care, which compromises safety and increases the risk of mortality. When the maximum number of patients assigned to a nurse is considered, there will be fewer cases of nurse burnout, which can be both emotional and physical exhaustion (McHugh, Berez & Small, 2013). Hence, each extra patient placed under the responsibility of a nurse is a potential cause of burnout, which will affect the quality of service the nurse is expected and obligated to deliver.

According to a study conducted in 2010, Pennsylvania could have avoided 14% of the reported nursing-related mortalities that year if it had a set nurse-to-patient ratio (Aiken, 2010). On the other hand, the same study found that California, which has a mandated nurse to patient ratio, reported less mortality rates of patients within a 30-day period of admission to hospital. Further studies have also shown that when the number of nurses is increased at the ratio of one nurse per every patient admitted, there is a reduction of 26% in the time they stay in the intensive care unit (Aiken, 2010).

From the business perspective, it may not be financially feasible to increase the number of nurses at that rate. However, it is evident from such surveys that when a certain number of patients per nurse is exceeded, both nurses and patients are endangered. Addressing the maximum number of patients a nurse may take care of is a direct way of addressing the nurses’ working environment (Bootman, Cronenwett & Bates, 2006).

With improved environments and working conditions, patient safety is improved. A large number of patients per nurse is linked to compromised safety and poor patient outcomes. Therefore, adequate staffing ratios will facilitate nurse satisfaction, which leads them to perform better and benefit their patients. On the other hand, when a nurse is charged with the care of a large number of patients, they will not be able to deliver services and medication on time (McHugh, Berez & Small, 2013).

They will also not be able to adequately monitor their patients and troubling symptoms may go unnoticed. For example, it may take up to 90 minutes for a patient whose heart has stopped to be stabilized (Stewart, 2006). At that rate, it shows that fulfilling schedules with too many patients may not be possible. Therefore, adequate staffing will imply that the maximum number of patients under one nurse is considered and that will lead to balanced workloads and achieve greater safety and better quality of care. Other studies have established that health care institutions that have better staffing levels of nurses are less at risk of being penalized under the Hospital Readmissions Program as compared to those with poor staffing levels (McHugh, Berez & Small, 2013).

It was also established that the main cause is nurses who lack basic care experiences such as patient education, care coordination, and evidence-based interventions. Essentially, this may be viewed in terms of nurse satisfaction or, more appropriately, the lack of it. Hence, administrators will be in a position to address issues of quality by placing more emphasis on system factors like, for example, nurse staffing (Chapman, 2009).

On the other hand, when the possibility of penalties increases because of too many readmissions, the entire staff will be demoralized, which will lead to the unfavorable results of poor service delivery. Therefore, when health care institutions invest sufficiently in nurse staffing, which will, in turn, afford them favorable nurse-to-patient ratios, the quality of care will be improved and benefit the patients (McHugh, Berez & Small, 2013). In conclusion, it can be demonstrated that when the maximum number of patients that a nurse can take care of at any one time is regulated, patients will benefit from better health care quality and safety.

This is mainly because the number of patients will also influence the kind of attention they receive and, eventually, the quality and safety. Understaffing will dictate that the ratio will be poor, which inevitably endangers both patients and nurses. When an optimum balance is achieved, nurses will report less burnout and instead, like their jobs. This will ultimately translate into better service delivery.

The right balance means the working environment is also addressed in planning the nurses’ schedules and that will enable them to perform at their best (Bootman, Cronenwett & Bates, 2006).


Aiken, L. (2010). Implications of the California Nurse Staffing Mandate for the Other States. Health Services Research, 45(4), 89-92.

Bootman, J., Cronenwett, L., & Bates, D. (2006). Preventing medication errors. Washington: National Academies Press.

Chapman, S. (2009). How have mandated nurse staffing ratios affected hospitals? Perspectives from California hospital leaders. Journal of Healthcare Management, 54(5), 321-335.

Cimiotti, J. (2012). Nurse staffing, burnout, and healthcare-associated infection. American Journal of Infection Control, 40(6), 64-66.

McCue, M. (2008). Nurse staffing, quality, and financial performance. Journal of Health Care Finance, 29(4), 2003, 54-76.

McHugh, M., Berez, J., & Small, D. (2013). Hospitals with higher nurse staffing had lower odds of readmissions penalties than hospitals with lower staffing. Health Affairs, 32(10), 1740-1747.

Stewart, R. (2006). Nurses see a danger in short staff. Massachusetts: Boston Globe.

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