Supplemental Nurse Staffing Helps Everyone

by Jennifer Bradford on May 18, 2010

A recent study performed by the California Nurses Association found that having a reduced nurse to patient ratio decreased the mortality rates of patients and also helped to decrease the burnout rate of nurses.

One of the ways California met the reduced patient ratio was by hiring nurses to supplement their regular staff from staffing agencies.

As a control, the study used New Jersey and Pennsylvania nurses. In total, the California nurses were caring for about one fewer patient in standard wings and two fewer in surgical or medical units. If the statistics for California held true, in regards to mortality rates, the decrease in surgical deaths across the board would be 10.6% in Pennsylvania and 13.9% in New Jersey.

What does this mean for nurses and patients? It means that a reduced nurse to patient ratio is a good thing all around. This is the same theory that has pushed reduced class sizes in schools and lower ratios in hospitals in other states; the more time a person has to focus on their charges, the better job they will be able to do. In a hospital setting this is more critical than anywhere else, because lives are on the line.

The one major issue with reducing the ratio is that it can cost the hospitals a significant amount of money to hire additional full time staff, especially if that staff is not always needed to meet ratio mandates. One option hospitals are increasingly turning to is nurse staffing agencies that can provide temporary nurses who are available for anywhere from one day to a few months. The reason this option is so appealing is that the hospitals only have to pay for the staff that they need, so if there is an increased outage amongst their own nursing staff due to illness or vacation time or an increased patient load, they are able to meet the requirements without adding permanent resources they ultimately do not need.

What about the patients? I know from personal experience that, when I was in the maternity wing, my nurse only had myself and one other patient to take care of, and the care was exceptional. I was checked on repeatedly, if we rang the bell for any reason it was promptly answered, and I had no post-surgical problems. On the other hand, when my father was in the hospital, his nurse had nearly half a dozen patients, and his medications were messed up routinely, tests that were scheduled were often overlooked, and communication was difficult. I know these are two different types of situations, but anecdotally they confirm what the study found: the lower the ratio, the better the service.

Have you found this to be true as a patient? If you are a nurse, have you had the opportunity to work in both a high and low ratio environment? If so, how would you compare the two experiences?


{ 2 comments… read them below or add one }

Lukasz Wiezel 02.03.11 at 10:51 pm

I’ve worked with RN’s for the past four years. One important question that is always asked has to do with nurse to patient ratios. I think California’s initiative to mandate a lower ratio is an example of putting the patient first.

Hiring contract nurses is a great way for facilities to put the patient first and control their budgets. Fluctuating census figures can be tough for managers to handle, temporary nurses offer the immediate solution.


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