Many of my colleagues in the nursing profession seem to concur that increasing nurse-staff ratios is the answer to the issue of delivering high quality care to a large number of patients. I, too, share the same view, believing that this is too critical an issue to leave up to the jurisdiction of individual hospitals. There are lives on the line as we speak, and in this lies the premium which makes this issue worthy of attention – and apt legislation. Strong regulation is the key to enhanced staffing, even amidst the complexity of its implementation which its critics have pointed out.
There has been empirical proof that suggests that increasing the staff to patient ratio does have a significant effect on improving patient outcomes. Moreover, there has also been numerous researches which indicate that “market forces” are just inadequate in triggering positive change among hospitals, specifically in attempting to enhance patient outcomes through improved nurse staffing. Apart from ensuring that the number of nurses is adequate, it is also crucial that the competence of nurses be ensured, as well as access and availability of support staff – that is, improving the number of nurses alone is insufficient without all these other critical variables which synergize to guarantee the delivery of high quality patient care. Logically, the education, skills, and experience of the nurse must be thoroughly reviewed and numbers must not be addressed at the expense of quality nurse staffing.
One viable suggestion to realize this means is the identification of clear clinical and human resource predictors of recruitment effectiveness, which aims to raise the standards of nurse recruits. The approach ought to be empirical, where actual research is conducted towards validating hiring and selection practices and their correlation with patient outcomes. This is similar to the stance put forth by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO).
This positive change is only possible if there are concrete steps taken towards its realization. In effect, we must lobby for this agenda and form support groups that will work towards this noble goal. We can only take California as the epitome of legislative success when it first adopted this move to standardize nurse-patient ratios. Lobbying for this cause may not be enough, and we go back to the need to build the business case – by lending credence to our claim that increasing nurse-patient ratios do increase the quality of healthcare accorded to patients. If this herculean task is left to the discretion of hospitals, we cannot hope for expeditious change. The reality is pretty apparent – there seems to be a dire lack of adaptability and the desire to maintain the status quo at all costs. There is also shrugging off of voluntary guidelines and the persistence in having nurses take more patients than can be realistically handled. After building our case, we proceed for legislation and strictly abide by the guidelines put forth before us. We cannot wait for hospitals to be altruistic – we have to move decisively. This is all in the name of enhanced patient care. In the end, positive patient outcomes are the bottomline.