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The Nurse to Patient Ratio Issue

Currently Michigan does not have any defined nurse-to-patient ratio standards, and that
can directly affect the quality of care a nurse gives to patients. A study done by the Journal of
American Medical Association(JAMA) found that In hospitals with high patient-to-nurse ratios,
surgical patients experience higher risk-adjusted 30-day mortality and failure-to-rescue rates, and
nurses are more likely to experience burnout and job dissatisfaction (Aiken et al., 2002). There
is no definitive staffing standard outlined by the Joint Commission, which leaves states to make
individual laws to pass.
The American Nurses Association (ANA) identifies the states that have some staffing
policies in place. At this time there are 13 states that have laws and regulations in place for
nurse-to-patient ratio staffing. Seven states require committees for staffing and reporting, five
require some form of disclosure or public reporting, and California is the only state in which
there is a law that requires a minimum nurse-to-patient ratio that must be maintained at all times
(ANA, 2014).
Michigan attempted to pass a bill to regulate staffing, however it was not passed. Since
California is the only state that has a defined staffing practice and this has been implemented into
law since 2004, Michigan has had plenty of time to evaluate the success of this law. The
Michigan Nurses Association (MNA), has advocated for this change and states simply put,
California is a success story and According to studies, patients are safer, the quality of nurses
has not gone down, and a nursing shortage has not emerged because with better staffing, the state
is a more attractive place for nurses to work (MNA, 2014).

I believe there should be some implementation of a staffing law. California has had this
law in place for over 10 years, with plenty of research supporting the positive patient outcomes
and staff satisfaction. I hope that soon, Michigan will wake up and consider staffing law as an


Aiken, L.H., Clarke, S.P., Sloane, D.M., Sochalski, J., & Silber, J.H. (2002). The journal of
American medical association (JAMA). Hospital nurse staffing and patient mortality, nurse
burnout, and job dissatisfaction. Retrieved from: http://jama.jamanetwork.com/article.aspx?
American Nurses Association (2014). Nurse staffing plans & ratios. Retrieved from:
Michigan Nurses Association (MNA) (2014). MI needs a safe staffing law NOW! Retrieved
from: http://www.minurses.org/legislation/safepatientcare