Running head: REDUCED NURSE-PATIENT RATIO

Reduced Nurse-Patient Ratio

Institution

Date
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Reduced Nurse-Patient Ratio

Summary

Nurses are of great importance in the operation of any hospital. The provision of high-

quality services largely depends on them (Falk & Wallin, 2016). The number of the nurses in a

hospital can be said to be low, sufficient, or high. All these occurrences have their effects on the

effectiveness of the service delivery of the nurses towards the patients. While low levels and

overpopulated hospitals with the nurses may largely lead to negative impacts, sufficient nurse-

patient ratios are said to result in the optimum efficiency of the nurses regarding their service

delivery towards the patients. Thus, this paper seeks to look deeper into the reducing nurse-

patient ratio and the probable effects that come along with this fact.

Reduced nurse-patient ratio refers to a state where a nurse is expected to serve as a

reduced number of patients as possible. Several types of research reveal that the management of

hospitals is always on a look for ways of reducing the costs while improving efficiency at the

safe time. As a result, they tend to reduce the number of hours the nurses spend at work since

nurses form a large fraction of hospital staff. However, the Affordable Care Act (ACA) compels

the hospitals to ensure appropriate nurse-patient ratio to facilitate value-based care (Leigh et al.,

2015).

According to various researchers and authors have found out very dire issues linking the

nurse staffing in a hospital to a mortality rate of the inpatients and the nurse’s job satisfaction

and burnout (Olley et al., 2018). It alludes that the patients who were in hospitals that had

increased nurse-patient ratios experienced increased mortalities to highs of 31 percent. Other

than negative outcomes of the patients, there was also the discovery that nurses who operated in
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worst staffed hospitals had high instances of dissatisfaction in their jobs. It was also brought to

light that the nurses who have the highest patient caseloads stand a double risk of experiencing

burnout related to their job. Thus, it is clear that keeping a reduced nurse-patient ratio is

imperative for the positive outcomes and quality patient care in hospitals.

Affirmative arguments for the reduced nurse-patient ratio

Reduced nurse-patient ratio plays a key role in helping to decrease the fatigue among the

nurses (Olley et al., 2018). Consequently, there results in increased safety and job satisfaction

among the nurses. Thus, there are reduced cases of chronic fatigue, insomnia, weight gain,

irritability, depression, and other health risks that result from overworking among the nurses. As

a result, this gives the nurses the ability to offer the best of their services to the patients when

they are in their best of the condition. Further, this law allowed the nurses to spend enough time

with their patients. Thus, the nurses have a better chance of creating a good rapport with their

patients which has positive effects on the recovery of the patient.

Further, the reduced nurse-patient ratio is integral in decreasing the patient mortality.

Apart from the reduced mortality, other preventable mistakes are also proven to undergo

significant reduction. These preventable mistakes may include among others pressure ulcers;

patient falls, healthcare-associated infections, and central line infections. It was found out that

the hospitals in California experienced reduced procedural mistakes as well as improvement in

the patient outcomes after the enactment of the law of proper nurse staffing.

Lastly, reduced nurse-patient ratio leads to improved retention and recruitment rates

(Leigh et al., 2015). For instance, it was seen that in the first year of the enactment of the proper

staffing law in California there was an increased application for nursing licenses as reported by
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the California Board of Nursing. This increase was over 60 percent as compared to the previous

periods. In addition, by the year 2008, there occurred increased vacancies for the registered

nurses in the hospitals belonging to the states by 69 percent.

Counter arguments against reduced nurse-patient ratio

One of the main drawbacks of the reduced nurse-patient ratio is the high cost that

accompanies it. There is a view that the minimum nurse-patient ratio tends to impose steep

financial costs on the hospitals. Further, it has an effect of allowing the hospitals to have a very

little effect on making decisions concerning staffing. Thus, it places a demand on the hospitals to

increase funding towards the nursing programs.

On the other hand, there is a dire need for the hospitals to employ more nurses as well as

increase their salaries and benefits to remain competitive and attract top-notch employees to fill

the required vacancies (Gelinas, 2016). Also, the pressures that result from high cost due to this

ratio laws impact negatively on other nurse support commitments. Such commitments may entail

development of professionals, programs of nurse residency, and research support among other

funding for nurses during the time they are away from the bedside. In the case of California, it

can allude that it was an investment. It is not implementable in every other state since not all of

them have the financial capacity to implement such an enactment.

According to Falk and Wallin (2016), laws regarding nurse-patient ratio tend to increase

the time that a patient has to wait before being attended to for treatment. In a case where the

patients are waiting to be admitted into a ward that has an available empty bed with no much

activities taking place, the nurses will be barred from attending to these patients as a result of the

ratio requirements of the law. Further, the nurse-patient ratio laws give no regard to the situations
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that demand high emergency cases within the hospital and city. These situations demand drastic

changes and actions in the assignment of the staff. However, due to constraints of these nurse-

patient laws, such emergency situations may be left to result in more devastating effects as a

result of the strains in the allocation of the nurses to various tasks. Thus, the reduced nurse-

patient ratio laws tend to prevent the health care service providers, that is doctors and nurses,

from using their best judgment in times of emergency and crisis.

In contrary to many studies that reveal that reduced nurse-patient ratios improve the

outcomes of the patients, a substantive of other studies shows otherwise finding. These studies

reveal that the nurse-patient law that was enacted in California had resulted in a very limited

impact on the events of adverse nature within the hospitals. On the other hand, this enactment

has also resulted in a mixture of effects on the quality of the nursing profession as it regards to

the provision of the patient care. Thus, the benefit of this law is more towards the nurses while it

neglects some fundamental issues towards the patients. Hence, it is not yet clear how the nurse-

patient ratio laws benefit the patients (Falk & Wallin, 2016).

In conclusion, the reduced nurse-patient ratio has a more positive impact on the nursing

profession as compared to the negative impacts that come along with it. As stated in the previous

paragraphs, these pros of the limited nurse-patient ratios range from having positive impacts on

the nurse's well-being, impacting positively on the turnover of the employees from the hospital,

and reducing on the mortality rate of the patients as well as helping to prevent some mistakes.

Further, the reduced nurse-patient ratio has a positive effect on the patient-nurse relations. The

nurse is able to find enough time to engage his/her patient. Thereby, the nurse stands a chance to

understand the patient better thus serving the patient better. These advantages of the nurse-

patient ratio have a greater impact on the general good of the nursing profession.
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Further, the drawbacks of the minimum nurse-patient ratios such as increased operational

costs, longer times of patients waiting before being admitted in a ward, and limited impact on the

adverse events in hospitals have not received proper recognition. Thus, it may be argued that

they are mere allegations which cannot sustain themselves when challenged. Consequently, it is

clear that bearing on the benefits of the reduced nurse-patient ratio and comparing with the

disadvantages thereby cannot be matched. Hence, the reduced nurse-patient ratio ought to be

upheld by all means for the betterment of the entire nursing profession.
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References

Falk, A. C., & Wallin, E. M. (2016). Quality of patient care in the critical care unit in relation to

nurse patient ratio: A descriptive study. Intensive and Critical Care Nursing, 35, 74-79.

Gelinas, L. (2016). Patient assignment vs. nurse staffing: More than just numbers.

AmericanNurseToday. com, 11(9), 6.

Leigh, J. P., Markis, C. A., Iosif, A. M., & Romano, P. S. (2015). California’s nurse-to-patient

ratio law and occupational injury. International archives of occupational and

environmental health, 88(4), 477-484.

Olley, R., Edwards, I., Avery, M., & Cooper, H. (2018). Systematic review of the evidence

related to mandated nurse staffing ratios in acute hospitals. Australian Health Review.