California’s Nurse-Patient Ratio Law Saving Lives, Reducing the Nursing Shortage

While the ratios have shown some improvment the nurses are still working under poor conditions and are without legal breaks. Since 2002 when staffing ratios were put into practice I can personally contest that the acquity and procedures per patient has increased exponentially. Meaning they require more care than 5 years ago.. Yes implementng the new ratios in California will promote safety if only because it will create two more hands and one more body to provide the extraordinary help needed. Hospitals need to staff above the ratios when census and acquity call for it. There needs to be repurcussions for the hospitals who do not comply with basic safety needs. Hospitals need solutions and desperately. We need to bring back the CNA's to the bedside in addition to more nurses. Patients need to have basic necessities met like bathing, feeding, mobilization. Hospital nursing today is unsatisfying because most nurses go into healthcare to make a difference. But our hands are tied. We can barely get our meds passed and the patients turned. We are tuaght to educate. But there is little time in our day. we are tuaght to be empathetic. But how do we continue with that when the very structure we work under is asking for us to do more and more without additional staff. Yes the ratios will help. But we are a long way from providing an environment that is condusvie to healing.

What is to celebrate about the new nurse patient ratio?
My hospital has taken away the certified nursing assistants on our telemetry floor. We used to have two in our floor on both day and night shifts. Now with the new ratio the cna's are gone. Now we are left with 4 patients to take care of. Four total care patients.
All the nurses in my unit are not happy about the it. Some hospitals still have thier cna's but not in our hospital. I thought the reason for the 4:1 ration was to lessen the work load of the nurses so we can actually focus on taking care of our patients. If we are to take vital signs, change diapers, turn patients, give baths, etc how can we focus on the care of our patients.

My hospital unit does not appear to be following the new 1:4 ratio. I work on the Medicine/Oncology Unit at Huntington Hospital in Pasadena, CA. We also do Tele on this floor. They claim that because our floors patient population isn't always 50% or more "cancer patients" or 50% or more Tele patient that we are not considered a "specialty floor" in the sense that the new 2008 nurse to patient ratio states. Each day our unit only gives 2-3 RN's the Tele patients and then it is only those RN's that are given 4 patients each. The rest of us RN's still receive 5 patients to care for. If there is an LVN working each day the the RN's who are not receiving Tele patients that day can have up to 5 patients to care for and can also be responsible for "covering" (as the hospital calls it) 1-2 of the LVN's patients. This easily puts RN's patient responsibility at 7 (not 1:4).
Our unit has used CNA's since I started working at Huntington. Now suddenly they are cutting the use of them as well. They are not using registry CNA's to replace staff CNA's (like they used to) when they call in sick. This leaves the unit short of CNA's at times and makes the nurses do primary care. It seems as though some hospitals in California are just interpreting the new 2008 nurse to patient ratio the way they want it to read. I thought this law would improve the patients care and the nurses working conditions. Instead, it has made matters worse for many of us nurses. Ultimately the patients are the ones who will suffer because of this. What can be done to make this hospital comply with this new law?

I work at a rural hospital where we have 6:1 ratios. When's that going to change? We're a hospital just like the others. Perhaps not as large, but the same types of patient diagnosis. Not Fair!

I work at a rural hospital where we have 6:1 ratios. When's that going to change? We're a hospital just like the others. Perhaps not as large, but the same types of patient diagnosis. Not Fair!

Hurray! I want to thank everyone who participated in getting this law passed. A 3:1 ratio can be (depending on aquity) safely managable. Having workded as a RN for 11 years (Telemetry/IMCU) I am accustomed to a ratio of 5:1/4:1.

I am a new grad RN who is currently working in an ER with a level one trauma center. Our ratio of trauma patients is 3 to 1... shouldnt they qualify, basaed on acquity as ICU patients, with a ratio of 2 to 1 or even 1 to 1??? Also, we have CNAs that are pretty much a joke.. they run errands.. which is good to have, but they dont take vitals or do much bedside care. Traditionally, the ER is like a fix em and move em spot.. so the theory is that we start the stabilization and management and then snd the patient to thier designated floor. But, we are getting ICU and step down patients that are waiting for a bed.. sometimes, these patients wait in our ER for a day or more... but the 1 to 4 ratio doesnt change. HOW IS THAT WITHIN THE GUIDELINES??????? Also, in an area that is where our monitored patients are.. where the policy states the PCU/ICU Step Down and or ICU beds are, we are at a 4 to 1 ratio....WHATS GOING ON WITH THAT???? What does the new grad RN do???

The patient-nurse-ratio in Memorial Hospital Bakersfield where I work is complying this ratio but there is a new director that was promted 3 steps up and meeting with nurses these days saying that "we expect as nurses to get 6:1 ratio". He was telling it to everybody that Federal Law supersedes the California Law. So, what's the use of the State Law then? Mr. Governor, can you address this issue or clarify this issue?

The patient-nurse-ratio in Memorial Hospital Bakersfield where I work is complying this ratio but there is something that bothers me today. There is a new director that was promoted 3 steps up and meeting with nurses these days saying that "we expect as nurses to get 6:1 ratio". He was telling it to everybody that Federal Law supersedes the California Law. So, what's the use of the State Law then? Mr. Governor, can you address this issue or clarify this issue?

The patient-nurse-ratio in Memorial Hospital Bakersfield where I work is complying this ratio but there is something that bothers me today. There is a new director that was promoted 3 steps up and meeting with nurses these days saying that "we expect as nurses to get 6:1 ratio". He was telling it to everybody that Federal Law supersedes the California Law. So, what's the use of the State Law then? Mr. Governor, can you address this issue or clarify this issue?

I am a new LVN graduate working on an acute rehab floor. On a typical day, I receive up to 11-13 patients and share my responsibility with an RN. My duties include all the med pass, prn meds, IV start, and treatment while the RNs pick up the other with charting, new orders and assessment. Because I am new, I find that it is still overwhelming to have 11-13 patients on an acute rehab floor, is this right? Can anyone provide any information for me?

I work for a rural area in Imperial Valley, CA. Our Nursing ratio is 6:1, I was wondering if and how this is acceptable since we too live in the state of california where the ratio is sapose to be 4:1. Since we are a rural area does that change the Nurse to patient ratio. We have adequate staffing and CNA's on the floor but every night and day that we come in we are staffed with 6 patient and 2-3 LVN team leads. Mr. Govener if you can please get back to me I would appreciate it.

What about NICU? Our patient population consists of grower feeders to ventilated patients. Are we considered step down? We have up to four patients (grower feeders, no respiratory issues). Ventilated patients are 1:2.

I am wondering what ratios you have seen for night shift on Mother/Baby units? What is considered safe? What is your thought on leaving only 1 RN on the unit at night for Mother/Baby?(even with 5 or 6 couplets)

Does the nurse to patient ratio include the charge nurse taking 4 patients? Does it include support staff such as unit secretaries,and orderlies?

Does the nurse to patient ratio include the charge nurse taking 4 patients? Does it include support staff such as unit secretaries,and orderlies?

Many of the messages I've read here are very pertinent to the current shortcomings of our health care system and shed light on many issues and how to improve them. Even if we are able to improve the current system and make health care affordable for everybody, we must not overlook the institutions themselves. As has been mentioned above, the majority of our clinics and hospitals employ professionals who are constantly overworked and the facilities are normally under staffed. If we are to rebuild/reorganize the health care system, we must begin at the roots of the system, and that is to be found at the caregiver level itself. There has to be a nurse/patient ratio established nationwide in order that the patients do receive the best of care and to make certain our nursing staff does not burn out in just a couple of years. California has seen these ratio laws come to fruition and it has paid off on both counts...patients are receiving good care and lives are being saved and the nursing staff is more effective and has even seen the turnover rates decline sharply.

If we truly want to fix our healthcare system and provide care to all our citizens as a basic human right, then we must begin at the foundation. Without taking a look at what our facilities need and what is the best way for them to function in order to provide the proper care we are talking about, we are destined to throw more weight on the mule while he is sinking in the mud. Finding the funding and working with insurance companies, state and federal programs is definitely a must, but let us not forget the basics. Otherwise any program that is attempted is doomed to fail.

I work med-surg which specializes in orthopedics, urology, and vascular surgery pts at a pretty big hospital in n.ky and on 11-7 I am in charge and get 8pts of my own. Most of these are broken hip post-ops, artery bypass pts, and renal failure pts. I don't even get paid anymore..i feel like if i get a 10 minute break i am lucky. We go w/o "lunch" 75% of the time. It's the patients that suffer.

I work in a hospital in Alabama as an RN I have had NINE Patients and one PCA that is too overwhelmed to do any thing other than Vital Signs. You all have it made!!! Take it from me it can get alot worse. If I had any one of your jobs I would truly be happy.

I am working at a rural hospital. The unit I work on is a combination medical/ surgical/ telemetry floor. The nurses are assigned 5 patients whether they be a medical, surgical, or telemetry pt. A nurse could be assigned 5 telemetry patients or no telemetry patients. No consideration is given for the acuity of the patient or the fact that they are telemetry patients. Frequently, nurses are assigned primary care pts., as well. The nurse could have several telemetry patients and 3 - 4 primary care pts. Nurses aides are pulled to be sitters which leaves few for the floor pts. After working a grueling 12 hour shift with little CNA assistance, they are having to stay overtime, just to try and meet the important needs of their patients. They do this out of a feeling of responsibility to the pt. Management will turn around and write nurses up for excessive overtime and tell them that if the hospital didn't have to pay so much overtime, maybe they could afford more CNAs to help. Some nurses actually clock out, then stay over to complete their documentation and other things they have not been able to complete. Many of the nurses being hired start looking for another job soon after they are hired. The dept. manager's typical practice is management by intimidation. A very experienced charge nurse was demoted to not being in charge any longer because she declined to take on up to 5 new admissions that she would personally have to care for as primary care patients. The manger told her that she was incompetent, uncaring for patients, not a team player, and, maybe not a good fit for the dept. The other charge nurses and their family's are well established in this area and would have difficulty relocating to another job. Subsequently, they do accept the responsibility of being in charge of a busy floor, as well as being assigned up to 5 patients for care. Nurses are being made to feel like they want to stay overtime day after day, when, in reality, they are exhausted. They strive to get out of that place on time. I could go on and on about this situation. I'm sure there are other hospitals with similar situations. This hospital even went as far as hiring several very experiences RN's at a decent rate of pay; then after the nurses had worked a few weeks, HR came back to them and told them a mistake had been made in their pay rate. Their pay rate was dropped significantly. I'm not sure that is legal, is it? It doesn't sound ethical. What agencies should be advised of these staffing issues. Is there anything that can be done about the situation to ensure that the required staffing mandate is followed appropriately?

I am working at a rural hospital. The unit I work on is a combination medical/ surgical/ telemetry floor. The nurses are assigned 5 patients whether they be a medical, surgical, or telemetry pt. A nurse could be assigned 5 telemetry patients or no telemetry patients. No consideration is given for the acuity of the patient or the fact that they are telemetry patients. Frequently, nurses are assigned primary care pts., as well. The nurse could have several telemetry patients and 3 - 4 primary care pts. Nurses aides are pulled to be sitters which leaves few for the floor pts. After working a grueling 12 hour shift with little CNA assistance, they are having to stay overtime, just to try and meet the important needs of their patients. They do this out of a feeling of responsibility to the pt. Management will turn around and write nurses up for excessive overtime and tell them that if the hospital didn't have to pay so much overtime, maybe they could afford more CNAs to help. Some nurses actually clock out, then stay over to complete their documentation and other things they have not been able to complete. Many of the nurses being hired start looking for another job soon after they are hired. The dept. manager's typical practice is management by intimidation. A very experienced charge nurse was demoted to not being in charge any longer because she declined to take on up to 5 new admissions that she would personally have to care for as primary care patients. The manger told her that she was incompetent, uncaring for patients, not a team player, and, maybe not a good fit for the dept. The other charge nurses and their family's are well established in this area and would have difficulty relocating to another job. Subsequently, they do accept the responsibility of being in charge of a busy floor, as well as being assigned up to 5 patients for care. Nurses are being made to feel like they want to stay overtime day after day, when, in reality, they are exhausted. They strive to get out of that place on time. I could go on and on about this situation. I'm sure there are other hospitals with similar situations. This hospital even went as far as hiring several very experiences RN's at a decent rate of pay; then after the nurses had worked a few weeks, HR came back to them and told them a mistake had been made in their pay rate. Their pay rate was dropped significantly. I'm not sure that is legal, is it? It doesn't sound ethical. What agencies should be advised of these staffing issues. Is there anything that can be done about the situation to ensure that the required staffing mandate is followed appropriately?

I am working at a rural hospital. The unit I work on is a combination medical/ surgical/ telemetry floor. The nurses are assigned 5 patients whether they be a medical, surgical, or telemetry pt. A nurse could be assigned 5 telemetry patients or no telemetry patients. No consideration is given for the acuity of the patient or the fact that they are telemetry patients. Frequently, nurses are assigned primary care pts., as well. The nurse could have several telemetry patients and 3 - 4 primary care pts. Nurses aides are pulled to be sitters which leaves few for the floor pts. After working a grueling 12 hour shift with little CNA assistance, they are having to stay overtime, just to try and meet the important needs of their patients. They do this out of a feeling of responsibility to the pt. Management will turn around and write nurses up for excessive overtime and tell them that if the hospital didn't have to pay so much overtime, maybe they could afford more CNAs to help. Some nurses actually clock out, then stay over to complete their documentation and other things they have not been able to complete. Many of the nurses being hired start looking for another job soon after they are hired. The dept. manager's typical practice is management by intimidation. A very experienced charge nurse was demoted to not being in charge any longer because she declined to take on up to 5 new admissions that she would personally have to care for as primary care patients. The manger told her that she was incompetent, uncaring for patients, not a team player, and, maybe not a good fit for the dept. The other charge nurses and their family's are well established in this area and would have difficulty relocating to another job. Subsequently, they do accept the responsibility of being in charge of a busy floor, as well as being assigned up to 5 patients for care. Nurses are being made to feel like they want to stay overtime day after day, when, in reality, they are exhausted. They strive to get out of that place on time. I could go on and on about this situation. I'm sure there are other hospitals with similar situations. This hospital even went as far as hiring several very experiences RN's at a decent rate of pay; then after the nurses had worked a few weeks, HR came back to them and told them a mistake had been made in their pay rate. Their pay rate was dropped significantly. I'm not sure that is legal, is it? It doesn't sound ethical. What agencies should be advised of these staffing issues. Is there anything that can be done about the situation to ensure that the required staffing mandate is followed appropriately?

Well from reading this article, I realize I don't work at the only hospital that does not understand the importance of nurse to patient ratio. I work in a rural hosp 40 bed med/surg-telemetry-even with a age range from 1 month to 100years. This is what our management believes works, 3-4 LPN's for 40 pts, & only 2 RN's for 40Pt's and 1 CNA. no ward clerk( we have to do our own)we never ever have a 1:5 ratio. The LPN's have to have 7pts each anything less and they put one on call and double up the remaining LPN's work load. anything less than 20 pts and they put a RN on call. We still have pen and ink charting. No computers, so we are in the dark ages... I just wish we could get some kind of ratio law in Alabama because right now it is left up to administration.

I have been a nurse for a year and a half in the state of NC. I work on a neuroscience/neurosurgery unit and take 6 patients every night. These patients range from spinal cord injuries, stokes, head traumas, to ETOH and drug withdrawals, seizures, and Altered Mental Status patients. Almost all of these conditions make the acuity of these paitents extremely high. I was just told that our ratio actually just went up to 7:1 and we can possibly have 7 patients if we are full. I am just shocked that, as RN's being taught to advocate for patient safety, that we would stand by and allow this. I brought it up to some of the experienced nurses on the floor and asked them "where do we draw the line" and the response I got was "we dont" and "there is no line" Am I just supposed to stand by and take whatever I am handed whether it be 6 patients or 8 just because everyone else does and thats just the norm? How did we allow this to happen? Did we stop caring about our patients enough to stand up for their safety? I am now in the process of moving to the state of California to work in an environment where the nurse DO care about the safety of their patients and they do not stand by and accept this. Never what I expected as a brand new nurse....

I have been a nurse for a year and a half in the state of NC. I work on a neuroscience/neurosurgery unit and take 6 patients every night. These patients range from spinal cord injuries, stokes, head traumas, to ETOH and drug withdrawals, seizures, and Altered Mental Status patients. Almost all of these conditions make the acuity of these paitents extremely high. I was just told that our ratio actually just went up to 7:1 and we can possibly have 7 patients if we are full. I am just shocked that, as RN's being taught to advocate for patient safety, that we would stand by and allow this. I brought it up to some of the experienced nurses on the floor and asked them "where do we draw the line" and the response I got was "we dont" and "there is no line" Am I just supposed to stand by and take whatever I am handed whether it be 6 patients or 8 just because everyone else does and thats just the norm? How did we allow this to happen? Did we stop caring about our patients enough to stand up for their safety? I am now in the process of moving to the state of California to work in an environment where the nurse DO care about the safety of their patients and they do not stand by and accept this. Never what I expected as a brand new nurse....

I have been a nurse for a year and a half in the state of NC. I work on a neuroscience/neurosurgery unit and take 6 patients every night. These patients range from spinal cord injuries, stokes, head traumas, to ETOH and drug withdrawals, seizures, and Altered Mental Status patients. Almost all of these conditions make the acuity of these paitents extremely high. I was just told that our ratio actually just went up to 7:1 and we can possibly have 7 patients if we are full. I am just shocked that, as RN's being taught to advocate for patient safety, that we would stand by and allow this. I brought it up to some of the experienced nurses on the floor and asked them "where do we draw the line" and the response I got was "we dont" and "there is no line" Am I just supposed to stand by and take whatever I am handed whether it be 6 patients or 8 just because everyone else does and thats just the norm? How did we allow this to happen? Did we stop caring about our patients enough to stand up for their safety? I am now in the process of moving to the state of California to work in an environment where the nurse DO care about the safety of their patients and they do not stand by and accept this. Never what I expected as a brand new nurse....

I need to know where I can get info on grading pt. acuity. I worked on a local DOU which should have a ratio of 3:1. One of my patients had a HR 170, RR40, BP unstable 85/_. She was an abdominal surgery from early April (my shift in question was
May 24th. She was transfered from MedSurg to DOU instead of ICU. She was on PCA, accuchecks, a stool leaking wound vac, dig pushes, trial diltiazen gtts, amiodorone bolus and drip. I appealed to the MD, charge and supervisor. The shift was a disaster as I had 2 other patients one of whom required blood products and had a transfusion reaction. The hospital uses Evalysis for acuity assessment. At 0600 the supervisor told me that the hospital gets dinged if I don't take a break. Where can I find the hard numbers used for acuity rating and unit assignment.

I need to know where I can get info on grading pt. acuity. I worked on a local DOU which should have a ratio of 3:1. One of my patients had a HR 170, RR40, BP unstable 85/_. She was an abdominal surgery from early April (my shift in question was
May 24th. She was transfered from MedSurg to DOU instead of ICU. She was on PCA, accuchecks, a stool leaking wound vac, dig pushes, trial diltiazen gtts, amiodorone bolus and drip. I appealed to the MD, charge and supervisor. The shift was a disaster as I had 2 other patients one of whom required blood products and had a transfusion reaction. The hospital uses Evalysis for acuity assessment. At 0600 the supervisor told me that the hospital gets dinged if I don't take a break. Where can I find the hard numbers used for acuity rating and unit assignment.

Does anyone know of a reliable source for information relating to caregiver hours in neonatal intensive care units throughout the country. In particular, Level 3C units.

Thank you, Barbara

I think this is the most ridiculous thing I've ever seen in all of my 15 years of nursing. This is all political & money oriented, and doesn't even touch the big picture. I'm a male L.V.N. and I'm very proud of my profession as well as my strong capabilities to perform intensely. I love my job, and sometimes I generally supplement a full time job with agency. Here in Texas, they are attempting to phase LVNs out of the hospital setting. For example, just recently while attempting to make the transition from agency to full staff at an "altac" with support from house sups, charge nurses, and the like of RN staff, I got the unfortunate news that I was going to be on the list of several other nurses who were being released because of another agency. They were giving me along with a list of other nurses a "rest". I work twice as hard to prove myself only to be replaced with RNs who can't draw blood, start an IV, or one who hasn't any inclination whatsoever that she's been infusing my patient's prescribed clinimix into the wrong patient. Oh, her patient was on clinimix as well, but one with a mulvit additive(yellow) along with other prescribed elements; how did she miss that. The sad part is she had the opportunity to look at the wrong patients label more than "three times" while unpacking the basic clinimix bag. She had to take the wrong patient's label off of the packaging bag as she opened it, stick it on the clinimix itself, and then still hung the clear uncolored bag with the wrong patient's label. Hospitals after hospitals are being built for the greedy businessmen and women alike trying to capitalize on the health care riches. Why isn't there any talk about the nurses, especially the RNs voluntarily surrendering there licenses month after month. I wonder do they know that these secondary acts are contributed to pressures in the workplace. Staff shortages remain a prevalent problem but yet hospitals continue to go up. Yes I agree they're not training LVNs the way they use to, turning quite a few out with very high incompetencies, and many RNs as well as LVNs are coming into the medical field just for the money. It's a pathetic shame what they are attempting to try and do, but trust me, LVNs are use to busting their butts in the workplace, RNs will now basically be the old LVN pawns of the past; Doing all the things that really consist of "true hallmark nursing"(baths, cleaning fecal matter and the like) when their CNAs occasional fail to show up for work. So much for that patient ratio idea, and so much for the idea that RNs will enjoy doing the kind of work most feel they went to school to avoid. So enjoy the new scent my fellow RNs, you won't be delegating nothing but your gloved hands now; To clean up the mess you all have made.

I work in California, and I think nurses are been abused, intimidated and exploted, and discriminated every single day in all the disciplines, our salaries are not increasing, but we have to solve everything, and we have to do it in silence, remains me of the sweat shop,(but we are in the hospital). I am glad I am retiring soon, but feel sorry for the new graduates, WHO WANTS TO BE A BEDSIDE NURSE?, A CHARGE NURSE?, WHO?.. NURSES ARE OVERWORK, AND ABUSED.

I work in a telemetry unit at a 450 bed hospital that has been meeting the ratios. We have a lunch relief nurse so that no nurse cares for more than his or her assigned patients. We also have a few stable ventilator rooms. If someone has two stable ventilator patients they only have one more low acuity patient (3:1). If they have no stable ventilators, they have 4:1, but we DO staff by acuity and if the acuity is above a certain score they only have 3 patients. We have a charge nurse who does not take patients on the floor. We have a respiratory therapist assigned to our floor. We have two CNA's for up to 18 patients and 3 CNAs for more than that. We also have one discharge planner on the floor (23 bed unit), one floor coordinator and a nurse practitioner always available. If we need a CNA to be a sitter, we get an extra CNA for that, too.

Our hospital has been winning all kinds of awards for patient outcomes and patient satisfaction. We have also won awards from Health Grades. Our nursing turnover is very low and our pay is excellent.

I have been a nurse over 20 years and these ratios have made a huge impact on patient safety and nurse satisfaction.We have fewer falls, fewer nosocomial infections, very little restraint use, fewer hospital acquired decubitus, less ventilator associated pneumonia, etcetera. Those things cost a hospital far more than an RN does. Our patient stays are lower, too, probably because of better care in my opinion, but also because of the discharge planner doing a good job and the physicians buying into it.

I have read all the comments above mine and am sorry you are working in a facility that is not living up to the nature of the ratios, but I do think most California hospitals are. If yours is not, do not fear, they will be held accountable. In the mean time, know that some hospitals ARE meeting the ratios in full and the patients ARE benefiting and the hospitals are NOT going broke because of the money proper care saves them.

I work in a telemetry unit that has a lot of respiratory and medical patients(there is another telemetry with more cardiac patients)at a 450 bed hospital that has been meeting the ratios. EVERYONE takes their lunch and breaks. The charge nurse relieves for the morning and afternoon breaks (charge nurse does not have patients). We have a lunch relief nurse so that no nurse cares for more than his or her assigned patients. We have a few stable ventilator rooms. If someone has two stable ventilator patients they only have one more low acuity patient (3:1). If they have no stable ventilators, they have 4:1. We DO staff by acuity (it is written clearly on the assignment sheet what the acuity is) and if the acuity is above a certain score they only have 3 patients. We have a charge nurse who does not take patients. We have a respiratory therapist assigned to our floor. We have two CNA's for up to 18 patients and 3 CNAs for more than that. We also have one discharge planner on the floor (23 bed unit), one floor coordinator and a nurse practitioner always available. We have radiology transport nurses so no nurse leaves the floor to transport. If we need a CNA to be a sitter, we get an extra CNA.

Our hospital has been winning all kinds of awards for patient outcomes and patient satisfaction. We have also won awards from Health Grades. Our nursing turnover is very low and our pay is excellent.

I have been a nurse over 20 years and these ratios have made a huge impact on patient safety and nurse satisfaction.We have fewer falls, fewer nosocomial infections, very little restraint use, fewer hospital acquired decubitus, less ventilator associated pneumonia, etcetera. Those things cost a hospital far more than an RN does. Our patient stays are lower, too, probably because of better care in my opinion, but also because of the discharge planner doing a good job and the physicians buying into it.

I have read all the comments above mine and am sorry you are working in a facility that is not living up to the nature of the ratios, but I do think most California hospitals are. If yours is not, do not fear, they will be held accountable. In the mean time, know that some hospitals ARE meeting the ratios in full and the patients ARE benefiting and the hospitals are NOT going broke because of the money proper care saves them.

Dear Nurses
To my knowledge the nurse ratio per bed as WHO standard .
The question is do i have to calculate the number of nurses in OR , or any supportive divsions as Nursing education
Thanks for advance

Not sure what you are asking, but the ratio is number of patients per nurse - direct care staff. Nursing education nurses have no patients. You wouldn't count them.

I'm an RN working in Illinois and we are trying to get the CA patient nurse ratio bill passed here. I currently work on a meg/surg neuro floor - all fresh post op patients - We do not have a current nurse patient ratio in place. On a good night I have 8 patients, yes 8 post op patients! on a bad night I will have 10. most nights I have 9-10 pts. and we only have paper charting. Consider yourselves lucky only having 4-6 patients. We would be happy with only 6.

I am an lpn in the state of New Jersey. I have worked and am currently working at nursing homes and assisted living residencies; where the lpn is giving medications any where from 30 to 70 residents, and also taking care of them. This is not safe for both nurses and residents. How do i go about fixing this abusive and on going hazardous situation. When I had done some research of my own the state of New Jersey has no nursing to patient ratio in a nursing home and assisted living setting.

I am an lpn in the state of New Jersey. I have worked and am currently working at nursing homes and assisted living residencies; where the lpn is giving medications any where from 30 to 70 residents, and also taking care of them. This is not safe for both nurses and residents. How do i go about fixing this abusive and on going hazardous situation. When I had done some research of my own the state of New Jersey has no nursing to patient ratio in a nursing home and assisted living setting.

I am an lpn in the state of New Jersey. I have worked and am currently working at nursing homes and assisted living residencies; where the lpn is giving medications any where from 30 to 70 residents, and also taking care of them. This is not safe for both nurses and residents. How do i go about fixing this abusive and on going hazardous situation. When I had done some research of my own the state of New Jersey has no nursing to patient ratio in a nursing home and assisted living setting.

I'M WORKING IN POSTPARTUM HERE IN CALIFORNIA,AND I WORK W/ LVN WE HAVE 8 COUPLETS,W/ 3 FRESH C SECTION,NO CNA AT ALL.I WORK LAST NIGHT,IS HAVING 6 PT'S W/ 2 FRESH C SECTION AND 2 PT W/ MAGNESIUM SULFATE IS THAT SAFE?IF I REFUSED A PT BECAUSE OF ACUITY,IS THAT GROUND FOR TERMINATION?I FEEL PRESSURE!!PLEASE HELP!

I am a nurse in a Chicago suburb & our hospital staffs for acuity. Illinois is trying to pass the same Nurse/Patient Ratio Bill that California passed & I have to say that after reading the above comments, I am truly committed to making sure that this bill is NOT passed in Illinois or any other state. Even with the Law passed in California, it sounds like many nurses are unhappy because they no longer have ancillary help and I don't know about you, but I would be very upset if my family member was the patient of the nurse who couldn't see my family member b/c her really high acuity patient was crashing & there was no one able to "pick up" my family member as their patient d/t some law saying that the hospital would be fined if a nurse took MORE than the ratio called for. The nurse patient ratio bill is not the answer to solving the problem of providing safe pt care or the nursing shortage. No offense to our comrades in arms that work in the rural hospitals but the reason your ratios suck so bad isn't because your administration wants to work you all to the bone, it's because most nurses, especially new grads, do NOT want to work in a rural hospital. They want to be at the big teaching hospitals where are all the action is. We need to somehow entice nurses to work in your area.
I'm surprised that none of the above postings have commented on how 22 California hospitals have closed since the Nurse to Patient Ratio Law was passed. I think that says volumes in & of itself. 22 hospitals had to close partly b/c they could not comply with the staffing ratio. I have been told by a former California Hospital CEO that California ER's are CONSTANTLY on divert b/c the nurses in the ER's can't & won't take anymore patients. Just think of the living saving, emergent care that the patient in the rig is NOT receiving b/c there was a law that was enacted by Senators & Representatives who have probably seldom ever needed emergent care nor set foot in a hospital for more than a few hours at a time.
***I think that part of the solution to providing safe patient care is to begin by talking with actual nurses who work at the bedside & then to educate our legislators on what it's like to be a nurse. Maybe then, smart laws...ones that actually make sense & are applicable in the real world, will be developed & passed. Then we can begin to address the bigger problem of the nursing shortage.

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