NCPA - National Center for Policy Analysis

How Many Nurses Are Enough?

May 6, 2002

With 13 percent of hospital nursing jobs unfilled, nurses and hospital executives around the country are squaring off over how many patients nurses can safely care for at once. Hospital nurses contend they are being made responsible for too many patients, and they want specific nurse-to-patient ratios set.

Some nurses have gone on strike over the issue, and California has adopted proposed staffing ratios to take effect next year.

  • The California proposal calls for four patients for every nurse in a pediatrics unit, and five patients per nurse on a general medical-surgical floor.
  • Similar laws are being debated in Massachusetts and Florida -- and staffing legislation has been proposed in Iowa and Kentucky.
  • The number of registered nurses working in hospitals increased to 1.3 million in 2000 -- up from 1.1 million in 1988.
  • The American Nurses Association reports that 41 percent of nurses choose to work outside hospital settings.

Opponents of the laws argue that with so many nursing positions unfilled, simply legislating that hospitals have more nurses won't make them appear, and that fixed staffing ratios are not useful because of differences among hospitals and the patients they treat -- thus flexibility is needed in deciding how best to use employees.

Source: Reed Abelson, "With Nurses in Short Supply, Patient Load Becomes a Big Issue," New York Times, May 6, 2002.


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