New poll shows nurse-to-patient ratio law could be key to addressing staffing crisis

Staff report

National Nurse Magazine - Jan | Feb | Mar 2023 Issue

A January 2023 poll of registered nurses in Michigan indicated that many would be more likely to stay at the bedside if the state were to pass a law limiting the number of hospital patients each nurse can be assigned.

“Hospital understaffing of RNs was bad before the pandemic and has only gotten worse,” said Jamie Brown, a critical care nurse and president of the Michigan Nurses Association. “The poll shows that this years-long trend has taken a toll on patients and nurses alike. Hospital executives cannot be trusted to regulate themselves. To truly address this staffing crisis, legislative action must be taken to hold hospitals accountable. This poll shows that nurses will continue to leave the profession until reasonable limits to the number of patients a nurse is assigned are in place.”

There is no law that sets safe RN-to-patient ratios in hospitals, leading to RNs having too many patients at one time too often. This puts patients in danger and drives nurses out of the profession. Legislation to set safe limits on hospital nurses’ patient assignments, known as the Safe Patient Care Act, is pending reintroduction in the Legislature.

Highlights of the poll include:

• 7 in 10 RNs working in direct care say they are assigned an unsafe patient load in half or more of their shifts.
• Over 9 in 10 RNs say requiring nurses to care for too many patients at once is affecting the quality of patient care. The number who say they know of a patient death due to nurses being assigned too many patients nearly doubled from 22 percent in 2016 to 42 percent this year.
• Requiring set nurse-to-patient ratios could also make a difference in retention and in returning qualified nurses to the field. Three-quarters of nurses currently working in direct patient care say they would be more likely to stay if such legislation passes, while nearly 4 in 10 of those who have left say they would be more likely to come back.
• The vast majority of RNs blame working conditions for the staffing crisis, rather than a shortage of qualified RNs.

Government data shows that nurses’ perception of the cause of the staffing crisis is correct. As of Jan. 11, 2023, Michigan Licensing and Regulatory Affairs (LARA) reported that there are 154,758 RNs with active Michigan licenses. Yet according to the U.S. Bureau of Labor Statistics, there are only 102,480 people who are employed as RNs in the state of Michigan. This means that a full one-third of RNs with active Michigan licenses are choosing to not work as nurses.

“The staffing crisis will never be adequately addressed until working conditions at hospitals are improved. Making nurses take care of too many patients is irresponsible and will lead to nurses continuing to leave the bedside,” said Brown. “Nurses have witnessed hospital CEOs making millions of dollars while the quality of care has declined. Our current system is broken. To keep patients safe in our hospitals and keep nurses working at the bedside, we need legislators to take decisive action and pass the Safe Patient Care Act.”

The poll was conducted by Emma White Research and commissioned by the Michigan Nurses Association. It has a margin of error of +/- 4.9 percent. A full report on the poll results is available at www.misaferhospitals.org/poll.