For years, as hospitals cut costs to survive ever-increasing financial pressures, nurses argued that inadequate staffing harms patients. California's controversial and, so far, unique response was to mandate minimum nurse-to-patient ratios, which, if applied locally, would prevent 222 surgical deaths annually in New Jersey and 264 in Pennsylvania, researchers here calculated in 2010. Now members of that same University of Pennsylvania team say they have figured out a key reason for that. Though it might seem clear-cut - fewer caregivers provide poorer care - they maintain the issue is not simply numbers but a bad work environment. And that leads to burnout.
