Safe Staffing: You’ve heard about it, but what’s REALLY going on?
We are going to try to describe safe staffing, safe staffing ratios, and the ways that safe staffing impacts healthcare providers in a quick, concise, unbiased, and easy way for you all. We are (by design) not going to get too detailed in hopes of broader understanding. This topic is widely discussed and oftentimes mentioned in healthcare articles and legislation. However, how much do you really know and understand what safe staffing encompasses? How much do you know about the legislation that was proposed in 2018 and what the plans are for 2019? We want to help, and in a way that is easy to understand.
Let’s begin with the definition of Safe Staffing.
There are two ways to understand this phenomenon.
- Safe Staffing (in general): safe staffing, for healthcare providers, is the notion that healthcare professionals want to practice within their scope of practice, protect their license when caring for patients, and feel safe in the care they are providing to patients whether that be not feeling spread thin or having the resources necessary to provide. The way this is fulfilled most often through safe staffing ratios.
- Safe Staffing Ratios: the ratio between one healthcare provider and the number of patients they are being asked to care for in any given shift period. Safe staffing ratio advocates desire for these ratios to recognize what the healthcare providers within that unit, department, or clinical setting feel is safest for their license with their individual experiences in each division of healthcare being taken into account, not just budget or demand.
Why are Safe Staffing Ratios important?
A direct quote from the Safe Staffing Act of 2018 answers this question: “proper nurse staffing helps prevent medication errors and nurse burnout through decreasing healthcare worker fatigue. Healthcare worker fatigue is a major patient safety hazard. The academic literature indicates that appropriate staffing policies and practices are an effective strategy to reducing such fatigue and protecting patients.” – Congress.com
California, the only state to have mandated safe staffing ratios, after implementation saw a 32% decrease in Registered Nurses having illnesses or injuries.
We would like to add that with an aging elderly population and far fewer nurses than there are patients, it is important to acknowledge the repercussions for nurses, patients, and facilities when these demands are met through unsafe patient loads for nurses.
How are Staffing Ratios developed currently?
Well, this varies from state to state and facility to facility. California has legislation that sets safe staffing ratios by law. There are also other factors that are considered:
- The types of patients that are seen, what they are there for, and how long a typical stay is
- Number of people that come in for medical care vs. how many people get to go home per day
- The skill level of the nursing staff
- The number of rooms or spaces a facility has for patient care
- Resources available to nurses in the area/facility
What is the biggest hurdle standing in the way of Safe Staffing Ratios?
Money. In order to cut costs in patient care, it is easy for facilities to lower the number of nurses working per shift and increase the number of patients each nurse cares for. In the long term, this is dangerous as the literature supports that this technique lowers the quality of patient care leading to longer hospital stays and readmissions. In addition, nurses are more prone to burnout, medical errors, and lower morale and self-care.
What legislation is being considered, currently?
The Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act went to Congress in 2018. The two bills ask for nationally mandated nurse-patient ratios and asks that the dangers for both nurses and patient with nurses caring for more patients than safely possible be recognized.
What can nurses continue to do?
In the midst of all of the desire for change comes an opportunity for nurses. As nurses, we do have a responsibility to protect our profession and advocate for our colleagues. The only people who have firsthand knowledge of what we do, and why safe staffing ratios are so important is nurses. It is imperative that we ensure our voices are heard and the forefront of healthcare in order to be active in this conversation and decisive in the resolution.
The American Nurses Association released a few “suggestions on how nurses should be supported to achieve greater responsibility:
- Nurses should practice to the full extent of their education, training, and licensure.
- Nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression.
- Nurses should be full partners, with physicians and other health professionals, in redesigning health care in the United States.
- Effective workforce planning and policy making require better data collection and an improved information infrastructure” –(American Nurses Association, 2018)
And, in order to achieve this responsibility, we recommend being an active voice and participant in facility, local, state, and national legislation and policy when you feel called to impact and influence change.
Zach Smith, Vice President of Nursing at NurseGrid mentioned, “the thing that we can always ensure is that we are moving forward and making the nursing profession better…we must create a community that supports and fosters one another. Change in nursing and the profession of nursing will be easier if we do it together.”
We want to hear your opinion on all of this as well as your comments. Let your voice be heard! Email Kelley@wanderly.us with any discussion.
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