The nurse staffing crisis is an urgent pain point for the country’s more than 5 million nurses, for patients, and for the entire health care system. In the last year, nurses have taken action to demand solutions to insufficient staffing levels, burnout, workplace violence and low wages, at both the state and national level. While this crisis is not new, the proverbial breaking point has arrived.
The staffing crisis has taken a heavy toll on nurses, compounding work environment challenges that worsened during the pandemic. It has seriously affected patient care.
Federal legislation introduced by Rep. Jan Schakowsky (D-Ill.) and Sen. Sherrod Brown (D-Ohio), the Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act, would set minimum nurse-to-patient staffing requirements as a starting point for supporting overworked nurses. The bill empowers the current and future nursing workforce by investing in training and career development and provides whistleblower protection for nurses who advocate on behalf of their patients.
It is not a balm to all that ails the nursing profession, but this legislation would go a long way to enhancing the health and well-being of nurses, patients and our entire health system. Many nurses currently provide care for more patients than they can safely manage. Research shows for every additional patient a nurse is given above the accepted standard, the chances the patient dies within 30 days of hospitalization increases 7 percent. Those odds double when nurses have two additional patients above the accepted standard.
For nurses, our patients and the health of our communities will always be our priority. And when our patients’ care is in jeopardy, we are put in the necessary position to raise our voices.
I entered the nursing workforce because of the reward I felt serving patients. I hear the same sentiment from nurses I speak with today. Nurses want to provide care, but we are too often overworked and understaffed, leaving us with inadequate time to provide the care patients deserve.
Appropriate nurse staffing is necessary and achievable. Yet, it will take national, bipartisan support to adequately meet the urgency of the crisis.
State policymakers began introducing minimum nurse-to-patient ratios as a potential solution, and we are seeing significant wins in both Oregon and Washington. Nationwide, 19 states have lobbied for safe staffing solutions, while the U.S. Centers for Medicare and Medicaid Services recently proposed minimum staffing standards for registered nurses working in long-term-care facilities. This progress, while powerful, does not eliminate the need for action on a national scale.
Minimum nurse-to-patient ratios are a pathway to achieving appropriate nurse staffing and promoting positive patient outcomes. However, nurses must be the decisionmakers, to ensure the approach is enforceable, specific to the care setting and unit, accounts for patients who require critical care, and balances the workload of staff nurses.
Staffing ratios cannot and should not be the only solution to the nursing crisis. The ongoing workplace challenges nurses face require broader, nurse-driven policies that address the root causes of high burnout and turnover. Eliminating mandatory overtime, preventing workplace violence, increasing transparency about nurse reimbursement, and increasing funding for training and education to grow the nursing pipeline are just some of the policies broadly supported by nurses.
Addressing the nurse staffing crisis must not get buried amid the partisan debates and legislative hurdles that lie ahead through the rest of the year. Lawmakers have an opportunity to show constituents and nurses — the country’s largest health care professional workforce — that their health and safety is paramount.
Nurses know patient care and understand the complexity of our health care delivery system. Policymakers must partner with us to find solutions that prioritize nursing and give patients the safe and quality care they deserve.
Jennifer Mensik Kennedy, Ph.D., MBA, RN, NEA-BC, FAAN, is president of the American Nurses Association.