How Many Patients Per Nurses? Correct Nurse To Patient Ratio


Nurse to patient ratio is probably one of the most talked about issues in nursing. And apparently, it’s also one of the most common reasons why nurses leave the profession.

When an institution suffers from short staffing, bad things start to happen.

Nurses become grumpier and the quality of care they deliver decreases. Infections increase and patients stay longer in the hospital.

These things don’t only affect nurses and patients; they can be bad for the health institution, too.

The Problem Worsens


There are tons of things that force nurses to hang their nursing caps and just quit work. Bullying, burnout, and poor working conditions are probably some of the reasons you are already familiar with.

See Also: How to Prevent Nurse Burnout and Achieve Work-Life Balance

These things easily make one out of five fresh nurses quit the profession within their first year of getting a license. One out of three, on the other hand, quit within the first two years of starting work.

With more nurses quitting work, most institutions require nurses to take longer shifts, reduce their off days and take on more patients than necessary. One good reason is that institutions don’t see hiring more nurses as cost-effective.

In reality, however, they actually end up spending more in addressing the poor outcomes of short staffing and poor nurse-patient ratio.

What Is The Correct Nurse-Patient Ratio?

The American Nurses Association advocates for a legislative model wherein nurses have the autonomy to create a staffing plan that will meet the demands of their units and patients. This approach allows for a staffing plan that’s flexible and can be adjusted based on the following:

  • Number of admissions
  • Minimum number of nurses
  • Staffing level advised by specialty nursing organizations
  • Number of discharges and transfers
  • The level of education, training and experience of the staff
  • The intensity of patient needs
  • Unit geography and availability of technology
  • Patient numbers
  • Availability of ancillary staff and other resources

In determining staffing ratios, it’s a good idea for institutions to sit down with their nurses as they are the people who are in direct charge of patient care. They have a realistic view of what goes on in each unit and what problems they encounter.

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What Does The Law Require?

In California, there are clearly and legally defined minimum nurse to patient ratios that are supposed to be maintained at all times.

For example, for Intensive/ Critical Care, one nurse should only care for two patients. The same ratio applies to Neonatal Intensive Care, Post Anesthesia Recovery and Labor and Delivery. A 1:1 ratio applies for the Operating Room and Trauma patients in the ER.

See Also: How to Become a Critical Care Nurse

Apart from California, there are 14 other states in the country that legally address nurse staffing. Seven of these states legally require hospitals to have staffing committees that will take charge in creating staffing plans and policies. This includes OH, OR, CT, NV, WA and IL.

Just recently, Democratic State Senator Mike Skindell reintroduced a bill that mimics the California law on safe staffing. It mandates a 1:1 nurse to patient ratio in certain areas of the hospital as well as prevents nurses from being overloaded and overworked.

The bill prohibits mandatory overtime as well as the use of cameras to substitute for nurses. It also prohibits the layoff of supporting personnel and practical nurses.

Why Does Proper Nurse To Patient Ratio Matter?

patient care

Proper nurse to patient ratio doesn’t only help achieve clinical improvements but it also offers economic benefits.

Here’s what adequate staffing can provide:

  • Decreased patient care cost related to readmissions from poor outcomes
  • Reduced medication errors
  • Decreased length of patient stay
  • Increased patient satisfaction
  • Reduced patient mortality

Safe staffing has also been found out to increase chances of stroke survival. When there are enough trained nurses, patients have a better chance of getting over the aftermath of stroke.

In the study, the addition of one trained nurse per 10 beds can reduce patient death after a month by as much as 30%. After a year, chances of death goes down by 12%.

What Can You Do?

Short staffing can be hard to deal with, particularly if you’ll be dealing with the actual institution you are working for. There are, however, a few things you can do to advocate safe staffing while staying employed.

  • Use the SBAR method in communicating your ideas

The SBAR method simply refers to Situation, Background, Assessment, Response. It’s a technique you can use to discuss staffing issues with the management. You can start with your immediate superior since most institutions follow a chain of command. Assess the response you get and find out the next best person you can talk to in order to get a better response.

  • Join nursing organizations

There are a couple of nursing organizations and groups that advocate for nurses’ rights. If you happen to belong to a union, make sure that your group is respectfully and positively working with your employer to avoid any conflicts that can affect the nurses in your institution.

  • Update your skills

As short staffing continues to be a problem, you should be more consistent in updating your training and improving your skills. This way you’ll be able to provide the best care to your patients despite your poor working conditions. It will also put you in the best position possible to advocate for your rights as well as your patients’.