In the 1990s, the idea of setting standard staffing ratios in other areas gained momentum, as the scope of the current nursing shortage started becoming apparent.Since then, many states have considered mandated ratios as well as some alternative staffing solutions for all healthcare facilities.By the turn of the 21st century, momentum for mandated ratios had grown.Then, the New York legislative focus shifted from mandated ratios to staffing plans that allow ratio adjustments with input from direct-care nurses.In fact, nurse employment rose approximately 15 percent after 2004 as a result of the law.The intent of the law was to improve care for patients and although no consensus has yet been reached, studies have shown that the law has improved patient care in a variety of domains.“I feel like some days I think of everything I did that day, and I think, ‘I could’ve done this for this person, if I’d just had the time to get to it.’ And I have to convince myself that I did my best to prioritize what the most important things are for each person, because I couldn’t get to everybody.” Why won’t the hospital hire more people?
(See Staffing solutions: State by state in pdf format by clicking the download now button.) Thirteen states plus the District of Columbia have either enacted legislation mandating nurse-patient ratios, created regulations requiring written staffing plans, or developed an approach using a combination of the two.
Connecticut, Illinois, Nevada, Ohio, Oregon, Texas and Washington have implemented laws requiring hospitals to have staffing committees responsible for plans and staffing policy.
Illinois, New Jersey, New York, Rhode Island and Vermont require certain disclosure/public reporting.
To date, California is the only state that has enacted legislation setting a nurse-to-patient ratio per unit in a healthcare facility.
That could change in 2014 as bills filed in Florida and Massachusetts both include set nurse-to-patient ratios depending on the hospital unit.