Cutting nurses’ patient loads boosts care, costs | USA Today | 7.25.04
…The California law took effect in January. But not everyone is pleased. Mary Dee Hacker is the chief nursing officer at the 286-bed Children’s Hospital Los Angeles.
“On any given day we have physicians who want to admit patients, and I cannot accept them because I don’t have enough nurses,” Hacker says. “California is in a public health crisis in not having enough nurses. We were dealing with that before the minimum staff ratio, but now it’s been exacerbated.”
In the USA, hospitals average a 13% nurse vacancy rate, or about 126,000 vacancies nationwide, according to the American Nurses Association. About 2.7 million nurses are licensed in the United States, with about 59% working in hospitals, the rest in other areas of nursing. Causes of the shortage are varied: not enough faculty to expand nursing school enrollment, wider opportunities for nurses outside of hospital care and a decade of changes by the hospital industry that nurses blame for increased workloads, driving some to leave the profession.
Hospitals in many metro areas around the country are already in a dog-eat-dog fight to attract and retain their nursing staff. The same is true in California. The state estimated that 5,000 nurses would be needed for the state’s hospitals to meet the new law’s requirements, but hospitals say the number is higher. Kaiser Permanente alone says it has hired 6,000 nurses statewide in the past two years to help it meet its staffing standards. …
In November 2001, I gave a presentation (images below) on the impact of nurse staffing ratios (NSRs) with the pending implementation of the AB394 (the enabling legislation)—at the time there was an average of 782 nurses per 100,000 population in the United States, with California at the bottom (25% below the national average, original data from NurseWeek). Additional factors at play, capacity in hospitals and health systems continue to decline, increase demand, and a continued rise in the age of an average nurse all bode poorly for California—especially if other states adopt similar legislation (IMHO, just a matter of time) and are functioning at higher per capita of nurses. We may see a siphoning of nurses from the low end of the per capita pool, whereas we’re now seeing lots of siphoning of nurses into traveling because of the better pay here out west. I’ve had whole shifts composed with nurses from Canada, South Africa, and the southern U.S.—including charge nurses and house supervisors.
