Patient-nurse ratio inaccurate mark of success

The National Nurses Organizing Committee, a California-based nurses’ union trying to make inroads elsewhere, is once again calling for higher nurse-to-patient ratios in Texas hospitals.

This isn’t the first time the group has called for lowering the number of patients each nurse is responsible for. In the previous legislative session a bill was introduced but was not voted upon.

Some Texas nurses have taken up the cause, saying patient safety is compromised if nurses have to divide their attention among too many patients. They want a bill submitted in the 81st Texas Legislature, which convenes in January, mandating a 1-to-5 nurse-patient ratio in general hospital wings, with a 1-to-4 ratio in pediatric units and 1-to-2 ratio in intensive care units.

Lawmakers shouldn’t have to be reminded to be skeptical about efforts to mandate more workers made by unions, which gain money and strength when they have more workers to recruit.

They should, however, remember that mandates don’t matter if there aren’t enough people to meet them.

The American Hospital Association released a report in June 2007 that 116,000 existing nursing positions remained unfilled nationwide at the time because there were no nurses to fill them. Several studies have concluded the shortages will only get worse, as an aging population creates ever-growing demands for nurses and other health care professionals. The National Council on Physician and Nurse Supply projects the nationwide nursing shortage could be as great as 800,000 by 2020.

People with medical needs and their families naturally want the best care possible. It’s safe to assume those filling those needs also want to do the best job they can. Those desires, however, don’t magically make nurses appear. Hospitals here and everywhere frequently offer large bonuses to nurses who are willing to sign long-term contracts, just to fill their immediate needs.

It makes no sense to mandate nursing minimums when there is no way those mandates can be met.

Hospitals, nursing homes and other health care facilities deal with such shortages by hiring the nurses they can and using them as supervisors for larger groups of certified nursing assistants. The assistants generally provide most hands-on care, allowing nurses to focus on the more critical cases.

Health care institutions already face periodic reviews and audits that determine how well they are meeting the needs of their communities. Those reviews should be thorough enough to uncover deficiencies; facilities that provide good care with limited resources should not be penalized for their efficiency, just because they might not meet mandated nurse-patient ratios.

Everyone involved should place the priority on quality of care, not on how well a facility meets numbers targets. We trust Texas legislators will see the folly in considering quotas that are impossible to fill.