The law effectively increased RN staffing in California hospitals, the study found, which supports proponents of staffing ratio laws. Those arguments, however, fail to address the number of travelers and temporary staff that hospitals must hire to meet requirements and that is expensive and inconvenient.
The staffing ratio debate will heat up as hospitals feel the first effects of payments for quality and patient experience. To head off legislation, hospitals must demonstrate that existing staffing plans provide safe patient care. Top performing hospitals often staff better than the laws require, but they do so with the freedom to adjust as necessary, depending on patient need and the organization's resources.
Patient acuity systems can be invaluable for maximizing staffing and saving money. So can offering nurses scheduling options beyond the 12-hour shift, such as peak-time shifts, multi-task shifts, group sharing, or job sharing.
To provide a reasonable argument against legislating ratios, hospitals must demonstrate optimal nurse staffing and a commitment to high-quality patient care. Involving RNs in the staffing decisions is the best way to head off union action.