Vitello was among those who gave testimony against the proposed Patient Safety Act, which "would set standards for the maximum number of patients that can be safely cared for by hospital nurses at any one time" in Massachusetts. She strongly counters the "unmitigated lie" claim, saying that nurse leaders at Brigham and Women's Hospital are constantly adjusting staffing based on patient needs.
"We do it with a patient acuity system," she says. "That's done on a day-to-day basis." Nurse leaders use a "synergy model" to make daily staffing choices based on factors such as how the needs of patients match up with the skills of the nurses, the number of new grads working on a unit, and even the physical layout of units themselves.
"It is very complex," agrees Patricia M. Noga, PhD, RN, Vice President of Clinical Affairs for the Massachusetts Hospital Association. "Everyone is unique, and you just can't come up with fixed ratios that will be applied everywhere across the board."
Instead of mandated ratios coming from legislation, nurse executives can and should make the business case for hiring more nurses when needed. Vitello says it's something she did successfully when she was CNO of a community hospital.