Legally mandated nurse-to-patient ratios are one of the most
controversial topics in health care today. Ratio advocates believe
that minimum staffing levels are essential for quality care, better
working conditions, and higher rates of RN recruitment and
retention that would alleviate the current global nursing shortage.
Opponents claim that ratios will unfairly burden hospital budgets,
while reducing management flexibility in addressing patient
needs.
Safety in Numbers is the first book to examine the arguments for
and against ratios. Utilizing survey data, interviews, and other
original research, Suzanne Gordon, John Buchanan, and Tanya
Bretherton weigh the cost, benefits, and effectiveness of ratios in
California and the state of Victoria in Australia, the two places
where RN staffing levels have been mandated the longest. They show
how hospital cost cutting and layoffs in the 1990s created larger
workloads and deteriorating conditions for both nurses and their
patients leading nursing organizations to embrace staffing level
regulation. The authors provide an in-depth account of the
difficult but ultimately successful campaigns waged by nurses and
their allies to win mandated ratios. Safety in Numbers then reports
on how nurses, hospital administrators, and health care
policymakers handled ratio implementation.
With at least fourteen states in the United States and several
other countries now considering staffing level regulation, this
balanced assessment of the impact of ratios on patient outcomes and
RN job performance and satisfaction could not be timelier. The
authors' history and analysis of the nurse-to-patient ratios debate
will be welcomed as an invaluable guide for patient advocates,
nurses, health care managers, public officials, and anyone else
concerned about the quality of patient care in the United States
and the world."
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