Nurse-Patient Staffing

New Mexico Nurse, Jul-Sep 2006

Regarding all the calls we've been receiving concerning "Staffing:"

Nurses are calling NMNA complaining about the number of patients they are assigned, and wanting NMNA to introduce legislation for staffing ratios. Several questions: 1) Are you an NMNA member? If you aren't paying $200.00 a year in membership dues (or $100 as a new grad), you are not a member, but just receive the NM Nurse because you are a licensed nurse in New Mexico.

2) Have you donated to the Lobbyist fund? The lobbyist fund helps us to pay our full-time lobbyist, who helps us get nursing and health care bills passed by the legislature.

3) What have you been doing in your work setting to try to change the situation? If you haven't been making your unit manager aware of "over assignment" of your patients per nurse, and talked with your co-workers about going to administration about the situation, what do you expect NMNA to do for you?

The question is not about the number of patients you are assigned each shift, but what is the acuity of those patients and what are your abilities to provide effective care for them? If they are 24-hours post-delivery and healthy with healthy babes, 4, 5, or 6 moms plus a post-op patient or two wouldn't be unreasonable for an experienced OB/GYN nurse. But if you are brand new to OB and unsure about skills and teaching, and they are all going home this morning, you may not be able to handle this assignment. If you have a new diabetic who speaks only Vietnamese and you do not know any Vietnamese, then you are probably not the nurse for this particular patient, unless you are given an interpreter for the teaching that is needed.

The assignments need to be based upon the acuity of patients, skill sets of the staff nurses, the amount of non-professional assistance available (unit secretary, aides or techs available to help), whether there is an available CNS for consultation. Also the number of discharges, transfers, and admissions, and procedures required are issues we must consider when discussing staffing.

ANA has recently published "Utilization Guide for the ANA Principles for Nurse Staffing," available at www.nursingworld.org from the bookstore. I suggest that nurses concerned about the issue join ANA/NMNA, and purchase a copy of the Utilization Guide.