States with Specific Nurse-Patient Ratios Laws
There are currently only 2 states that have set a determined number of patients that can be cared for by a nurse; California and most recently, Massachusetts. California is the largest state by population size and often has very specific rules that regulate professional industries, such as healthcare. There are many nurses and other bright minds in this field, so the state is proud to be a leader in enabling its workforce to be protected in many different scenarios.
California has the highest recorded range of ratios, with as many as 6 patients to one nurse for psychiatric care. To put this in perspective, New York's average nurse-to-patient ratio for psychiatric care is around 3.6.
Massachusetts has recently passed laws that mimic the Californian model. Notably, it not only presents the nurse-patient ratio in terms of number but also the stability of the patients. Generally speaking, Massachusetts has set a ratio of between 1:1 and 1:2 depending on the severity. This has reduced the number of patients that each nurse is responsible for, which the government of Massachusetts hopes to help increase wages, increase demand and increase the number of nursing jobs available. Additionally, nurses with a low patient ratio will take better care of their patients.
States That Are Searching For Concrete Legislation
In addition to California and Massachusetts, 11 other states have taken steps forward to attempt to enact guidance regarding ratios. These are:
State governments require that the hospitals within their jurisdiction form committees or their tribunals to determine the correct nurse-patient ratio depending on their circumstances. Policies and Procedures of each hospital must be well-documented to be extremely tenable in the event of a malpractice suit against their practitioners. It must also justify this number to the workforce, as nurses need to understand what is expected of them in each hospital.
This controversial topic has always been spoken about but was quickly moved along during the pandemic. It shined a light on the situation, and pressure is being put on governments and hospitals equally to share the burden of enacting proper legislation.
Federal Laws Regarding Nurse-Patient Ratios
Generally speaking, there are no federal rules that states must abide by in their decision-making process. With this being said, there are federal ratios that are suggested to be used as a standard, and all states, counties, and municipalities can choose to accept them or use them as a model for their purposes. The largest federally-suggested ratio is 1:6, for Well Baby Nurseries. The lowest suggested ratio of 1:1 is for extremely intensive tasks, such as caring for an ER trauma patient, and patients that are actively in the operating room. Other severe issues, such as intensive care and neonatal intensive care have low ratio suggestions of 1:2, although many hospitals may require that the ratio is lowered to 1:1, especially for patients with a high risk.