American Nurses Association Backs Nurse-Patient Staffing Ratios

Ayla Roberts, MSN, RN
Updated November 29, 2023
Edited by
    The ANA recently announced its support of mandated nurse-patient ratios. Find out what this means for the nursing workforce.
    Nurses looking at staffing schedule boardCredit: Getty Images
    • The ANA recently confirmed its support for nurse-to-patient ratio laws.
    • Lower nurse-to-patient ratios are associated with both lower patient mortality and lower rates of nurse burnout and turnover.
    • A commitment to advocacy from nurses and organizations can help ensure nurse-to-patient ratio legislation is passed.

    The American Nurses Association (ANA) recently released a statement announcing its support of nurse-to-patient ratio laws, including one currently working through the halls of Washington.

    The legislation, known as the Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act, would establish minimum nurse-to-patient ratios in every hospital across the country. While a few states have already implemented safer nurse staffing laws, this bill would be the first legislation of its kind to be passed on the federal level.

    “Inadequate staffing standards exacerbate the work environment challenges nurses already experience, such as workplace violence, burnout, barriers to practice, and attrition,” the ANA told NurseJournal in an email. “We convened a nurse staffing task force this year that crafted a definition of appropriate staffing, which is a dynamic process that aligns the number of nurses, their workload, expertise, and resources with patient needs in order to achieve quality patient outcomes within a healthy work environment. Safe staffing standards and a healthy work environment have the potential to improve nurse and patient outcomes.”

    The ANA’s stance is also backed by research. Recent studies have confirmed that lower nurse-to-patient ratios are directly associated with lower patient mortality rates. In other words, safe staffing ratios save lives.

    Are Mandated Ratios the Solution to the Nurse Staffing Crisis?

    Additional research has proven that high nurse-to-patient ratios result in increased rates of burnout and job dissatisfaction among nurses, which ultimately results in nurse turnover and worsened staffing shortages. In one ANA study, a staggering 89% of nurses admitted that their place of employment was short-staffed.

    “Enforceable nurse-to-patient ratios can significantly support nurses particularly if they recognize key factors such as patient acuity, intensity of the unit practice setting, and nurses’ competency,” ANA officials told NurseJournal. “However, ratios alone will not solve this national crisis. ANA urges leaders and policymakers to work towards eliminating mandatory overtime, advancing workplace violence prevention plans, increasing the transparency of nurse reimbursement, and advocating for education funding to support and grow the nursing pipeline. ANA views minimum nurse staffing ratios as one critical aspect to solving the nursing crisis and supports the rights of nurses to advocate for themselves.”

    It’s clear that inadequate staffing has a direct correlation to the nursing shortage as more nurses continue to leave the bedside. In addition to nurses leaving the bedside in record numbers, staffing concerns are a primary reason for the widespread surge in nursing strikes across the country. While mandated staffing ratios alone are unlikely to solve the nursing shortage, research suggests they are a worthwhile step in the right direction.

    ANA Advocacy Initiatives for Safe Staffing

    Legislation and politics are often complicated, to say the least, and nurse staffing regulations are no exception. It can take months or even years for legislation to become law. In this case, that delay could be detrimental to both nurses and patients.

    The ANA believes that nursing expertise can play a crucial role in the development of health policy, explaining to NurseJournal:

    In addition to supporting the Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act, ANA continues to engage Congressional leaders, the Centers for Medicare & Medicaid Services (CMS) and other key stakeholders to refine approaches to implementing staffing standards. Additionally, ANA launched a Nurse Staffing Think Tank and Task Force and published practice and policy solutions to help end the nurse staffing crisis.

    The ANA also encouraged nurses to contact their elected officials in Congress and ask them to support the legislation. The bill currently has 84 cosponsors in the House and seven in the Senate.

    What Other Organizations Support Federal Staffing Ratio Laws?

    In addition to the ANA, other organizations have announced their support for mandated nurse-patient ratio laws. For example, the American Association for Critical Care Nurses and the U.S. Department of Health and Human Services have both released statements regarding their stance on safe staffing standards. Leaders from several different nursing unions have also endorsed the legislation.

    Staffing shortages are one of the most difficult challenges nurses face today. The ongoing staffing crisis affects nurses and the patients they care for. A commitment to advocacy is a critical part of ensuring meaningful legislation is passed so that nurses can perform their jobs safely and effectively.