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These types of factors are vague, can be manipulated by the hospital, and diverge from minimum staffing standards based on numerical RN-to-patient ratios.

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Its policy required one RN for every six patients in this unit where most patients required intensive care.

Then, the New York legislative focus shifted from mandated ratios to staffing plans that allow ratio adjustments with input from direct-care nurses.

Today, this shift is being played out in states across the country.

Massive reductions in nursing budgets, combined with the challenges presented by a growing nursing shortage have resulted in fewer nurses working longer hours and caring for sicker patients.

This situation compromises care and contributes to the nursing shortage by creating an environment that drives nurses from the bedside.

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