Letter to the editor: Mandated nurse-to-patient ratios reduces death rate

The Sun Chronicle: I am writing regarding a Massachusetts ballot initiative regarding safe patient limits for nurses. As a nurse who worked for 40 years in a major teaching hospital in Boston, I can speak with authority about present day patient acuity in the hospital setting.

Patients who are hospitalized these days are either recovering from major surgery, or are sick enough to require round-the-clock care.

Hospitalized patients who would have been in an intensive care unit even a few years ago are routinely cared for on hospital medical-surgical units. One’s best hope in this situation is a caring, observant and competent nurse.

However, each additional patient on a nurse’s assignment will pull that nurse away from the bedside for longer periods of time.

Reliance upon technology does not substitute for one’s ability to observe a patient for subtle changes in condition.

As far back as 2002, it has been shown that larger nursing patient assignments adversely affect patient outcomes, including mortality.

The state of California passed legislation in 2003, mandating certain nurse-to-patient ratios. Since that law went into effect, there has been a significant drop in patient mortality, and an overall improvement in nursing job satisfaction. This begs the question of why it has it taken so long for Massachusetts, with its internationally recognized and excellent hospitals, to follow suit.

Our patients deserve the best care that can be offered. Medicine in general and nursing specifically continues to become more complex, and this will only increase as patients live longer with complicated illnesses.


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