Nursing leaders have the responsibility to ensure patient safety and quality patient outcomes.

Nursing leaders have the responsibility to ensure safe practice conditions for nurses.

Hospital work environments are dynamic and unpredictable. They run 24/7 and must be flexible in order to meet multiple changing patient care needs.

Mandated nurse-staffing ratios are based on a fixed number of patients per nurse.

• Mandated nurse-staffing ratios fail to consider the:

• needs of specific patient populations and specific needs of each patient;

• environment in which care is delivered;

• education and experience of the nurse;

• impact of technology;

• variability of patient needs throughout a 24 hour period of time;

• availability of adequate support staff and services.

Staffing decisions require the critical thinking, judgment and flexibility of nurses who best understand the patients and their healthcare needs. This needs to be a collaborative process between nursing leadership and direct care staff.

Unintended consequences of mandated staffing ratios could include: cutbacks in services, bed closures, emergency room diversions and increased healthcare costs. In addition, minimum ratios could translate into maximum ratios which potentially contradict the needs of both patients and staff.

Mandated staffing ratios will increase the stress on an already overburdened healthcare system and potentially create greater public safety risks.