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Nurse Staffing Standards for Hospital Patient Safety


Nurse staffing is one of the burning issues in the US healthcare system that needs effective solutions and proper legislation. The bill H.R.2581 entitled “Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act of 2019” dwells upon the standards concerning nurse staffing in all American hospitals (Congress, 2019). The bill includes the guidelines regarding a minimum nurse-to-patient ratio in healthcare facilities depending on the unit (Congress, 2019). It is recommended that trauma emergency units and operating room units had one nurse per one patient. The bill includes suggested ratios for critical care units (two patients per one nurse), emergency room units (three patients per nursing professional), and medical-surgical units (four patients per nursing practitioner). Rehabilitation units (with suggested five patients per nurse) and postpartum units (with six patients per nursing professional) are also covered in the bill. The sponsor of this bill is Ms. Schakowsky, who introduced it on May 8, 2019. This paper includes a brief review of the bill and its potential impact on nursing practice and the US healthcare system.

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Nurse staffing has become an urgent issue that has adverse effects on patient outcomes and nursing staff retention. The problem has become a matter of heated debate in society. Nurse staffing issues were addressed by policymakers earlier as a similar bill was introduced in the House in 2017 (Congress, 2017). It is noteworthy that the 2017 bill did not become law but was simply left with insufficient attention. The sponsor of the 2017 bill was also Ms. Schakowsky, and the politician stated that the bill failed due to policymakers’ inadequate understanding of the problem (Thayer, 2019). The legislation related to nursing staffing is associated with two quite opposing views.

In many states, certain attempts to regulate the nurse-to-patient ratio have been made, and the adoption of standards has had positive effects on nurse retention and the quality of the provided services. The 2019 bill includes information regarding the effective use of such guidelines in California (Congress, 2019). Still, the bill has both supporters and opponents who concentrate on different aspects of the problem and provide their arguments to defend their perspectives.

The supporters of the bill and corresponding changes are nursing practitioners. These healthcare professionals emphasize the benefits of the minimum nurse-to-patient ratio that will ensure the provision of appropriate care to every patient (Thayer, 2019). At present, nurses have to provide services to a large number of patients, which often has a negative effect on quality. Moreover, nurses’ workload and associated stress combined with low salaries make nursing practitioners leave their working places or even profession. The bill could become a solution to this problem and ensure the development of an appropriate working environment for nursing professionals.

At the same time, the opponents of the bill and the corresponding changes claim that minimum nurse-to-patient ratios can have negative effects on nursing practice and healthcare facilities’ development. Hospital administrators tend to share this view, and other healthcare professionals also focus on the negative aspects linked to the legislation. The opponents of nurse staffing regulations claim that hospitals would have to increase prices for their services due to the need to hire more nurses (“Letter: Local nurses oppose mandatory staffing bill,” 2019). The critics of the legislation state that they advocate for flexible nurse staffing that is based on patients’ peculiarities and nurses’ qualifications rather than rigid numbers.

Nevertheless, these arguments seem rather insufficient as the benefits of the bill outweigh the negative aspects of the enactment of the corresponding law. On the one hand, hospitals will have to allocate more funds to ensure proper nurse staffing. On the other hand, the quality of care will improve, which is the highest priority of the system. Furthermore, the bill has the potential to improve the quality of care and facilitate more effective funds allocation.

Nursing professionals can and should contribute to the bill’s transformation into the law. One of the ways to achieve this goal is to advocate for the introduction of the regulations regarding the nurse-to-patient ratio. The implementation of nursing research is another possible solution as nurses can provide evidence that can help policymakers to pass the bill. Finally, nurses should initiate a large-scale discussion of the introduction of the ratio. This discussion should involve nursing practitioners, other healthcare professionals, hospital administrators, and the public.

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In conclusion, it is necessary to note that the bill under consideration can have a positive effect on the development of the healthcare system. The introduction of standards regarding the nurse-to-patient ratio can improve the quality of provided care and have a positive effect on nurse retention. Clearly, it may lead to additional investment, but this funding may be minimal since hospitals may find the necessary funds through effective resource allocation. A similar bill failed to be passed, which shows that there is no agreement among legislators. Moreover, healthcare professionals have diverse views on the matter. Therefore, nursing practitioners should become active advocates of this legislation. They need to implement research to provide sufficient evidence indicating the effectiveness of nurse staffing standards. Nurses should also initiate and guide a discussion of the need for these regulations, which may have an effect on public opinion, and, as a result, the perspective of policymakers.


Congress. (2017). H.R.2392 – Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act of 2017. Web.

Congress. (2019). H.R.2581 – Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act of 2019. Web.

Letter: Local nurses oppose mandatory staffing bill. (2019). Chicago Tribune. Web.

Thayer, K. (2019). Patient-nurse ratio bill fails, but nurses aren’t giving up. Chicago Tribune. Web.

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