Public Policy: Nurse-Patient Ratios and Care

To control the process of administering treatment to patients and keep the process of meeting their needs continuous, nurses have to engage with the dialogue with inpatients. However, given the broad range of responsibilities that nurses have in the hospital setting, the amount of time and extent of care that a nurse can provide to the target demographic drops. Given the recent tendency toward a rise in nurse shortage in most U.S. hospital settings, the problem of a dropping nurse-patient ratio is on the increase. While one may claim that the connection between a drop in nurse-patient ratio and the shifts in the quality and accessibility of care is self-explanatory, further analysis is required. Herein lies the urgency and importance of the issue as a problem in contemporary nursing. Due to the increased opportunities for effective time management and a drop in the workload, nurses are likely to address patients’ health-related needs more carefully once the nurse-patient ratio is reduced.

The problem of nurse shortage does not exist in a vacuum. Instead, it is affected by a broad range of social, economic, and financial issues that shape the attitudes toward responsibility and task management in the nursing setting. The motivation and eagerness to educate oneself have also seen a vast reduction among nurses, as reports show (Griffiths, 2019). Consequently, the shortage of competent nurses in the inpatient setting is being reduced along with the nurse-patient ratio. The described trend is believed to lead to problems such as medical errors, miscommunications, poor timing of health interventions, and an overall decline in the quality of healthcare. The connections between the described variables may seem obvious, yet a further analysis of recent reports and research on the problem at hand is needed. The insight into the studies performed lately may inform the creation of new approaches to increasing the nurse-patient ratio.

There are numerous pieces of evidence that point to the presence of a doubtless connection between the quality of patient care and the levels of nurse-patient ratio in a nursing institution. For instance, the article by Driscoll et al. (2017) shares the results of an analysis that proves the connection between nurse-patient rates and the quality of services in a nursing setting. According to the results of the study, the propensity among nurses to make medical errors rises extensively with the drop in the nurse-patient ratio (Driscoll et al., 2017). Specifically, Driscoll et al. (2017) “reported on medication errors and found that as the number of nurses decreased, the OR for parenteral medication errors increased, some of which caused harm and death” (p. 19). The outcomes outlined in the research are mostly self-explanatory since a larger workload suggests that nurses cannot disperse their attention to focus on communication with patients and monitoring of their health status as effectively.

Moreover, there are indications that the change in the nurse-patient ratio will cause a change in the nurse-patient dialogue. Currently, the quality of communication between the healthcare staff and inpatients leaves much to be desired due to the restricted amount of time that nurses have to converse with patients (Lu, Ruan, Xing, & Hu, 2015). Consequently, a range of essential information that could potentially be used to enhance the productivity of nurses’ work exponentially is omitted. An extended nurse-patient dialogue, in turn, will shed light on external and internal factors affecting patients’ health, including cultural issues. In addition, immediate threats to patients’ well-being can be recognized faster with the enhancement of communication. Finally, a nurse can use the developed rapport with their patients to introduce them to the notion of self-care (Asamani, Agyemang, Afful, & Asumeng, 2017). Therefore, the correlation between the nurse-to-patient ratio and patient outcomes becomes quite evident.

Although the arguments in favor of increasing the nurse-patient ratio to boost the efficacy of care are quite sufficient to launch a change in the current nursing environment, there is the reasoning of the opposite side of the argument, which is worth considering before making a decision. The studies that deny the presence of a connection between low nurse-to-patient rates and poor performance in the healthcare environment are not numerous, yet most of them focus on the unique specifics of a particular setting that allow maximizing the utility without putting nurses under greater pressure.

However, the specified arguments cannot be considered as fully indicative of the absence of any link between the nurse-patient ratio and the quality of nursing services. The drop in the number of patients per nurse and the reduction in responsibility that each staff member has to face in the context of a nursing facility creates premises for avoiding medical errors and mismanagement of patients’ data. Even with quality issues that do occur in the described environment, the opportunities for managing emergent health risks and correcting the mistakes made by nurses are far greater than with a low nurse-patient ratio, which suggests a lesser amount of time spent on each client (Liang, Chen, & Lin, 2015). Therefore, the incorporation of strategies aimed at increasing the nurse-patient ratio is quite justified.

I believe that there is a correlation between the nurse-patient ratio and the extent of care that patients receive, as well as the quality thereof. Although the described correlation is far from being linear, the link exists, which means that tools for increasing the nurse-to-patient ratio should be developed and introduced to the modern nursing setting. Therefore, strategies aimed at creating a more comfortable and satisfying environment for nurses to consider applying for hospital jobs should be created. In addition, Healthcare facilities should offer nurses additional options for career advancement, including training, courses for increasing competency levels, and similar opportunities. I believe that the described measures will help to overcome the problem of nurse shortage in most hospital settings, which will cause a rise in the nurse-patient ratio.

It seems that the problem of low nurse-patient ratio and, therefore, the increasing shortage of nurses, is defined by a combination of high expectations for candidates and very few financial opportunities, including low salaries, lack of financial benefits, and absence of training options. Therefore, reconsidering the existing nursing system and building a robust talent management framework should become the foundational principles of change in the human resource management strategies in the nursing context. Moreover, the problem of managing the needs of an increased number of patients can be addressed by introducing culture-specific approaches toward communicating with the target demographic and using innovative tools for transferring information from one nurse to another. Involving a patient in the conversation that occurs during patient handovers should also become an important part of handling information properly in the target setting. As a result, the pressure of workload will be reduced so that nurses could focus on improving the quality of their performance


Asamani, L., Agyemang, B. C., Afful, J., & Asumeng, M. (2017). The work attitude of Ghanaian nurses for quality health care service delivery: Application of Individual and Organizational Centered (IOC) interventions. International Journal of Research, 7(1), 37-46. doi:10.5861/ijrsm.2018.3003

Griffiths, P., Maruotti, A., Saucedo, A. R., Redfern, O. C., Ball, J. E., Briggs, J.,… & Smith, G. B. (2019). Nurse staffing, nursing assistants and hospital mortality: Retrospective longitudinal cohort study. BMJ Quality & Safety, 28(8), 609-617. doi:10.1136/bmjqs-2018-008043

Liang, Y. W., Chen, W. Y., & Lin, Y. H. (2015). Estimating a hospital production function to evaluate the effect of nurse staffing on patient mortality in Taiwan: the longitudinal count data approach. Romanian Journal of Economic Forecasting, 18, 154-169.

Lu, M., Ruan, H., Xing, W., & Hu, Y. (2015). Nurse burnout in China: a questionnaire survey on staffing, job satisfaction, and quality of care. Journal of Nursing Management, 23(4), 440-447. doi:10.1111/jonm.12150