Fact Sheet
Nurse Staffing and Patient Safety in Illinois Hospitals
Numerical nurse-to-patient ratios are not the answer.
Hospitals and nurses have the same agenda: providing the best patient
care possible.
Hospitals and health systems strive every day to provide high quality
care and realize that nurses are at the heart of achieving that mission.
Health care leaders have always known: nurses are critical to high quality
patient care.
IHA agrees with organized labor groups that our state needs solutions
that will provide optimal staffing in hospitals and other healthcare
facilities. But we strongly disagree that state-mandated nurse-to-patient
ratios are the answer.
Staffing plans are – and should continue - to be driven by patient
needs. Illinois hospitals plan their staffing and then, continually adjust
that plan according to changes in the number of patients, the severity of
their illness, and available staff skills mix.
Establishing "minimum, specific and numerical" ratios implies that there
is a scientific basis for determining the number of nurses to patients above
which good outcomes for patients are guaranteed. The reality is that no
study has provided conclusive evidence of what such thresholds might be.
The quality of hospital care is associated with a complex array of
organizational and patient characteristics, with nurse staffing being just
one of them. Mandated staffing ratios focus too simplistically and narrowly
on numerical variables at the expense of all the other factors that
contribute to safe, quality patient care and the satisfaction of nurses.
Healthcare professionals -not lawmakers or regulators – are in the best
position to determine appropriate staffing. Laws are changed from year to
year – caregivers need to have the flexibility to adjust patient care moment to moment depending on what patients need.
Illinois state government and its hospitals are simply not in a position
to address the financial realities of nurse-to-patient ratios. California
passed a nurse ratio law that took four years to be implemented.
Furthermore, California’s governor appropriated more than $60 million to
help build the state’s nursing workforce. Illinois’ state budget worries are
well documented, and the average Illinois hospital barely broke even last
year.
The real staffing issue for hospitals is a growing workforce shortage.
- Would hospital leaders like to hire more nurses today? Absolutely. Illinois
hospitals, however, are facing a shortage of health care workers that is
steadily growing.
- In the midst of a nursing shortage, mandated ratios will do nothing to
increase the number of nurses at the bedside.
- The supply of health care workers is declining just as demand for
caregivers is increasing as the "boomer" generation ages. What will happen if
hospitals cannot meet the ratio requirements? Will this result in closed beds
and curtailed services?
- The shortage of nurses with special training and extensive experience is
especially severe – so severe that some Illinois hospitals have been forced to
turn away patients who need specialized nursing care.
- Illinois hospitals are addressing this shortage with aggressive recruitment
and retention initiatives, e.g. offering flexible hours, better pay and
benefits, relocation bonuses, and housing allowances. But these short-term
fixes do little to address the underlying supply problem.
- The issue of nurse staffing is a complex one that requires thoughtful
solutions. That is why hospitals are collaborating statewide with educators,
nurses and nursing organizations through the Illinois Coalition for Nursing
Resources (ICNR). The organization, the only one of its kind in the nation,
has over 140 members and is working diligently on long-term and lasting
strategies to the nursing shortage.
- In concert with the General Assembly, ICNR and others, IHA efforts have
helped to pass and support legislation, such as scholarship funds, loan
repayments programs and easing reciprocity to help bolster the supply of
available nurses.
HOW LEGISLATORS CAN HELP
Illinois lawmakers and elected officials need to take continued measures to
increase the supply of health care workers for the future. Suggestions include:
- Upward mobility scholarships to train caregivers for advanced licensure and
certification.
- Funding for repayment of student loans.
- Interstate agreements to make licensed nurses in nearby states easily
available for work in Illinois.
- Grants to health care organizations for nurse mentoring and internship
programs.
- Promotion of health care professions as a rewarding and needed career
field.
- Scholarships for nurses who will work in medically underserved areas of the
state.
- Initiatives to enable experienced foreign-educated nurses to work in
Illinois.
- Support the development of an Illinois Center for Nursing to prevent future
shortages.
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