Legislation Addressing Minimum Registered Nurse Staffing Deficiencies in Healthcare Settings

This paper addresses nurse staffing ratios within health care facilities and resulting patient outcomes in the light of a bill known as Assembly, Number 647 State Of New Jersey 216th Legislature (the bill). The bill was originally introduced in 2006 as Assembly, Number 745 with ensuing reintroductions in 2008, 2010, and 2012. The bill seeks to establish minimum safe staffing standards for registered professional nurses in hospitals, ambulatory surgery facilities, and State development centers and psychiatric centers. The bill has undergone a resurgence of sorts after being tabled and sponsored anew by a different legislator – and this process is discussed as well. A brief description of the legislative process with regard to the creation and furtherance of a bill in its journey through the legislative process is briefly discussed as well. The existence of a relatively sparse amount of legislation nationwide gives some cause for concern that the number of positive patient outcomes, (low in comparison to those of other nations, and low relative to a comparatively high amount of dollars spent as part of GDP when quantified against those outcomes) is not being advanced by government. Nurse understaffing within healthcare facilities outside the United States is also briefly addressed. Perceived deficiencies among staffing-to-patient ratios in comparison to those seen as adequate are discussed. Understaffing is seen to be contributory to higher patient assignments for nurses leading to job dissatisfaction, nursing burnout, and higher turnover rates among nurses further contributing to the current nursing shortage. Other findings with regard to favorable patient outcomes as a result of lower nurse-to-patient ratios have been inconclusive however and call for additional research. Others have determined that lower nurseto- patient ratios leading to improved patient outcomes are conclusive however and thus provides grounds for legislation to be enacted nationwide in order to provide for more stringent nurse staffing levels.