- New York’s Public Health and Health Planning Council is set to approve one component of the Safe Staffing Act on Thursday. It requires a nurse-to-patient staffing ratio of one nurse for every two critical care patients in hospital units.
- The law was passed under Gov. Andrew Cuomo in 2021, as COVID-19 strained healthcare capacity and drew attention to decades-old concerns over nurses’ workloads.
- Nancy Hagans, president of the New York State Nurses Association, applauded the act but said she wanted to see staffing laws expanded to cover nurses outside critical care units.
In a statement to Healthcare Dive, Hagans said the law will improve “safety and working conditions for nurses at the bedside” and will help “to recruit and retain enough nurses for quality care everywhere.”
But she added the law is just a step in the right direction. “We would like to see safe patient ratios extended to all patients in New York’s hospitals,” she said.
Linda Aiken, founding director of the Center for Health Outcomes and Policy Research and professor at the University of Pennsylvania School of Nursing, testified in favor of a broader approach in February 2021. She showed peer-reviewed research that found New York nurses could be responsible for between 4.3 to 10.5 patients prior to COVID-19.
Aiken’s research suggested standardizing nurse-to-patient ratios to the recommended 1:4 could prevent 4,370 deaths of elderly New York Medicare patients, save hospitals $720 million over two years due to shorter lengths of stay and fewer readmissions, and boost patient satisfaction.
The original bill stipulated such ratios for all units. But, according to reporting from New York Focus, requiring set ratios fell apart after negotiations between labor unions and the Hospital Association of New York State. The final regulation requires hospitals only to adhere to the 1:2 staffing ratio in critical care and intensive care units. Instead, hospitals must use staffing committees to determine the appropriate ratios for other care units. Committees are made up of half nurses and half hospital administrators.
In a statement, Erin Clary, public information officer at the New York Department of Health, said “the proposed regulation allows each hospital to collaboratively develop clinical staffing plans with nurses and other staff,” allowing hospitals to “balance what is best for the patient and workforce while taking into account the varying needs of each individual hospital.”
But Karen Lasater, an assistant professor with the University of Pennsylvania Nursing Center for Health Outcomes and Policy Research, told NY Focus, “Those staffing ratios are negotiated between clinical nursing staff and high level executives, who are effectively their employers. So it becomes a very lopsided table to sit around.”