I have to respond to my classmate post. This is what he wrote. Staffing is a topic that we hear about so often during the day. In my current position majority of my work is centralized staffing for the organization. Floating between units, offering incentives tracking agency needs all come through my office. The discussion of ratios vs. acuity has come up often and how to staff each unit. Evidence varies but it has shown that mandating staffing ratios in California have not changed patient outcomes (Olley et al., 2019).
My organization does not have mandated ratios and we do not even have a ratio number in our policy that I have reviewed. We try to stay at a max of 1:5 on day shift for med-surge and 1:6 on night shift and this is a conversation with senior leadership. There are days that we can not meet those ratios because we do no refuse patients to the floors based on ratio. We have an acuity system that runs reports based on documentation. This is used to show the utilization numbers on all the units and figure out where the limited resources need to be placed. This is also used at the unit levels with making patient assignments because ratios are not the only thing to make assignments fair or equitable. We do have an operational budget showing what ratios should be based on our ADC and skill mix that is created through finance but with so many unfilled positions we do not hit that mark. When census increase and we do not have the staff the ratios go up and the operational budget is not met.
We have been mandated in NYS to develop staffing committees and report to the state what out staffing plans will be in 2023. This data was used through what finance uses for budget and broken down to what the ratios should be. The concerns here is with the increase in census we are not going to meet these needs. Having a forum to for staff to discuss unsafe staffing or decided on what ratios should be is what the states requires (Skarbek et al., 2022). We have discussed what the grievance process will be but again there is not enough data to support staffing ratios increase better outcomes.
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