Nurse viewpoint: Mandatory staffing ratios are the wrong fight

Mandatory nurse staffing ratios are a temporary solution to a larger issue and will not bring about the respect the profession deserves, Kathleen Bartholomew, MN, RN, a national speaker and nurse advocate, wrote in an op-ed for Instead, nurses should be advocating for charge nurses to have the authority to set ratios on an hourly basis and "get as many nurses as they request. Period," she said. 

In healthcare's current business model, the core focus is profit. Billing codes don't exist for being the only nurse who can get a patient to take his or her medication, or for intervening just in time to prevent a medical error, Ms. Bartholomew said. 

"Because the work we cherish has no monetary 'value' in the current business system, our self-esteem decreases, in-group arguing prevails, and we start measuring ourselves using the language of the dominant group: turn-around time, length of stay, and hours of care per patient day," she wrote. "This is why staffing ratios are the wrong fight. It's still about control."

Ms. Bartholomew said the charge nurse is the only person in a healthcare organization who is qualified to decide staffing levels based on real-time patient acuity and staff members' experience and skills. These individuals should be the ones in control of setting staffing ratios, she argued.

"By playing into ratios, we are still holding ourselves in an oppressed position because we are discounting our own ability to make this critical decision," she wrote. "If you are going to fight, fight for the real thing: your own autonomy and power."

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