Kiwi nurses call for staffing ratios

March 1, 2004 -- Today the New Zealand Herald ran a generally good article by Rebecca Walsh about the recent call by the New Zealand nurses' union for mandatory nurse staffing ratios "to assure patient safety and attract more nurses back to the profession," as well as the opposition to the ratios by the Ministry of Health and district health boards, who view the ratios as "too inflexible and costly."

According to the story, the Nurses Organization (union) was seeking nurse-to-patient ratios of 1:4 in "general medical and surgical wards" and 1:2 to 1:3 in emergency wards. The union pointed to a late 2003 survey of public hospitals that found nurses commonly caring for 6-9 patients. Union President Jane O'Malley was quoted as saying that many nurses were leaving the profession because of short staffing, resulting in an estimated shortage of 2,000 practicing nurses, with some 5,000 licensed nurses not working as nurses. In addition to the mandatory ratios, O'Malley said the union sought "associate charge nurses" to provide leadership on the units, as well as time for nurses to plan care and enhance their professional development. She also noted that since mandatory ratios had been introduced in Victoria, Australia in 2001, "more than 4000 nurses had returned to its hospitals."

The story devoted significant space to the opposition to the proposed ratios from the Ministry of Health and district health boards. The piece quoted the Ministry of Health's chief nursing advisor Dr. Frances Hughes as saying that the "jury was still out" on the effectiveness of staffing ratios, and appeared to attribute to Hughes the statement (not a quote) that "[i]n America, cost pressures and restructuring in the 1990's meant it was impossible to maintain them." It's certainly true that "cost pressures and restructuring" in the 1990's have led to dangerously inadequate nurse staffing, but to our knowledge there were no mandatory staffing ratios in the 1990's. Only since the start of 2004 have mandatory ratios have been in place in California, the first state in the U.S. to impose them; other states, such as Massachusetts, are considering them. Evidently the Ministry instead supports the "magnet" hospital concept, which in the article's words means "hospitals could attract and retain staff by flexible measures such as providing for professional development and allowing nurses to make decisions on how they practice." Contrary to the impression that might be created here, we are aware of no tension between staffing ratios and "magnet" status.

Learn more about the benefits of magnet hospital status.

See Rebecca Walsh's article "Nurses seek mandatory case ratios" in the March 1, 2004 edition of the New Zealand Herald.