As Covid-19 continues its worldwide rampage, more and more voices in the United States are calling for new laws that would require hospitals and other facilities to meet specific nurse staffing ratio targets. There is no federally mandated ratio so far, and California is the only state that’s put one into law. Thirteen other states have “softer” laws that require general management, but not a mandated target.
But advocates are pushing for similar laws in other states, too — and they’re making progress, too, particularly in New York, which has emerged as a key battleground in a Covid-related push for new ratios.
On the face of it, this is nothing new. The lines have been drawn over nurse staffing ratio reform for years now, with nurses unions and associations advocating for new laws versus hospital associations and insurers. But just because the fight is a long-established one, it might be a mistake to dismiss the voices calling for nurse staffing ratio reform as more of the same.
In the Covid-19 era, those voices have new urgency, and they’re receiving a greater share of media attention. Potentially, they’ll enjoy renewed attention from local and state lawmakers, as well.
Though hospitals and facility administrators may be resistant to mandated ratios, they can take assurance in the fact that they have more tools than ever before to meet that obligation without incurring a serious expense. Specially, healthcare managed service providers (MSPs) can help provide the flex power to meet nurse staffing ratios during these more demanding times. Here’s a quick rundown of the situation, and a look at a potential solution that’s already available.
Concerns Grow Over Fluctuating Nurse Staffing Ratios
In New York, the Safe Staffing for Quality Care Act of 2019–20, which seeks to codify ratios in critical care, ICU, med/surg and well-baby nursery units, is in active legislation. Advocates argue that the lack of such a law during the Covid-19 crisis has led to tragic consequences not just in terms of patient care, but to the larger nursing profession, too.
“Our feeling was that staffing was so tight, when this came to be, the system broke. It just broke,” as New York State Nurses Association executive director Pat Kane told Crain’s New York Business.
Across the country, RN and CNMT Andrea Hardesty recently made a similar argument vin an opinion piece for the Everett, Washington Herald. Current staffing ratios have shown little flexibility in adapting to new and extraordinary circumstances, she writes, such as no-visitor policies and sustained critical care. And this has affected not only the ability to treat Covid-19 patients, but also to accommodate the sometimes-radical changes the pandemic has caused everywhere else, too.
“Beyond the disease, the demands for care for non-Covid patients have increased,” she added. “Staffing must increase, too. … We need staffing models based on the acuity of patients being seen now.”
But the push for nurse staffing ratio reform isn’t just a policy debate. Legal action has been taken in a number of cases; recently, two nurses associated with a local union filed a complaint with the Washington State Department of Health against a major Yakima hospital regarding staffing and safety measures.
Among other complaints, the two nurses argue that the hospital “averaged one nurse per three patients” in its critical care unit “since the pandemic,” compared to a typical nurse-to-patient ratio of 1:1 or 1:2 before then, as Lex Talamo explains at the Yakima Herald-Republic. As a result, they allege, they work every day “in anticipation of a disaster.”
The case illuminates an underlying reality of the situation — that it’s about more than agreeing on nurse staffing ratios, but maintaining standard ratios during a crisis. For some facilities, this was a problem even before the pandemic. In areas where qualified local nurses have simply become unavailable — even for non-critical settings — how can healthcare providers hope to meet even stricter mandates?
Getting Past the Nurse Staffing Ratio Stalemate
Opposition to nurse staffing rations is usually centered on the sheer wage cost of hiring thousands of new nurses. Yet this expense could potentially be offset by partnering with an MSP. Companies like CareerStaff offer access to a nationwide network of healthcare professionals that can deploy rapidly, helping facilities scale to more conservative nurse staffing ratios when it’s needed the most.
Indeed, many experts believed that healthcare would increasingly embrace a flexible contingency workforce to meet its staffing goals for years. The pandemic has only accelerated that trend. Or, as StubHub founder Jeff Fluhr writes at TechCrunch, it’s “brought into focus a problem that has long been simmering in healthcare: The movement of labor is highly inefficient.”
Contingency networks already help providers utilize temporary workers like “travel nurses, per diem nurses and locum tenens doctors” to meet seasonal spikes or geographic challenges, Fluhr notes. And, writing as an investor, he notes that contingency networks “also creates financial opportunities for underutilized clinicians by better allocating their labor to geographies and hospitals that need them.”
On top of that, contingency staffing “would provide relief to hospitals by shifting a larger portion of clinician labor from a fixed cost to a variable cost,” he continues. “Hospitals would have a smaller number of permanent employees and a larger number of temporary contingent workers. When demand drops, hospitals would use fewer contingent clinicians. When demand rises, they could tap into the marketplace to bring on more capacity.”
So, while hospitals contend that mandated nurse-to-patient ratios are “unworkable and unaffordable”, MSP services could go a long way toward finding a compromise. Because they offer access to a nationwide network of professionals standing by to travel, MSPs like CareerStaff give facilities a cost-effective way to flex up when needed, scaling up nurse staffing ratios in times of heightened need.
How Healthcare Managed Services Can Help
Offering a full suite of workforce management tools, MSPs do more than just round out nurse staffing ratios. They can also ensure that facilities are equipped with the most efficient processes for hiring, onboarding and training. They also provide access to any additional vendors, technology and workflow expertise as needed, as part of a single, comprehensive package.
And of course, by choosing an MSP with a nationwide network of clinical staffing offices, facilities can gain the ability to scale up their pool of available labor almost instantaneously. That could make all the difference when it comes to choosing between mandatory ratios and continuing to embrace the flexible staffing model currently favored by many providers.
There’s more: In addition to giving you access to a pool of healthcare talent that spans the United States and includes not only thousands of nurses across all major specialties, but also allied clinicians, respiratory and physical therapists, pharmacists, technicians and technologists, administrators and HR professionals, among many others.
Because MSPs like CareerStaff specialize in recruitment, you get access to top-flight talent acquisition methods and networks, as well as the latest workforce management technologies, sourcing techniques and recruitment strategies. Best of all? It’s all customizable to match whatever existing system a facility may already have in place.
Ready to learn more? With decades of collective experience in healthcare workforce management and a nationwide network of skilled, trained and motivated professionals to call upon, CareerStaff Unlimited is standing by to fill you in on the solutions you need to meet your ideal nurse staffing ratio, and so much more. Contact us today to find out more.