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12 Q & A Q. Where will the RNs come from? A. The number of actively licensed RNs in California has increased by nearly 130,000 following enactment of the staffing ratio law in 1999. Strong, effective ratio laws have been a critical factor in helping to mitigate the effects of the nursing shortage. RNs do not remain in unsafe, understaffed hospitals. A study published in the Journal of the American Medical Association in October 2002 linked higher RN-to-patient-ratios with a 15 percent increase in nurse dissatisfaction with their jobs. Today's shortage is the direct product of more than 10 years of the failed policies of market-driven medical care that included reckless downsizing and displacement of RNs with unlicensed staff. California and Victoria Australia, both with mandated ratios, prove this point. In California, since the signing of the law in 1999: n Vacancies for RNs at Sacramento-area hospitals plummeted 69 percent since early 2004 when the ratios were first implemented. Throughout the state, many of California's biggest hospital systems have seen their turnover and vacancy rates fall below 5 percent, far below the national average — Sacramento Business Journal, January 11, 2008. n The number of actively licensed RNs grew by an average of 10,000 a year, compared to under 3,000 a year prior to the law's passage — California Board of Registered Nursing. n There has been a 60 percent increase in RN applications since the law was signed in 1999 — California Board of Registered Nursing. n The ratios have helped fuel a dramatic growth in student interest in nursing in California. In the last six years, the number of RN graduates has jumped by 45 percent — Annual School Report, Board of Registered Nursing, 2005–2006. Victoria, Australia, which adopted nurse-to-patient ratios in 2000: n Experienced a 24.1 percent increase in the number of employed nurses. n There are no vacancies in urban hospitals because better staffing levels lured more than 7,000 inactive nurses back into the workforce. Everything you ever wanted to ask about ratios