National Nurses United

The Ratios Solution

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16 In an effort to derail mandated RN-to-patient ratio laws, the hospital industry along with its allies have pushed for passage of inferior "staffing" bills. When analyzing the merits of a particular bill, be suspicious when a bill has any of the following markers. Is it a real ratios law or a fake, weakened "staffing" plan? n Voluntary and/or "permissive" ratios These laws may provide specific numeric ratios, however they also include loopholes giving employers the right to staff as they please. One of the loopholes allows employers to interchange RNs for "other healthcare personnel." n No public disclosure n No enforcement n No rights for the RN as patient advocate, no whistle-blower protection n LVN/LPN and RN interchangeability n Staffing based solely on patient classification systems without ratios as a minimum safety standard These approaches make vague and undefined references to "appropriate" staffing levels without providing specific ratio numbers. Acuity-based staffing — using tools developed by hospital industry consultants — is presented as an alternative to mandated minimum ratios. All of these "plans" are designed to prevent the implementation of real, enforceable, RN-to-patient ratios. The Half-Measures Beware of "staffing" bills masquerading as ratios

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