Whilst the refuting arguments made have a certain validity and merit, they are in my view outweighed by the strong and legitimate reasons for legislating nurse caseloads. Dilcher (1999) agreed that “setting of minimum nurse-to-patient ratios has the potential to enhance patient care in hospitals, encourage nursing education programs, and attract former nurses, who have become frustrated with inadequate ratios, to the nursing profession and hospital practice.” Dilcher recognized that such legislation could increase costs, but as indicated in the “Support” section of the subject PowerPoint presentation, a nurse working with a regulated caseload (hence not trying to fit in too many patients into a working day) will perform better, give patients the attention they need and deserve, and will above all have greater job satisfaction. That is key to retaining nurses in the profession, especially at a time when the implementation of Obamacare is likely to further overload the healthcare system in the U.S.
Without such legislation, some see safety as an issue. Judson and Kaplan (2009) published an article in Metro West Daily News, in which they described various problems caused by overworked nurses working in an under-staffed environment where each nurse may have up to 12 patients to care for. These included patients suffering with bed sores and/or other infections. One case of a urinary infection cost $44,000 to resolve.
So the refuting argument that legislating caseloads will increase costs may – as mentioned above – have some validity, but costs can and probably will be increased by not legislating, as the overworked nurses make mistakes or overlook/neglect needed attention to patients. Yes, there may be a growing nursing shortage, but the solution is not to further overwork nurses, which will exacerbate the shortage, by causing more to leave the profession for a less stressful working life. Legislating to control nurse caseloads has to be the way forward.
Dilcher, Amy. (1999). “Legislating Nurse-to-Patient Ratios: California Legislation Falls Short.” University of Houston, Texas. Retrieved from http://www.law.uh.edu/healthlaw/perspectives/MedicalProfessionals/991019Nurse.html
Judson, Jen & Kaplan, Matthew. (2009) “Nurses press for patient limits.” Metro West Daily News. Retrieved from http://www.metrowestdailynews.com/news/x1659495133/Nurses-press-for-patient-limits