Mandating Nurse-Patient Ratios

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Any nurse may look for a way to become a confident advocate as long as s/he has interests in influencing the process of policymaking. Methods of involvement range from writing simple letters, calling the involved parties, or holding a public office through an election. Some of the health care policies are sophisticated. Therefore, for one to understand such issues, s/he should be highly knowledgeable together with enlisting the services of professionals. Therefore, as a nurse, I would join a professional organization to foster collective bargaining. When nurses are in a professional group, they have more resources, and they can strategize effectively, hence bringing the perspective of the fellow nurses into the decisions of policymakers. Professional associations in the nursing sector can monitor the health care policy and teach nurses about it (Abood, 2007).

Another advantage of using professional affiliation is that it provides information and tools for the nurse advocate. These tools ensure that supportive nurse candidates are elected to hold public offices. Having officials of professional bodies elected in the office helps in initiating or influencing the decisions of political action committees. Policymaking can only be shaped effectively from a point of power. The best point of influence is holding a position in a professional body, which can lobby for some policies.

The strategies mentioned above are supported by several sources of power possessed by nurses. The nurses can use their power of numbers because they form the largest group of health care workers. This numerical advantage can influence the policy process and thus reform the sector. Nurses possess the expert power, viz. the power of skills, and this aspect can enable them to speak out on health care issues. Nurse advocates can also use the legitimate power, which is given after becoming a registered nurse. Lastly, nurse advocates can use referent power, which comes with the respect that professionals get from society. In a democratic setup, numbers matter and nurses can use this understanding to cause changes in health care policymaking. The referent power adds to the nurses’ numerical advantage.

The following are the implications of patient-nurse ratios in the hospitals:

  • Hospitals with lower patient-to-nurse ratios (as set by California mandate’s benchmark) report lower unfavorable incidences. Nurses are very motivated, they report higher job satisfaction, and hence high-quality care (Aiken et al., 2010).
  • Having a sufficient workforce is one of the ways of motivating employees. In such cases, nurses do not struggle to meet the needs of an overwhelming number of patients. Motivated nurses offer quality patient care (Aiken et al., 2010).
  • Nurses with higher workloads get dissatisfactory remarks from the patients due to poor service delivery. They report low work morale due to a poor or unfair work environment, which affects service delivery to patients (Aiken et al., 2010).
  • Nurses with higher workloads report high burnouts, being dissatisfied with the job, and a poor work environment. As a result, they offer poor quality of care to patients (Aiken et al., 2010).
  • Nurses in hospitals with poor patient-nurse ratios report that the workloads cause them to overlook some important issues concerning patients. This aspect is dangerous because the patients’ conditions may advance unnoticed, thus leading to loss of life (Aiken et al., 2010).
  • There is an increased mortality rate due to inadequate care offered in hospitals with poor staffing of nurses (Aiken et al., 2010).


Abood, S. (2007). Influencing health care in the legislative arena. OJIN, 12(1), 1-12.

Aiken, H., Sloane, M., Cimiotti, P., Clarke, P., Flynn, L., Seago, A.,…Smith, H. (2010). Implications of the California nurse staffing mandate for other states. Web.

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NursingBird. (2022, April 25). Mandating Nurse-Patient Ratios. Retrieved from


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NursingBird. (2022) 'Mandating Nurse-Patient Ratios'. 25 April.


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1. NursingBird. "Mandating Nurse-Patient Ratios." April 25, 2022.


NursingBird. "Mandating Nurse-Patient Ratios." April 25, 2022.