Nurse-to-patient ratios around the world

WHAT THEY ARE

1. A legal cap on your patient load

• A ratio law sets a maximumPatients per nurse, by unit
• Without one, staffing is set locallyHospital policy, staffing plans or contracts
• Ratios count licensed nursesNot total staff on the floor

CALIFORNIA

2. The best-known US example

• Medical/surgical: 1:5Since January 1, 2005
• Telemetry: 1:4Since January 1, 2008
• Pediatrics: 1:4At all times

Source: California Code of Regulations, Title 22, Section 70217.

CALIFORNIA, CONTINUED

3. Higher-acuity units get fewer patients

• Critical care: 1:2At all times
• Emergency department: 1:41:2 for critical care patients
• Labor and delivery: 1:2Active labor patients

Source: California Code of Regulations, Title 22, Section 70217.

AUSTRALIA

4. Victoria wrote ratios into law too

• Safe Patient Care Act 2015Victoria, Australia
• Level 1 hospitals: 1:4 on day shifts1:8 at night
• Plus a nurse in chargeRatios vary by hospital level

Sources: Victorian Department of Health; ANMF. Ratios have been amended since 2015.

ASK BEFORE YOU ACCEPT

5. Questions for your interview

• What's the usual ratio on days and nights?
• Does the charge nurse take patients?
• Is there a staffing plan or committee?
• What happens when the unit is short?