Nursing staff to include APRNs, RNs, LPNs and CNAs are overworked and under appreciated. These jobs have a high degree of burnout and therefore see a lot of turn over or people leaving the profession all together. This has lead to a severe shortage of nursing staff across the board and ultimately reducing the quality of care as the average age of nursing staff continues to drop and experience disappears.
We should propose a national mandate on staffing ratios for nursing staff. For Nurses, I propose a 5:1 maximum ratio for general med surg and short stay units. 4:1 max on cardiac and psychiatric care, and 2:1 max for ICU and other critical care.
For CNAs, I propose an 8:1 maximum ratio for most situations with an addition restriction to 6:1 based on an acuity threshold. ICU and other critical care should be no more than 4:1. Possibly mandating a resource position for each shift could also improve staff moral and wellbeing.
With this, I propose expanding the CNA scope of practice to cover certain duties delegated by the RN with the proper additional certifications. CNAs could be incentivized to achieve these additional certifications through increased pay rates and make the CNA career path a sustainable one for those who do not wish to further their education.
Ultimately, this will create a more dedicated and experienced work force and reduce the strain on RNs and improving quality of care across the board. These would take time to implement as there is a shortage of nursing staff across the nation, particularly in more urban areas where ratios are often the highest. Rural areas tend to align more with the ratios listed above.
These mandates would also increase the job market for nursing staff, expanding the availability of higher paying jobs across the entire country.