Why staff-patient ratios matter

There’s a word that I always type incorrectly – somehow ‘ratios’ always comes out as ‘rations’. And when I think about nurse-patient ratios, ‘rations’ becomes a Freudian slip.

American nurse academic Linda Aiken has been writing about this stuff for years. She’s proven beyond doubt that increasing the number and qualifications of nurses in general hospitals improves patient outcomes and lowers mortality. Her latest research, repeating the same study in Europe, produced the same results in England and eight other European countries.

In a nutshell this is what she found: in hospitals where 60 per cent of the nurses were educated to degree level and where nurses cared for an average of six patients, patients had almost 30 per cent lower mortality than patients in hospitals where only 30 per cent of nurses had degrees and nurses cared for an average of eight patients.

Let me spell this out. Patients do best when they are cared for by better qualified nurses who look after fewer patients. Well, who’d have thought it?

So all that talk about degree nurses being ‘too posh to wash’ has been proved to be the nonsense every sensible person thought it was. And, surprise, surprise, not having nurses rushed off their feet means they can provide better care and save patients’ lives.

Why is nobody acting on this evidence? The government - every government - has shied away from mandatory nurse to patient rations (there I go again!) for the obvious reason that hiring more nurses - you could call it ‘enough nurses’ - is ‘expensive’.

But how expensive would it be really? Certainly having more nurses would increase the staffing bill in the short term. But the benefits, in terms of improved patient satisfaction and decreased morbidity and mortality, would surely outweigh this extra cost pretty quickly. After all, having inadequate staffing levels cost lives, and that’s a price nobody should ever have to pay.

Summary of Professor Aiken’s work: Surgical patients at greater risk of dying if nurses are overworked

About the author

Colin Parish is editor of Learning Disability Practice and Mental Health Practice

Follow Colin on Twitter: @editorLDPandMHP