Why new laws won't fix the nursing shortage

We all know nurses are burned out. They're working long hours under strenuous conditions for low pay. And then there were the extremely stressful months of the pandemic, during which nurses often bore the brunt of a terrified public and an overtaxed health care system pushed to the brink.  

Understandably, many nurses are just plain fed up. That sentiment is leading to phenomena like "quiet quitting" among nurses and a national nursing shortage. In fact, from 2020 to 2021, the total supply of RNs in the U.S. decreased by over 100,000. That's leading to higher patient mortality rates, among other worrisome consequences. 

Policymakers have proposed new pieces of legislation to tackle the crisis, seeking to mandate minimum patient-nurse ratios. Legislation like the Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act would essentially require hospitals to hire more nurses to ensure the ratios are within predefined limits. 

However, I've been a nurse for thirty years, and I don't believe legislation is the answer. Simply mandating certain ratios does nothing to increase the actual supply of nurses. Creating such onerous requirements would only serve to place an even greater burden on the health care system. Also, the situation is simply too dire to wait for new regulations, especially those that could result in lengthy legal battles between states and health care systems.

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Why legislation won't work
Here's why any legislative attempts to address the nursing shortage are doomed to fail. Laws can't possibly address the root of the problem. Being a nurse means providing compassionate care in an environment that can be emotionally and physically exhausting. Nurses need to be on their feet for long periods of time, they have unpredictable and demanding schedules, and they need to contend with conflicting demands and sensory overload. More nurses per facility won't necessarily mitigate these challenges. 

Laws can't magically create more nurses, but it is possible to make hospitals easier places to work in. Hospitals should focus on addressing specific conditions that enhance nurse morale and resilience.

What's more, hospitals are likely to oppose new legislation that will raise operating costs, and this back and forth negotiating is bound to build acrimony between nurses and hospital board members. Policymakers are essentially asking for a drawn-out battle that won't do nurses or patients any good.

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We've already seen that when states pass — or attempt to pass —  such legislation, the effect on nurse satisfaction and patient outcomes is mixed at best. Interestingly, Minnesota's proposed Keeping Nurses at the Bedside Act attempts to learn from prior state's mistakes and gives nurses negotiating power on a site-by-site basis, allowing nurses to dictate maximum nurse-patient ratios where they personally work. The bipartisan bill is backed by the Minnesota Nurses Association and hospitals. 

However, even with more initiatives like the one in Minnesota, legislation focusing solely on nurse-staff ratios can't address the underlying issues. While it acknowledges the importance of involving nurses in decision-making processes, it still puts the focus on numbers rather than the work environment itself. 

Improving work burdens
To mitigate some of the burden imposed on nurses, hospitals should look to where sources of stress originate. One recurring complaint is a lack of time and resources to provide adequate care. Here's where technology can be a solution, automating cumbersome processes and leaving nurses more breathing room to provide the human element of care.

While there's been some hesitance to embrace tech in healthcare, technology can significantly streamline workloads, organize operations, and improve nurse and patient satisfaction alike. For instance, mobile applications and devices can provide nurses with instant access to patient information, medication records, and care plans. This accessibility allows nurses to quickly retrieve information, make timely decisions, and deliver efficient care. By reducing the time spent searching for information, mobile technology can minimize stress.

Furthermore, AI-powered software can track daily performance metrics and measure workload and operational efficiency. It can also help health care facilities determine when nurses are becoming overburdened, which indicates that something needs to change. 

Sometimes the answer isn't even that complicated. Simply stocking hospitals with adequate equipment and supplies is another solution to burnout. As we saw during the pandemic, lack of everything from N-95 masks to ventilators put more stress on nurses trying to keep patients and themselves alive. 

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Final thoughts
So while well-intentioned, the government doesn't necessarily know what's best for nurses, and imposing top-down regulations isn't the solution. Rather, the focus should be on improving working conditions and giving nurses negotiating power. Instead of treating nurses like tired hapless creatures, give them the power to determine their needs, listen to them, and then answer accordingly.