Clinicians see increased understaffing and want protections, per survey

A number of clinicians have seen patient-to-staff ratios grow more lopsided over the last year, according to a survey from healthcare talent marketplace Vivian Health.

Of 863 clinicians that Vivian surveyed between December 2023 and January 2024, 39% reported that the ratio of patients under their care had increased compared to the prior year.

“We don’t have enough staff,” Venessa Thompson, a travel nurse who’s used Vivian’s platform, told Healthcare Brew. “And the days when there are enough nurses on the unit, typically they get pulled to do something else.”

The issue of high patient-to-staff ratios, or safe staffing, can jeopardize the quality of care clinicians provide and has increasingly become a call to arms for unions, like the New York State Nurses Association (NYSNA). Despite union and legislative efforts to decrease the ratio, the survey found that less than 15% of respondents thought the ratio had decreased.

Spreading healthcare workers thin can have serious effects on patient care. One 2021 BMJ study looked at 210,493 Illinois Medicare beneficiaries in inpatient settings and found that mortality rates had grown 16% for every additional patient a nurse took on.

“As nurses, in all honesty, we can only do what we can do,” Thompson said. When a facility is understaffed, “the nurse is overwhelmed, they’re stressed out, they’re panicking […] it definitely puts the community at risk of potential health errors.”

States like California and New York have adopted laws to implement safe staffing.

In New York’s case, a 2023 law required the more than 200 hospitals in the state to establish staff and management committees to help oversee safe staffing and lower staff-to-patient ratios.

Respondents to Vivian’s survey support such protections, with 81% agreeing that states should have laws to govern staff-to-patient ratios.

However, passing a law doesn’t equal enforcing it.

Last December, NYSNA, which represents healthcare workers in New York, said that staff shortages and violations remained widespread. Weeks earlier, another union, Communications Workers of America District 1, cited what it identified as almost 8,000 clinical staffing violations occurring in hospitals since January 2023, according to a complaint filed with the state’s health department.

The same percent of respondents who supported legal protections (81%) said that they’d consider leaving a job that lacked safe or proper staffing.

“I fear, God forbid, a day that myself or a loved one gets sick,” Thompson said. “Because I wonder, who’s going to care for us?”