Mandatory Nurse-Patient Ratios

Strategies and/or Powers used to assure a Busy Legislator Will Consider Information

In strategies, I can write letters or make calls to the legislator to draw his attention to the underlying problem involving nurse-patient ratios in the hope of influencing his vote. As a nurse, I can also work with the media to illuminate the problem and possibly influence how the legislator thinks about the issue (Abood, 2007).

Having joined several professional nursing groups, I can use the potential power of numbers (collective power, as nurses form the largest group of health care providers) to influence the thoughts of the legislator and assure him that he shall be reelected back into office if he considers the information being presented about nurse-patient-ratios (Abood, 2007). I can also use expert power as a qualified nursing professional to assure the legislator that I posses the knowledge and skill necessary to make a correct diagnosis on the existence of the problem and why the legislator’s input is required. As acknowledged by Abood (2007), this type of power puts nursing professionals in a frontline position to share their expertise and knowledge when meeting with legislators not only to educate them and urge them to action in terms of voting for the required policy frameworks in health care settings, but also to hold them accountable when their positions of power and voting patterns do not match their rhetoric.

Lastly, I can use referent power and coercive power to ensure the busy legislator takes time to consider my information and influence his vote on nurse-patient ratios (Abood, 2007). As a nursing professional, I am respected and valued within the community and I can therefore use referent power to influence the legislator’s vote on nurse-patient ratios. I can also use coercive power to punish the legislator if he refuses to consider my information by declining to reelect him.

Legislator Information Sheet on Nurse-Patient Ratios

  • Lower nurse-patient ratios are associated with considerably lower patient mortality rates, lower nurse burnout, higher job satisfaction, better nurse retention, as well as consistently better quality of care (Aikan et al., 2010).
  • There exists mounting evidence supporting a positive correlation between nurse staffing and superior patient outcomes in health care settings (Aikan et al., 2010).
  • There are minimal unintended consequences arising from employing more unlicensed clinical and support personnel (e.g., vocational nurses and non-nurse ancillary support personnel) to assist nursing professionals in facilities experiencing higher nurse-patient ratios (Aikan et al., 2010).
  • Higher nurse-patient ratios are positively associated with increased nurse complaints from patients or their families, elevated verbal abuse or mistreatment of nursing professionals by staff or patients, decreased quality of care, as well as enhanced lack of confidence that patients can manage on their own after being discharged from health care facilities (Aikan et al., 2010).
  • State-mandated nurse staffing ratio can be effectively employed to improve hospital nurse staffing and, in the process, guarantee better outcomes for nursing professionals and patients (Aikan et al., 2010).
  • Nurse staffing can increase substantially if states and legislators pass effective legislation and implement regulations aimed at decreasing nurse-patient ratios in order to improve outcomes (Aikan et al., 2010).
  • State-mandated nurse staffing has an impact on the wage growth for registered nurses owing to its association with nurse shortage (Aikan et al., 2010).


Abood, S. (2007). Influencing health care in the legislative arena. Online Journal of Issues in Nursing, 12(1), Manuscript 2.

Aikan, L.H., Sloane, D.M., Cimiotti, J.P., Clarke, S.P., Flynn, L., Seago, J.A…Smith, H. (2010). Implications of the California nurse staffing mandate for other states. Health Services Research, 20(20), 1-18.

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