NY hospitals must assign a nurse for every 2 critical care patients under new rule

New York State’s 212 hospitals must assign at least one nurse for every two patients in critical care units under a new rule drafted by the state Health Department.

The higher nurse-to-patient ratio edict for critical care patients is one component of the new “Safe Staffing Act” approved by the legislature in 2021 amid the coronavirus pandemic.

“There shall be a minimum of one registered professional nurse assigned to care for every two patients that an attending practitioner determines to require intensive or critical care,” the regulation expected to be approved by the state Public Health and Health Planning Council on Thursday says.

New York nurses and health activists for decades called for higher ratios of nurses to patients, which research has shown curbs patient deaths and stems work burnout and exodus.

The strain on the overburdened medical staff at hospitals during the COVID-19 outbreak spurred state lawmakers and former Gov. Andrew Cuomo to pass the long-sought law to set and enforce higher staffing levels.

It is now being implemented by Gov. Kathy Hochul’s administration. 

The law is a compromise, limiting the state to set higher staffing ratios at hospitals to just critical care and intensive care units instead of across-the-board minimum staffing levels for all units, as is done in California.

The legislature instead requires every hospital to form a “staffing committee” — half made up of nurses, half hospital administrators — to negotiate other staff-to-patient ratios in non-critical settings.

“The proposed clinical staffing requirement codifies standard industry practice and places patient health and safety first,” said state Health Department spokesman Cort Ruddy.

“The proposed regulation allows each hospital to collaboratively develop clinical staffing plans with nurses and other staff, and this hospital-by-hospital approach will enable facilities to balance what is best for the patient and workforce while taking into account the varying needs of each individual hospital.”

Ruddy said the new staffing-to-critical-patient ratio is one piece in Hochul’s $20 billion, multi-year program to bolster the state’s healthcare industry walloped by the COVID-19 pandemic.

The effort includes the medical care and mental hygiene worker bonus program to help recruit and retain staffers and increase the health care workforce by 20 percent over the next five years and other initiatives such as a loan repayment program.

To date, more than 613,000 people have received bonuses up to $3,000 each, totaling $1.6 billion.

The Greater New York Hospital Association did not object to the new staffing edict.

The state Nurses’ Association and other unions, including SEIU Local 1199, backed the staffing law.

Still, the imposition of a strict, higher staffing ratio in critical care units is not without critics.

One administrator noted that many hospitals still suffer from a shortage of in-house nurses and have contracts with firms that provide traveling nurses to fill the gaps, suggesting a mandated staffing ratio is impractical and counterproductive.

The law authorizes the health department to impose a civil penalty against a hospital if it fails to submit a corrective action plan after it’s determined that it is violating mandatory staffing in critical care units.

One study published in 2021 said New York hospitals averaged one nurse per six patients, below the industry recommendation of one nurse for four patients.

The report done by researchers at the University of Pennsylvania School of Nursing Center for Health Outcomes estimated that 4,370 lives would have been spared and $720 million saved in shorter stays and readmissions over a two year period if there were one nurse for every four patients.