The one challenge I would address in the health care industry, is that of unsafe nurse to patient ratios. Even though organizations are attempting to cut labor cost, the increase in costs due to patient poor outcomes from nursing shortages or improper ratios is becoming costlier. “CA is the only state that stipulates in law and regulations a required minimum nurse to patient ratios to be maintained at all times by unit” (ANA, 2015). In the ICU I am employed in, we have a patient free charge nurse, which provides our breaks and lunches for the seven nurses during our 12-hour shift. The problem is that the same patient free charge nurse also must respond to code strokes, code blues and is part of our rapid response team. The 3 pagers are alternated between our 3 critical care units, but there is one pager in each unit at all times. The problem is, when she leaves the unit and responds to a call. The staff nurses are left to cover themselves for breaks and lunches, as there is no one else to cover us and at times the charge nurse can be gone for an extended period, even an hour or so depending on the situation. If I ask another ICU nurse to care for my patient’s while I go to lunch, I have automatically changed her ratio to caring for 4 ICU patients, which can be a dangerous situation if something happens. We have asked for a nurse specifically designated to provide lunches for us, but we have been denied this many times. “ANA and its Constituent & State Nurses Associations (C/SNAs) in the states are promoting legislation to hold hospitals accountable for the development and implementation of valid, reliable, unit-by-unit nurse staffing plans. These staffing plans, based upon ANA’s Principles for Nurse Staffing, are not mandated ratios. They are created in coordination with direct care registered nurses (RNs) themselves, and based on each unit’s unique circumstances and changing needs” (ANA, 2015).

“More than a decade of research has shown that RN care is insufficient, patient safety is compromised and risk of death is increased” (Wyoming Nurses’ Association, 2003).

 I would attempt to talk to the CNO, and explain the dangers of not providing proper nursing staff, and how it is not safe for one nurse to care for four ICU patients, even if it’s for a short period of time.


American Nurses Association. (2015). Nurse Staffing. Retrieved from

Wyoming Nurses’ Association. (2003). ANA applauds federal legislation to mandate safe nurse-to-patient ratios: Sen. Inouye introduces bill to protect patients, hold hospitals accountable for RN staffing.  16(2), 17 Retrieved from

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