Joan M. Vitello
Associate Chief Nurse at Brigham and Women's Hospital
The public debate about whether mandatory nurse-patient ratios are necessary for patient safety is often framed as a battle that pits overworked nurses against faceless hospital bureaucrats who rigidly refuse nurses' demands.
The argument that such limits would be expensive and wouldn't allow hospitals the flexibility to adjust staffing according to patient needs was recently met with opposition from the Massachusetts Nurses Association/National Nurses United.
A spokesperson from the organization went so far as to call that argument "an out-and-out unmitigated lie," in a telephone interview with me earlier this month, implying that hospitals are willfully ignoring the pleas of their nurses.
But digging a little deeper into the debate reveals that not all nurses feel this way, and nurse leaders often take serious issue with the idea of a mandated, one-size-fits-all approach to staffing.
"A patient is not a patient is not a patient," says Joan M. Vitello, Ph.D., RN, NEA-BC, FAHA, FAAN, Associate Chief Nurse at Brigham and Women's Hospital in Boston. "We, as nurse leaders, decide staffing based on the needs of our patients, and the skills of our staff, and the competencies of our nurses, and that is the right way and the only way to provide patient care."