Nursing Staff Ratios

Updated on February 15, 2017
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Vince is a technical writer working in the medical research field. He also enjoys exploring literature in his free time.

Staff Ratios

Staff ratios in nursing refers to the number of nurses and nurses’ aides, relative to the number of patients, in a unit. It is common for patients to outnumber nurses, and no precise ratios is held to be the best in all situations. An intensive care unit, for example, may require a higher number of nurses and aides than average due to the critical nature of the patients who will be seen there. Depending on the acuity of the patients, a psychiatric unit may have low nurse-to-patient ratios due to a predictable routine and patient behavior, and can call for support if they need additional help.

According to Bowblis (2011), nursing staff ratios are directly linked with quality of care: more nursing staff has a positive impact on patient outcomes, whereas a smaller nursing staff has the opposite effect. It is the duty of both nursing leaders and nursing managers to ensure that proper ratios are devised and met by all units within a hospital to ensure the best care possible.

Managers and Leaders

Part of the reason for nursing staff ratios to dip below appropriate levels is lack of funding and a shortage of available nursing staff. It is the role of nursing managers to handle the day to day operations of a facility and find a way to make the budget work in the favor of the patients by way of the staff. There are a number of things managers can do such as hiring nurse’s aides who are payed less but can often fulfill many of the duties of a nurse that are required by the units ratios. Manager’s handle the system of nursing, and though they inherently work with people, really they work with numbers. Ratios are a matter of math and can be kept at proper levels when managers properly balance the equation (Huber, 2014).

Nursing leaders serve the important purpose of motivating nurses to do better and to get through difficult times while still doing great work. Nursing leaders also advocate for policy changes and mobilize the other nurses to work together to get things done on an administrative and even legislative level. Nursing leaders primarily serve the people, with the belief that nurses inherently have a right to be treated well and also that better supported nurses lead to healthier patients. They serve the purpose of consistently raising the bar for the field as a whole. There job is not to manage the small day to day items, but to see the big picture and move the field forward (Huber, 2014).

Neither nursing leaders nor nursing managers can improve nursing staff ratios on their own, since they are two sides of the same coin. In fact, an individual nurse may act as both a leader and a manager at times, and such a person has the proper balance of detail oriented day to day thinking and big picture forward thinking to really effect change. Even without such a person, managers and leaders can work together by having open communication. In this way, both parties can be kept in check. Managers can be made aware when the policies that they handle are becoming outdated or are shown to be harmful, and leaders can focus on forward momentum rather than getting bogged down in details. In this way, these two complementary roles within the nursing field keep it stable and moving upward in standards of practice (Huber, 2014).

Final Thoughts

Nursing staff ratios are a well known issue that needs to be addressed by policy changes, hiring processes, and budgetary management, which is the purview of nursing managers. These individuals serve the purpose in the nursing field of making that policies are adhered to and that new rules can be put in place. In a situation where policy change is pending, nursing leaders have a role in motivating the staff to stay focused and to continue doing a good job even under strenuous circumstances. Within the narrow focus of nursing staff ratios, managers have a greater role, though leaders still have their place As both of these groups within the nursing field work together, improvements to staff ratios are inevitable (Huber, 2014).


Bowblis, J. R. (2011). Staffing Ratios and Quality: An Analysis of Minimum Direct Care Staffing Requirements for Nursing Homes. Health Services Research, 46(5), 1495-1516.

Huber, Diane. (2014). Leadership and Nursing Care Management, 5th Edition. [VitalSource Bookshelf Online]. Retrieved October 16, 2016 from

Mannix, J., Wilkes, L., & Daly, J. (2015). ‘Good ethics and moral standing’: A qualitative study of aesthetic leadership in clinical nursing practice. Journal of Clinical Nursing, 24(11-12), 1603-1610.

This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.

© 2017 Vince


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