Nurse-patient ratios probably aren’t discussed in most nursing ethics classrooms. But it’s clearly an ethical issue. Check out this recent story out of Massachusetts:
Mass. Nurses Association demands mandatory nurse-patient ratios
The trade group representing nurses is pledging to put the “sweat equity” of its 23,000 members behind a push to impose statutory nurse-to-patient ratios, but hospital officials are decrying the proposal as running counter to the trend toward a health care system where providers are reimbursed based on the quality of care they deliver and patient satisfaction.
The Massachusetts Nurses Association on Monday outlined plans to press for passage of a 2014 ballot proposal if the Legislature does not act by the middle of next year to pass nurse staffing legislation, which would apply to acute care hospitals.
The proposal calls for one nurse for every four patients in medical/surgical units….
It’s clearly a complicated issue. Nursing ratios are of course crucial to patient care, in general, but I suspect it is very hard to describe a one-size-fit’s-all solution, which is more or less what regulation would require.
Note also the difficult challenge, here, from the point of view of responsible advocacy. The MNA wants to advocate from the point of view of patient safety, which is entirely appropriate. But any attempt to legislate nursing ratios will of course be perceived by some as an attempt to maintain employment levels for nurses.
Finally, note that this issue raises questions of interdisciplinarity and the role of allied health professionals. In some cases, nurse ratios are being reduced because nurses are being replaced (or supplemented) with other kinds of workers. Sometimes that will be a very bad thing (for patients). Sometimes that will probably be a good thing (for patients). Sorting out which is which is a significant ethical challenge.
The Nursing Ethics Blog 
At what point do ethics matter and our residents count? A nurse should not have to jeopardize her lic. And be made to take care of 31 residents in an 8hr. Shift. Where do u draw the line. Where are our rights? It’s sad to see this is how we are expected to do our job. No nurse can properly do their job with taking care of that many residents. That’s a mistake waiting to happen. A stress on the nurse that’s not at all fare. I feel the person barking the orders to do these things should come to that facility and do that nurses job a few days b4 they start barking orders they have no clue about. What happened to being able to voice ur opinion and how our residents feel. Where did compassion go? Sad is what the health care has become and its heart breaking to our elders.
Coming from an institution whereby a nurse is taking care of many patients is very hectic. The main focus is always the patient and the patient’s well being, how will it be possible to provide adequate nursing care to each of the patients if you have to take care of up to 12 patients most of the time in 8 hours and without adequate allied health professionals. Issues like these open up to a whole different persona hence we have malpractice e.g. medication errors, patient safety maybe breached, it results in burnout for the nurses and in turn, they will not be able to perform and provide the right care so it all comes back to the patient being disadvantaged. I believe healthcare should move to being more patient centered and find alternatives to how they can employ more nurses, encourage and provide ways for other people to enroll in nursing schools, that way there can be more staffing available.