NZNO to launch nurse/patient ratios soon.

NZNO'S NURSE/patient ratios, worked out after wide consultation, are scheduled to be launched later this month. The ratios for wards and specialist units in all levels of public hospitals, are contained in the booklet Nursing the system back to health: Nurse to patient ratios (right), produced and published by NZNO.

The ratios were finalised after wide consultation within the profession and are just one component of NZNO's safe staffing model. The other components are the establishment of associate charge nurse (ACN) positions; dedicated time for professional education and development; and the evaluation of patient outcomes.

NZNO decided to push for nurse/patient ratios as a way of safely managing nursing workloads, after their success in easing the nursing shortage in Victoria, Australia. The Victorian branch of the Australian Nursing Federation (ANF) fought a successful campaign in 2001 for nurse/ patient ratios. By late last year it had drawn more than 4000 nurses back into the workforce. The architect of that campaign, the then ANF Victorian branch secretary Belinda Morieson, spoke on the campaign to NZNO's annual conference in 2002. There was widespread support for pursuing nurse/patient ratios following her visit.

During 2002 and 2003, an NZNO safe staffing model was developed, including nurse/patient ratios and the establishment of ACN positions. The model was endorsed at NZNO regional conventions last year.

In her introduction to the booklet, NZNO president Jane O'Malley, says New Zealand nurses have had enough of unmanageable workloads, staff shortages and unpaid overtime. "Many nurses have left nursing because of the stress related to work overload, saying they feel demoralised because they cannot deliver the care that they went into nursing to provide."

NZNO was impressed by the Australian results and made a commitment to achieving safe staffing conditions for nurses here, through the introduction of nurse/patient ratios and other measures to support the work of nurses, O'Malley said.

A key factor in the Victorian and now the New Zealand nurse/patient ratios are the ACN positions, which are additional to the number of nurses providing direct patient care. The role is focused on supporting nurses and providing "on-the-floor" leadership. The positions improve staff retention and patient outcomes.

The nurse/patient ratios for specialist units have been confirmed with relevant NZNO colleges and sections. The Victoria ratios also influenced the New Zealand ratios. Nurses have given NZNO a strong message that computer-determined patient dependency systems cannot support effective nurse allocation adequately for consistently safe practice. Nurses report that such systems regularly fail to deliver the right number of nurses on a prospective and regular basis. They are also time-consuming and take nurses from the bedside to enter patient and nurse data.

Ten thousand nurse/patient ratio booklets have been printed and O'Malley says they are a resource for nurses, the public, patients and employers and will be widely distributed.