As New Mexico continues to struggle with a nursing shortage, a lawmaker with a background in health care wants to pass a bill that would limit the number of patients a nurse must oversee.
Representative Eleanor Chavez (D-Albuquerque) is the executive director of the National Union of Hospital and Health Care Employees, District 1199. On Friday — New Mexico Nurses Day — she announced that she will co-sponsor the New Mexico Patient Safety Act Mexico with Sen. Brenda McKenna (D-Corrales).
The main reason for this, Chavez said, is that nurses are often overwhelmed with too many patients and can’t care for everyone.
Under the bill, the Department of Health will convene a group of health leaders and frontline workers to clearly define nurse-to-patient ratios in various areas of health care.
Calculation of ratios
Chavez did not specify what the ratio would look like, as the state will help figure that out. Each ratio is likely to differ by health care field.
For example, Chavez said, one area the bill would set ratios for is neonatal intensive care units. Nurses struggle, she said, looking after four babies when they should be looking after just two. “And these babies need a nurse’s attention,” she said.
“We don’t need nurses taking on piles of six, 10 patients that they can’t take care of,” Chavez said. “We don’t want to overburden our nurses or other health care staff because they won’t be able to attend to the needs of the patients.”
As it stands now, it’s up to hospitals to set limits on how many patients a nurse can have. To participate in Medicare, federal regulations require hospitals to have “adequate numbers” of nurses on staff. The federal government recommends ratios, but hospitals don’t have to follow them.
Claire Soucy is a registered nurse who attended Friday’s press conference. She said federal Medicare rules define “recruitment to the point” and are too vague. As a result, she added, New Mexico hospitals don’t have strict enough policies.
Soucy said he directly linked the patient deaths to staffing issues. She pointed out how many patients she saw as an ICU nurse in the COVID unit. The federal recommendation is two patients, but she said there are often three.
“In these scenarios with these critical patients, you can expect to lose a patient quite easily,” she said.
Lawmakers sponsoring the bill agreed that it was not possible for nurses to safely care for too many patients at once, which research supports. Nurse Suzanne Bell spoke at the conference and said she had experienced this first hand.
“We can only be in one place at a time, and errors increase with too many patients, no matter how hard you work,” Bell said.
Retaining desperately needed nurses
Chavez said the bill could help retain and recruit nurses. Health care is a key area where New Mexico desperately needs workers, according to the Legislative Finance Committee report. The state had a shortage of health workers before 2020, and the pandemic has exacerbated it.
“We saw how devastating COVID was for all of us, but especially for healthcare professionals,” Chavez said. “They carried us. They took care of us. They are exhausted and one of the things they have asked us is to improve their working conditions.
Bell said she has watched other nurses leave the field because of a lack of support.
“Now we feel scared and defeated every day, not just occasionally, because we stepped up and tried to manage too much adrenaline when it was a pandemic,” Bell said. “But sisters are people. We kept this smashing system. It’s been three years now and it’s breaking us now.”
Nurse Adrian Enghaus also spoke at the conference. She pointed out how nurses were more likely to be depressed or died by suicide than the general population. And, she said, these poor conditions aren’t just a problem in New Mexico.
“We are not alone. If you’ve noticed, RNs and healthcare professionals across the country are goes on strike,” she said. “They’re picketing. They’re filling their state capitols and demanding what we know and have known for years is best for our patients.”
McKenna said the biggest challenge to getting the bill through the Roundhouse will likely be making sure lawmakers read the legislation carefully and realize it will help hospitals, nurses and patients.
“We all know how expensive turnover is,” she said. “And especially in the field of medicine in New Mexico and across the nation, we cannot invite more turnover.”
It’s California only state so far this has codified nurse to patient ratios. Along with New Mexico, other states like it Washington and Oregon are trying to push through similar legislation this year.
“All of us have family members who need care,” McKenna said. “We saw it with the pandemic and we have such a shortage of nurses — well, all the providers here in the state.”
