title: What is the harm in imposing mandatory hospital nurse staffing regulations?
abstract: Efforts to establish mandated staffing ratios are shortsighted, and, though proponents may have the best intentions, many negative outcomes would flow from the public airing of this issue. The Institute of Medicine concluded in 1996 that there was insufficient quality outcome evidence to support the imposition of mandated nurse staffing ratios. The Massachusetts Nursing Association got legislation introduced in early 1996 which, if passed, would turn over to state lawmakers decisions governing nurse staffing in hospitals and other employment settings. There are high opportunity costs. Staffing regulations (if imposed) would force employers to ignore the dynamic interactions of economic, technology, capital, and labor supply variables, and thus needlessly impose the effect of increased labor costs on hospitals, taxpayers, and nurses themselves. Chance for passage of this highly controversial legislation is unlikely, but the expenditure of political chips (and the loss of credibility) will increase the difficulty of obtaining a hearing from legislators the next time a nursing issue comes up.
authors.affiliation: Center for Interdisciplinary Health Workforce Studies, Institute for Medicine and Public Health, Vanderbilt University Medical Center, Nashville, TN, USA.
authors.forename: Peter I
authors.initials: PI
authors.lastname: Buerhaus