Universal 1:2 Nurse-to-Patient Ratio in Effect for Critical Care Patients

The long-awaited universal 1:2 nurse-to-patient ratio rule for patients requiring critical care was finally adopted on June 29. This rule was enacted by the New York State Department of Health (NYS DOH) and will be in effect in all of New York's 212 hospitals. The regulation states there must be: “A minimum of one registered professional nurse assigned to care for every two patients that an attending practitioner determines to require intensive or critical care.”

The ratio is dependent on the acuity of the patient, not the location. The law states that the ratio applies: “Whenever the attending practitioner determines that the condition and medical needs of the patient requires admission to an intensive care unit (ICU) or critical care unit (CCU), and considers the continued need for that level of care based on ongoing assessments. The minimum staffing standard or ratio provided to a patient in an ICU or CCU shall be based on patient acuity, as determined by the attending practitioner and not solely based on the location of the patient.”

The DOH can now impose civil penalties on hospitals that fail to follow the law.

When the hospital industry tried to water down this rule, NYSNA and other unions that represent nurses pushed back! While NYSNA nurses celebrate this win, we will track hospital compliance and fight to enforce the law. We will also continue the fight to win safe patient ratios for all patients in all units in New York’s hospitals.

NYPost, Becker’s Hospital Review, Healthcare Dive, Nurse.org covered this victory.

What to do if your hospital exceeds the 1:2 safe patient standard

Some highly acute critical care patients require a 1:1 nurse-to-patient ratio. Other patients require 1:2. It is never safe for
one ICU nurse to be “tripled up,” or to care for more than 2 patients requiring critical care at a time, even if the third patient has been “downgraded” or no longer requires critical care. If this happens on your shift:

  • File a complaint with the DOH online
  • Document the incident. File a POA as an individual or as a group. Download the NYSNA POA form

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