Nationwide Nurse Survey Points to Mass Exodus From Bedside, Huge Increase in Nurse-to-Patient Ratios

WASHINGTON--()--Sixty percent of respondents in a nationwide survey of more than 1,000 registered nurses reported that nurse-to-patient ratios, a critical staffing measure that directly relates to patient safety and outcomes, have risen to unsafe levels in the last year.

"The availability of nurses was the preeminent concern for hospital administrators long before the coronavirus," American Association of International Healthcare Recruitment Association (AAIHR) President Shari Costantini, RN, said. "But one year into the pandemic, the confluence of a historic staffing shortage with unprecedented workforce demands and emotional burnout is leaving patient bedsides unattended in virtually every pocket of the country."


Staffing: Seventy-eight percent of RNs believe the coronavirus has strained staffing in their unit to "unsafe levels."

Asked if nurse-to-patient ratios have risen due to the pandemic, 60 percent reported an increase. Of those reporting an increase, 83 percent—or fully 50 percent of all survey respondents—reported a workload increase of two or more patients. Thirty-nine percent of all survey respondents reported a patient workload increase of three or more.

Model nurse staffing mix is one of the strongest predictors of positive patient outcomes, whereas understaffed units carry increased patient safety events, morbidity, and mortality. One study by the National Institutes of Health found that increasing a nurse's workload by just one patient increases the risk of patient mortality by seven percent.

Ninety percent of RNs said they believe their patients would benefit from additional nurses. At the same time, roughly one-in-four reported they could not provide adequate care to their patients today.

Safety, mental health, and burnout: Fifty-nine percent of RNs said they knew a nurse in their unit or hospital who was exposed on the job and became seriously ill. One-in-five said they knew a fellow nurse that died from covid.

Seventy-five percent said they experienced extreme stress or anxiety over the previous year.

Thirty-six percent of respondents said they have or are considering leaving the bedside. Even before the pandemic, emergency and critical care nurses were among the most in-demand in the health care sector. America's healthcare system would collapse if one-third of the country's nursing workforce vacated the bedside unless a massive pipeline of qualified talent is made available to healthcare providers.


Last week, US Senators Dick Durbin (D-IL), John Cornyn (R-TX), Patrick Leahy (D-VT), Todd Young (R-IN), Chris Coons (D-DE), and Susan Collins (R-ME) introduced the Healthcare Workforce Resilience Act, a stopgap healthcare proposal to recapture previously unused visas for qualified international nurses to help meet the unprecedented challenges facing the US healthcare system.

The HWRA would recapture and reallocate 25,000 previously issued but unused immigrant visas for nurses and another 15,000 for doctors.

Survey results were gathered from RNs working for member companies of the AAIHR. The results cover the period from March 9 to March 26, 2021.

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Media contact:
James Richardson


Media contact:
James Richardson