Lawmaker who works in health care pushes for New Mexico to codify nurse-to-patient ratios

While New Mexico continues to struggle with a nursing shortage, a lawmaker with experience in the health care field wants to pass a bill that would limit how many patients a nurse has to oversee.

Rep. 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’ll be sponsoring the New Mexico Patient Safety Act along with Sen. Brenda McKenna (D-Corrales).

The main reason for this, Chavez said, is because nurses are often overburdened with too many patients and can’t take care of them all.

Under the bill, the Department of Health would convene a group of health care management and frontline workers to clearly lay out nurse-to-patient ratios in different fields of health care.

“We don’t need nurses, taking on patient loads of six, 10 patients that they can’t possibly take care of,” Chavez said. “We don’t want to overload our nurses or our other health care personnel because they are not going to be able to attend to the patient care needs.”

As it stands, it’s up to the hospitals to determine limits on how many patients a nurse can have. In order to participate in Medicare, federal rules require that hospitals have to have an “adequate number” of nurses working. The federal government has recommended ratios, but hospitals don’t have to follow them.

Claire Soucy is a registered nurse who attended the Friday news conference. She said the federal Medicare rules define “staffing to acuity” and are too vague. As a result, she added, New Mexico hospitals don’t have stringent enough policies.

Soucy said she directly correlates patient deaths with staffing issues. She brought up how many patients she oversaw as an ICU nurse in the COVID unit. The federal recommendation is two patients, but she said she often had three.

“In those scenarios with those critical patients, you can expect to lose a patient pretty easily,” she said.

The legislators sponsoring the bill agreed that it’s not possible for nurses to safely take care of too many patients at once, which research supports. Nurse Suzanne Bell spoke at the conference and said she’s experienced this firsthand.

“We can only be in one place at one 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. Nursing is a key area where New Mexico desperately needs workers, according to a Legislative Finance Committee report. The state had a health care worker shortage before 2020, and the pandemic exacerbated it further.

“We saw how devastating COVID was to all of us, but especially to health care professionals,” Chavez said. “They carried us through. They took care of us. They’re exhausted, and one of the things that they’ve asked us to do is improve their working conditions.”

Bell said she’s watched other nurses leave the field because of a lack of support.

“We feel scared and defeated every day now, not just the occasional eruption, because we stepped up and tried to manage too much adrenaline when it was a pandemic,” Bell said. “But nurses are people. We’ve been holding up this breaking system. It’s been three years now, and now it’s breaking us.”

Nurse Adrianne Enghouse also talked at the conference. She referenced how nurses are more likely to be depressed or die by suicide than the general population. And, she said, these poor conditions aren’t just an issue in New Mexico.

“We’re not alone. If you’ve noticed, RNs and health professionals around the country are going on strike,” she said. “They’re picketing. They’re filling up their state capitals and they’re 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 that lawmakers read the legislation carefully and realize that this will help hospitals, nurses and patients.

“We all know how expensive turnover is,” she said. “And especially in the medical field in New Mexico and across this nation, we cannot invite any more turnover.”

California is the only state so far that has codified nursing to patient ratios. Along with New Mexico, other states like Washington and Oregon are trying to push through similar legislation this year.

“All of us have family members that need the care,” McKenna said. “We’ve seen it with the pandemic, and we’ve got such a shortage of nurses — well, and all providers here in the state.”