Op-Ed: Hospital caregivers and patients deserve safe staffing levels

NJ Spotlight News

HPAE President Debbie White

September 3, 2025

For decades researchers have studied the impact of the law passed in California mandating nurse-to-patient ratios in hospitals, aka safe staffing. Those studies have shown that patients survive more often, recover better and are more satisfied with their hospital stay. In addition, workers experience fewer injuries and remain in their jobs. Improved patient outcomes and retention of staff alone result in increased cost savings for hospitals.

So why, then, would any hospital not want what’s best for patients, for nurses and even for the financial health of the hospital?

Here’s why: They don’t want to spend the money on extra nurses. Can hospitals in New Jersey afford it? Absolutely.

Of course, we know hospitals need to be fiscally responsible. But fiscal responsibility recognizes that patients come to the hospital for the 24-hour care given by nurses and other bedside caregivers. Patients need a nurse at the bedside who is not preoccupied, stressed, unable to answer questions, pressed for time and generally overwhelmed. This is unsafe staffing.

The stress and burnout of unsafe staffing is also the primary reason nurses are migrating out of our hospitals. Trying to care for too many patients at one time creates an environment where nurses can’t possibly give the best care. The solution, according to most nurses we’ve surveyed, is safe staffing. Science shows safe staffing also saves hospitals money, so it’s a win for everyone.

To be clear, it’s been over 20 years since the California law was passed. In the many studies that one can easily access, there exists a wealth of information showing that when there are mandated limits on the number of patients a hospital nurse can care for at any given time, it’s good for patients. The following are the documented benefits for patients:

• Lower mortality rates. This means patients survive more often;
• Fewer readmissions. Patients fully recover from admission to discharge;
• Shorter length of stay. Patients are discharged quicker and healthier;
• Fewer intensive care unit admissions. Patients are less likely to become critically ill;
• Fewer patient infections, injuries and bed sores. Patients get better rather than worse;
• Greater patient satisfaction. Patients like when a nurse is actually available to them.

The following are the well-documented benefits of safe staffing to nurses and to the hospitals where they work.

• Greater nurse job satisfaction;
• Less burnout and stress;
• Greater retention of nurses in hospitals;
• Decreased turnover costs for hospitals;
• Safer environment for patients and staff;
• Better reimbursement for hospitals for better patient outcomes;
• Better reimbursement for hospitals for greater patient satisfaction scores (Yes, hospitals actually get more money when patients rate them higher).

Every hospital needs safe staffing.

At this moment in history, and especially coming out of the pandemic, nurses are no longer willing to tolerate the status quo. As we saw with the USW nurses strike at Robert Wood Johnson-Barnabas Hospital in New Brunswick, we also will do whatever it takes to make sure safe staffing is included in our new contracts.

Members of Health Professionals and Allied Employees, or HPAE, can be proud of our victories in winning safe staffing in 12 contracts bargained in hospitals across New Jersey. HPAE, the largest health care union in the state, is leading the fight for mandatory, enforceable, safe nurse-to-patient ratios in our hospitals.

By the end of 2024, HPAE had won contract language mandating nurse-to-patient ratios in five hospitals and in 2025 HPAE will have added another seven contracts.

Currently the nurses at HPAE Local 5058 are bargaining a new contract with Hackensack Meridian Health to include the same safe staffing language that now exists in every other contract negotiated in the past 18 months.

Remember, only unionized health care workers can bargain over wages, hours and working conditions, including safe staffing. Only unionized health care workers have a true voice in their workplace that can effect lasting change.

Our push to get New Jersey lawmakers to pass the Patient Protection and Safe Staffing Act (S-2700 and A-3683) into law also continues unabated because we know that not every hospital in New Jersey is unionized. Passing this bill into law would create mandatory staffing ratios, just like those in California.

As for our union, until we have a law just like California’s staffing law, we continue to tell our employers that safe staffing is our primary issue in every contract campaign — and we will win.

“SAFE STAFFING” DEBBIE WHITE HPAE NJ HOSPITALS NURSE BURNOUT NURSE CONTRACTS NURSE RETENTION NURSE-PATIENT RATIO PATIENT CARE