Iowa Nurses Plan to Protest Higher Nurse-Patient Ratios Amid Staffing Crisis

The nurses at University of Iowa Health Care (UIHC) recently received a letter from administrators that said nurses are about to face “some of the most challenging” staffing problems to date. The memo warned that nurses in some units may have to take on as many as five patients at once.

“The first two weeks of October present the most staffing challenges,” UIHC leaders told employees. “But the challenges will continue for the adult inpatient staffing through mid-November. I have already received some feedback and suggestions from staff on how to have staff safely care for five patients.”

But many nurses were quick to criticize the decision, and they are now planning to protest outside the hospital on Thursday. The demonstration is set to take place from 11 AM to 1 PM local time near one of the parking ramps.

“We refuse to let our hospital administrators make poor decisions that affect our quality of care because they couldn’t plan well and prepare properly,” according to a Facebook event page for the event. The organizers are encouraging staff, patients, family, and managers to “bring the cowbell, noisemakers, signs, ALL of it!”

“Increasing nurse-patient ratios is NOT the answer,” according to the event page. “You can’t have quality and safety as a priority when you stretch your nurses so thin, they go home crying!!”

In response to the planned demonstration, UIHC declined to comment whether these changes would increase the current nurse-patient ratio, and, if so, by how much.

“Hospital staffing needs can change quickly based on the number of patients and their level of acuity (severity of illness),” according to an official hospital statement. “When more staff are needed, existing staff have the option to pick up additional shifts or hours for additional pay.”

The hospital added that it “is committed — and always will be — to providing safe, high-quality care,” the statement said. “This means having a team of staff who care for patients in a safe, supportive work environment.”

The university has had to depend on travel nurses over the last several years to keep up with rising demand for services. They are paid more than permanent staff members and only stay for several months at a time.

“The number of travel nurses who accept those roles may vary from month to month. Traveler rates vary based on supply and demand and prevailing market rates, and we continue to pay contractual rates that are competitive in the market,” the organization said.

UIHC says it is doing everything it can to bring more permanent staff members on board. As of last week, 805 inpatient beds were in use out of a total of 866, bringing capacity to 93%.

According to the hospital’s website, it currently has 380 open “nursing” positions, including 144 full-time posts and 236 part-time jobs across the campus — from labor and delivery to adult psychiatry and from nurse management positions to nursing assistants.

Hospital leaders are even looking to staff for possible solutions to the ongoing retention crisis.

“We are open to all suggestions on how to staff during these challenges,” the statement said.

“You can expect to see leadership on the floor more often to try and mediate some of the holes while balancing what we need to accomplish in the office,” the email read. “I know this is really hard to hear for all of us, and I understand the feelings of being frustrated and nervous for what the future is going to bring. I do hope we can all come together to help get through this as a team.”

UI Hospitals and Clinics Interim Chief Executive Officer Kim Hunter added that patient safety is the organization’s number-one priority. 

“In healthcare, staffing is flexible and we safely match resources with constantly changing patient care needs,” she said. “We are grateful for our nursing and care teams who come together to support one another as they care for our patients and their families.”

The university is facing mounting staffing challenges as it begins to expand its operations. It is currently building a new $525.6 million hospital campus in North Liberty; a $95 million expansion of its inpatient tower; and a $24.6 million emergency room expansion, among other projects.

The campus is also planning to spend $620.9 million over the next five years on a new inpatient tower on the main UIHC campus and $212 million on a new “modern health care research facility.”

The nurses planning the protest fear the new patient ratios will become permanent as the university continues to expand.

“Figure out a solution STAT that doesn’t affect quality & put every nurse’s license on the line! Let’s keep UIHC as a top place for care by keeping our patients and nurses SAFE!” the nurses wrote on Facebook.