How Understaffed are NJ hospitals? Nurses Say They are Stretched Thin — and Care Suffers

 In Nurses Weekly

Three years since the COVID-19 pandemic prompted scores of health care workers to leave their profession, nurses say New Jersey hospitals continue to be critically understaffed and therefore less safe, with far fewer medical professionals to attend to patients.

Hundreds of nurses and union leaders rallied outside the Statehouse in Trenton on Thursday, chanting “Safe staffing saves lives!” in support of legislation that would establish staffing ratios at hospitals and other medical facilities.

Nearly a third of nurses have left direct patient care at hospitals over the past three years, according to the Health Professionals and Allied Employees union.

“We are set up to fail by our employers, who are risking the safety and comfort of patients by understaffing,” Alice Barden, a nurse at Englewood Hospital, told the crowd, decked out in red union T-shirts. “We already know that corporate hospital employers will not do the right thing for patients and staff unless they are forced to do so.”

Workforce needs ‘flexibility’

A spokeswoman for Englewood deferred comment to Cathy Bennett, president and CEO of the New Jersey Hospital Association, who praised nurses and other health care workers but said in a statement that the entire workforce needs “flexibility to appropriately respond in real-time to the needs of their patients.”

“We are focused on identifying ways to expand the pipeline of nurses and other health care professionals to ensure we have all the team members needed to continue to deliver that needed care now and in the future,” Bennett said.

COVID exacerbated existing shortage

Nurses said staffing issues have long been a problem. COVID did not start the shortage, they said, but exacerbated it when nurses and other health care workers put their lives on the line to care for a tsunami of very sick, very contagious patients.

The health professionals union released a report Thursday titled “Code Red: Understaffed. Overworked. Unsafe for Everyone” that said staffing is based on cost-effectiveness, not patient care. The union wants regulations similar to those passed 20 years ago in California that mandate staffing ratios.

In a survey of its members, the union found that 72% of hospital nurses have considered leaving in recent years and newer nurses are more likely to consider leaving. The major reasons are poor staffing, burnout and stress.

“We have to stop the bleeding,” Debbie White, the union president, said at the rally. “Hospital workers were already stressed out by the time the pandemic hit us. Who made the problem? Hospitals.”

More nurses per patient

The unions are lobbying for the Legislature to pass a bill — S304 — that would establish staffing standards for nurses in hospitals, surgical facilities, developmental centers and psychiatric hospitals. The bill has languished for years in Trenton with little movement. It would mandate:

  • one registered nurse for every five patients on a medical/surgical unit.
  • one RN for every four patients in a step-down, telemetry or intermediate care unit.
  • one RN for every four patients in an emergency department along with one RN for every two patients in a critical care ward of an emergency department, and one RN for every patient in a trauma ward of an emergency department.
  • one RN for every five patients in a behavioral health or psychiatric unit.
  • one RN for every two patients in a critical care, intensive care, neonatal or burn unit.
  • one RN for every patient under anesthesia in an operating room and one RN for every two post-anesthesia patients in a recovery room.
  • one RN for every two patients in a labor and delivery unit; one RN for every four patients, including infants, in a postpartum unit in which the mother and infant share the same room, and one RN for every six patients in a mothers-only unit.
  • one RN for every four patients in a pediatric or intermediate-care nursery unit, and one RN for every six patients in a well-baby nursery.

(This story originally appeared in

24/7 Crisis Hotline for Impaired Nurses - 1-800-662-0108