I doubt that this would increase offload times for EMS. Typically the primary issue for EDs is bed space, especially when surging, rather than nursing resources; especially so in higher volume EDs.
I think that it's a bit crazy that they think the feeders and growers need to be 2:1, level II and even some level III babies can be safely tripled (and they are only getting 30 minutes of cares ever 3 hours anyway).
The problem with mandates are that they are minimums, and often are still not based for safety especially in critical care units. If we have a kid on ECMO they are potentially a 1:3, we may have one nurse running pump and one to two actually caring for the kid. According to that law we could staff one nurse to a fresh post-op heart.
That being said the reality is that most hospitals are going to staff to the bare minimum, just like private for profit EMS does. The number one cost hospitals have is nursing department staffing (although this is also what they are mostly billing for). I remember training at a county hospital and the med/surg nursees having often had 7-8 patients each, and distinctly thinking about how I would never want to be a patient at that hospital and how unsafe it was.
Like
@Summit said hospitals will likely respond by reducing nursing assistants and techs. Generally total care is considered to be safer than primary or team nursing so I don't necessarily think that this is bad for patient safety, it is also much more costly for the hospital and why most systems avoid it. Keep in mind that total care is the primary staffing model for ICUs and most pediatric hospitals. While total care is more expensive hospitals in California also saw a reduction in the number of occupational injuries so I think the costs may be more of a wash than the hospitals let on.
The reality is that EDs are not being overwhelmed with sick patients, but rather those who don't or can't go to primary care as well as the failed mental health system. Increased waiting room and offload times are a symptoms of this, and nursing taking on more patients isn't going to increase safety or provide for more efficacious care. As the local proliferation of urgent cares and free standing EDs developed our ED saw a drop in our daily census, but have have seen a substantial increase in average acuity (this is not a promotion of free standings, I think they are the epitome of what is wrong with our healthcare system).
I guess you should ask yourself if you were a medical patient in the hospital, or for the patients you bring in, would you want to have your nurse available for your care, charting, and coordination of care for 6 hours a day or a small fraction of that?
