Hospital employment of nursing personnel. Has there really been a decline?

There was a steady increase in the number of hours worked by nursing personnel in California hospitals from 1977 through 1996, mostly due to an increase in the number of hours worked by registered nurses (RNs). The hours worked by nursing personnel and RNs per case-mix adjusted discharge and per adjusted patient day also have increased. Possible explanations for the discrepancy between perceptions of declining nursing staffing and the data are discussed.