Nurse labor effects of residency work hour limits.

Hospitals employing large numbers of residents increased their hiring of registered nurses, (including nurse practitioners, nurse anesthetists, and other RNs with greater training) significantly more than hospitals with smaller numbers of residents as a result of the ACGME work hours reforms. Patient safety was the main intent of the regulation and should remain the central concern when discussing the merits of resident work-hours limitations. However, the regulations also reduced the number of resident labor hours available to hospitals. This analysis suggests that nurses have compensated for reduced resident workload, with an additional full-time nurse for every 5.5 residents. This finding contributes to a better understanding of the hospital labor response to the regulation that resulted in the reduction in resident hours.