Bill would require nurse-to-patient ratios in Michigan hospitals

Nurses Union

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The Michigan Nurses Association joined Democratic lawmakers Monday in their push to make Michigan the second state to mandate hospital staffing levels, but hospital officials expressed concern the requirement could backfire due to higher costs.

Democratic Sen. Rebekah Warren of Ann Arbor and Rep. Jon Switalski of Warren recently introduced legislation that would require Michigan hospitals to develop and implement staffing plans and meet statewide minimum nurse-to-patient ratio requirements, depending on the type of patient.

The bills would, for example, require hospitals to have one nurse for every patient in critical care units and one nurse for every four patients in pediatric units. It also would ban mandatory overtime for nurses except in emergencies.

Dr. Laurence Rosen, a health care researcher at Public Policy Associates in Lansing, said research shows low nurse staffing levels are associated with higher death rates and can also cause patient complications such as blood stream infection and hospital induced pneumonia.

The Michigan Nurses Association agreed. It represents about 2,200 nurses and other health care professionals at Sparrow Hospital in Lansing, where nurse-to-patient ratios were inked in a 2010 employee contract and continued under an extension ratified last month. ...

http://www.lansingstatejournal.com/viewart/20130304/BUSINESS/303040053/Bill-would-require-nurse-patient-ratios-Michigan-hospitals

I would love to see this, but it isn't likely to happen. There have been similar bills introduced in every legislature since 2004 and every single one of them bit the dust. The hospital industry in Michigan wields incredible power over our legislators. In addition, one of the the current bill's sponsors, Rebekah Warren, is so disliked in so many quarters that she is positively the last person who should have introduced this bill if it were to have a snowball's chance in hell of passing. Ms. Warren proposed amendments to a recent abortion bill that sought to require men to have digital exams before they could be prescribed viagra and to be screened to make sure they weren't being coerced into getting a vasectomy (all to supposedly create parity in how she perceives reproductive health care is provided in Michigan). Her amendments were soundly rejected and she earned a reputation as a mindless grandstander bent on making a point rather than passing sound legislation. With her name on the bill, I think it is dead before it gets to the floor, if it even gets that far.

Specializes in Dialysis.
I would love to see this, but it isn't likely to happen. There have been similar bills introduced in every legislature since 2004 and every single one of them bit the dust. The hospital industry in Michigan wields incredible power over our legislators.

That's why it is important for the nurses in Michigan to use the publics approval of our profession to speak out on why this is a public health issue. Every nurse cast a wide shadow in the number of people they can influence just by voicing their opinion. But first you have to speak out. Slavery had powerful supporters and many were convinced it could never be ended.

Specializes in being a Credible Source.
I work in CA and MANY hospitals do NOT follow the state laws about ratios or breaks. More commonly they follow ratio laws but not breaks, especially in southern California. This is my experience after working in 12 hospitals in CA as a traveler.
Well, if they don't follow the rule about breaks, report them. You get paid DT plus a penalty if they don't provide breaks and no nurse should accept an assignment to 'cover' beyond their ratio limit.

Sounds like as much an issue with the nursing staff as it does with the hospital management.

Judging by how many nurses are trying to get *TO* California, all of its warts notwithstanding, your opinion is in the minority.

Mandated ratios and strong collective action by the nurses is vital. Obviously, if you're an at-will employee, making waves is hard.

Specializes in ICU/PACU.
Well, if they don't follow the rule about breaks, report them. You get paid DT plus a penalty if they don't provide breaks and no nurse should accept an assignment to 'cover' beyond their ratio limit.

Sounds like as much an issue with the nursing staff as it does with the hospital management.

Judging by how many nurses are trying to get *TO* California, all of its warts notwithstanding, your opinion is in the minority.

Mandated ratios and strong collective action by the nurses is vital. Obviously, if you're an at-will employee, making waves is hard.

There is one hospital in particular I would like to report. Do you think writing a letter to state would do anything? This is a non union hospital. And I am a traveler, my contract is now complete.

I worked in the majority of the units in the hospital, so it was really hospital wide where breaks weren't provided. Some things in particular, in the ICU you were required to break your neighbor, giving you 4 patients. On the floors you took your lunch when you could, and had to carry your phone with you. The charge nurse would usually have patients. You could give your phone to her, depending on who it was, but she would then be responsible for 8 patients. Morning breaks were not provided.

Specializes in being a Credible Source.

For issues of ratio violations, contact the Dept of Public Health.

For issues of lunch/break violations, contact the Dept of Labor... and they can't make you accessible during lunch or it doesn't count. That is unpaid time and it's yours free and clear of anything else.

We do lunch when we can but there is always somebody taking the assignment or else we skip lunch and get paid the time plus the penalty.

Specializes in Critical care, tele, Medical-Surgical.

You can call or write the district office where the hospital is located.

District Offices

The ratio page -- Nurse-to-Patient Ratio

Wow! I used to work in Michigan. Sometimes 10 postpartum patients! Of course that meant teaching breast feeding moms, changing diapers, etc. the vitals were taken by nursery staff, but then the babies came out to us.

Go Blue!

Specializes in ER, ICU, Administration (briefly).

Not to mention the impact on nurse retention and getting nurses who simply refuse to work in these conditions backinto the work force.

SInce it costs the hospitals around $50,000 to replace an RN, it makes sense that these costs would go down.

Once, in a discussion with a CEO about the need for sane staffing on my 3 telemetry floors, I brought up the issue of improved patient safety. His response to me was, "That's why we pay insurance."

What a callous prig. Interesting how when they or one of THEIR loved ones comes in, it's private rooms and private duty nursing. Evidently what's good enough for the goose is not good enough for the golden calf.

Specializes in ER, ICU, Administration (briefly).

If you go to My Florida News website, follow the link to Florida Roundtable, and then scroll thru the podcasts on the Florida Roundtable, you can hear Dr. John Silver (RN) talk about these issues. He is the author of "just a union...of nurses". Boring intro but good discussions. We need more nurses speaking up!

I worked St Joe's on Woodward in the middle 80's. Post partum....would routinely have 10 mothers-some first day c-sections. Even though the nursery did vitals/assessment, we still spent time teaching/nursing, which in essence gave us twenty patients.

Don't get me wrong--PP is easily the easiest job ever. But twenty pts is ridiculous! Maybe someone is tired of lawsuits!

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