NJ staffing legislation

  1. undefined
    Just wondering if people know about the staffing disclosure bill that was passed by the NJ state legislature last month. Also, staffing ratio bills have been introduced in both the state Senate and state Assembly, but nurses are needed to write letters, postcards, and emails to legislators, etc. so we can get this passed.
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  2. 12 Comments

  3. by   rnmaven
    Quote from trita
    [font=Comic Sans MS]undefined
    Just wondering if people know about the staffing disclosure bill that was passed by the NJ state legislature last month. Also, staffing ratio bills have been introduced in both the state Senate and state Assembly, but nurses are needed to write letters, postcards, and emails to legislators, etc. so we can get this passed.
    This issue is an important one but I don't see nurses at the bedside actively pushing to educate legislators on how important an issue this is.

    I will be writing a letter about my experience caring for 8 med/surg patients in a holding unit. I protested being alone with these patients and was told that I had an aide working with me. (For that I should be downright grateful). Well, I am sorry, but I do not find this safe or acceptable. It is impossible to give good care to eight patients alone. The problem is that many nurses have accepted their working conditions and are either too weary to fight or just don't care anymore.

    California law is 6 to one on med-surg and the pressure is on to change that to five to one. Without a law we are at the mercy of administration. Save money and see how many patients one nurse can take care of without mistakes being made.

    And who is going to back you up when you make those mistakes?
  4. by   trita
    That is great that you are writing a letter about this! The legislators need to hear from more nurses. Of course, the Hospital Association opposes ratio legislation - and they make that known to the legislators.

    I know nurses who have sent post cards and testified and can get more information about that if anyone wants. Let me know.

    The proposed legislation in NJ is similar to California as far as no more than 6 patients for med-surge per RN to start, then going to 5 patients per RN after one year. This is at ALL times - so that means more than the minimum scheduled to cover for breaks, etc.

    Let me know if you know anyone who would actually like to testify.

    Also, FYI, for anyone who lives near Philadelphia, author Suzzanne Gordon, who writes about nurses will be speaking at a free forum to help nurses learn how to speak better about nursing issues to the general public -- in order to get more support for better laws, contracts, and policies to improve conditions for nurses and patients.
  5. by   rnmaven
    Quote from trita
    T
    Let me know if you know anyone who would actually like to testify.

    Also, FYI, for anyone who lives near Philadelphia, author Suzzanne Gordon, who writes about nurses will be speaking at a free forum to help nurses learn how to speak better about nursing issues to the general public -- in order to get more support for better laws, contracts, and policies to improve conditions for nurses and patients.
    PLEASE!!!!! Let me know who I should write to and also I would love to testify!

    Thanks!
  6. by   NRSKarenRN
    I went to PASNAP's last presentation by Suzzane Gordon it was fabulous! Then heard Bernice Burrell, coauthor of "From Silence to Voice: What Nurses Know and Must Communicate to the Public" speak at PSNA Convention.
    Suzzane was better at communicating and getting nurses to speak in lay "Patient Language" communicating what and why we perform nursing tasks "to keep you safe". This is a not to miss opporutnity!

    Free Workshop is sponsored by PASNAP: PA Assoc. of Staff nurses and Allied Professionals.
    Location/Date: Tuesday, Jan 25th, 2005 at Hilton Philadelphia Hotel
    Register: 610 567 2907

    Topics:
    How Nurses Can Communicate for Themselves, For Their Patients
    Speaker Suzzane Gordon
    and Winning the Changes We Deserve through Unified Patient Advocacy
    Speakers: Terri Evans RN and Bill Cruice Esq. PASNAP
    Last edit by NRSKarenRN on Jan 13, '05
  7. by   trita
    Quote from rnmaven
    PLEASE!!!!! Let me know who I should write to and also I would love to testify!

    Thanks!
    New Jersey state government is divided into 40 districts. Each district has one State Senator and two State Assembly members. You should write to all three in the district where you live to tell them why you support the safe staffing law. If you are in Monmouth County, you could be in the 10th, 11th, 12th, or 13th district, depending on your town. You can email me directly at terrihpae@aol.com with your town & I will give you the names and addresses of your representatives. Also the League of Women Voters has this information at www.lwvnj.org and the state government website at www.nj.gov. (But sometimes the information is not easy to find.)

    I also have pre-printed postcards to send to legislators.

    I will let people know when there will be testimony. The dates are not set yet.
  8. by   KathyMomRN
    My friend is on the Retention and Recruitment Committe at my hospital, and they have her so brainwashed about staffing ratios. They claim that in California, ambulances are riding around for hours looking for a hospital to accept the patients because more patients will force them to not be able to comply with the nurse-patient ratios. They are claiming that as the RN on the unit, you can be held liable if you take a lunch break or even a bathroom break and you leave the unit down one nurse. They are claiming that hospitals are closing left and right and nurses are being put out of work. To me, it sounds like scare tactics and it makes me sick.

    [QUOTE=trita]That is great that you are writing a letter about this! The legislators need to hear from more nurses. Of course, the Hospital Association opposes ratio legislation - and they make that known to the legislators.
    The proposed legislation in NJ is similar to California as far as no more than 6 patients for med-surge per RN to start, then going to 5 patients per RN after one year. This is at ALL times - so that means more than the minimum scheduled to cover for breaks, etc.

    [
  9. by   trita
    Yes, I have heard the hospitals are putting out a lot of untrue propaganda and scare tactics. The California Nurses' Association has been refuting these -- but, of course that is not what gets publicized. From my understanding, the one or two hospitals that have closed since the ratios started were tiny and would have closed anyway. Individual nurses cannot be held liagble for taking breaks -- the hospitals can be held liable for not staffing well enough to take breaks into account. Hospitals always cry about the "nursing shortage", but the truth is there is no shortage of nurses with an RN license. The shortage is because many RNs have chosen to not work at the bedside - or to severely cut back hours - due to conditions. If they know the conditions are better and nursing can properly be practiced, more will return to the bedside and up their hours. I will look up some facts and post them soon - so maybe you can give them to your friend.

    [QUOTE=KathyMomRN]My friend is on the Retention and Recruitment Committe at my hospital, and they have her so brainwashed about staffing ratios. They claim that in California, ambulances are riding around for hours looking for a hospital to accept the patients because more patients will force them to not be able to comply with the nurse-patient ratios. They are claiming that as the RN on the unit, you can be held liable if you take a lunch break or even a bathroom break and you leave the unit down one nurse. They are claiming that hospitals are closing left and right and nurses are being put out of work. To me, it sounds like scare tactics and it makes me sick.
  10. by   trita
    Here is a good article about hospitals meeting ratio requirements (Where there is a will, there is a way!)

    Some Hospitals Met Nurse Ratios
    By Jia-Rui Chong
    Los Angeles Times
    February 6, 2005
    http://www.latimes.com/news/local/la...,3488447.story

    Though the hospital industry has insisted it was all but financially impossible to meet the state's strict nurse-to-patient ratios, a number of hospitals have been able to do it without breaking their budgets.

    About 36% of the hospitals inspected by the state's Department of Health Services passed their surveys, according to a Times review of state data from the first 10 months of last year.

    That's more than the 15% compliance rate that the California Healthcare Assn. has estimated based on its survey of 300 institutions.

    The findings come as the Schwarzenegger administration and major hospitals are trying to scale back the ratios in California, which was the first state in the nation to limit the number of patients a nurse can treat.

    Though most of the hospitals inspected by the state did not meet the ratio standards, those that did offer a lesson in balancing the financial burden of hiring more nurses with the benefits of complying with the law.

    The hospitals that have been able to meet the ratios vary in size and location, from a 70-bed public facility in Banning to a 540-bed medical center run by UC San Diego.

    But they tend to have several things in common:

    * Many have been able to make up the costs of more nurses by renegotiating rates with private insurance companies or persuading insurers to send more patients their way.

    * Most are in relatively good fiscal health, with a median net income of about $10 million for 2003. Only two facilities reported losses for 2003.

    * Officials at some hospitals say they have less trouble recruiting than other medical centers because their facilities have nationally known specialties and they work hard to keep their nurses happy. Their rates for turnover and job vacancy are lower than state averages, which both hover around 15%.

    The hospitals also tend to have low rates of using temporary nurses. Many have the added perk of being in attractive locations: pretty seaside towns, for instance, or areas with affordable housing.

    The numbers of patients that nurses are allowed to handle are based on the severity of patients' illnesses. In an operating room, for example, each patient is required to have a nurse. In a medical-surgical ward, one nurse can care for six patients.

    The nurse-patient ratio law took effect in January 2004. But Gov. Arnold Schwarzenegger's administration has moved to scale it back, citing complaints from hospitals. Schwarzenegger wants to give hospitals more flexibility in emergency rooms during unexpected surges of patients. He also wants to delay implementation of a second phase of the law that would further reduce nurse-to-patient ratios.

    The department inspects hospitals only when it receives a complaint, and it had completed reports on nurse staffing at just 28 hospitals by October. A Times review of those reports showed that 10 hospitals complied with the law.

    One of those hospitals was UC San Diego Medical Center, which was accused of assigning nurses too many patients in the orthopedics department in January. When a state inspector reviewed records in February, she found nothing wrong.

    Mary Middleton, the hospital's chief nursing officer, said she manages the situation by having her office count heads at the units every four to six hours.

    She also constantly tries to predict influxes of patients by the time of day, day of the week and weather. For instance, she said, clusters of patients often show up after 5 p.m. because clinics close at that time.

    People often arrive Monday because they wait for doctors' offices to open on the first work day of the week and then find out they need care at the medical center. When it rains, she added, there usually are more car accidents, so she beefs up intensive care units.

    If a unit needs a nurse, Middleton said, she tries not to use temporary nurses - who cost on average about $65 an hour, compared to $40 an hour for a staff nurse.

    If staffing officials determine that a unit needs more nurses, they begin by calling part-time nurses who work only on certain days and full-time staffers who might want to earn overtime pay.

    Robert Hogan, the hospital's chief financial officer, said it has cost an extra $10 million to meet the ratios. Administrators found the money by renegotiating contracts with private insurance companies to reimburse at 6% to 10% more than they did before. Hogan said the hospital also expected to make up some of the money by economizing on supplies.

    But even facilities that have done well in meeting the ratios insist that they struggle to do so, and say they may not always have the numbers right every hour of every day.

    Passing an inspection can be "luck of the draw," said Jennifer Jacoby, who oversees nursing at Sharp Mary Birch Hospital for Women in San Diego, which also passed a state inspection.

    "If they come in and say, 'Show me staffing schedules for April 5 and 10,' it can be great on the 5th and 10th and not on the 11th," she said.

    Indeed, two other hospitals she oversees at the same campus, Sharp Memorial Hospital and Sharp Mesa Vista Hospital, did not pass the state review. Jacoby said she set down the same nursing rules for all three sites.

    One policy that has helped Mary Birch is shifting some scheduled nurses to "on-call" status when there are not as many patients as expected. If, for instance, four nurses were scheduled to work, but managers found that three could handle the load, the fourth could leave and return when new patients came to the unit. This nurse would receive a lower rate of pay when she was off-campus, but would receive full salary if she had to come back.

    Jacoby said Mary Birch had several strategies for paying the $2.3 million in added costs for nurses to meet the ratios. As an example, she said, the hospital was able to persuade insurers to send more women to give birth at Mary Birch because the free-standing women's hospital handles a high volume of births and has specialized staff and equipment to handle difficult deliveries.

    A state inspection of Glendale Memorial Hospital for staffing has not been completed, but the nursing union and the Hospital Assn. of Southern California say the hospital has become a model for complying with the ratios.

    The facility has added about $1 million to the budget - including creating two positions just to monitor the ratios - to pay for the new staffing law, said Patrick Lash, chief financial officer. The hospital will make less money this year than the $6 million in profit last year, but will remain on the plus side, he said.

    Like UC San Diego, Glendale Memorial has been able to stanch most of the loss by negotiating higher reimbursement rates from private insurance companies. Lash said the hospital, which is part of Catholic Healthcare West, also plans to reduce some costs by buying supplies in bulk with other network hospitals and paying less for services such as legal consultations.

    Glendale's low usage of traveling and local registry nurses helps keep the costs of the ratios in check, officials said.

    Fewer than 1% of the nurses at work on a given day come from temporary agencies, said Rhoda Vincent, who oversees nursing for the hospital. Vincent said the facility has been able to hire 340 full-time nurses and has to cover for only 36 vacancies.

    "We have to make sure our nurses are happy," Vincent said. "We have a low turnover rate - 0.2% for this past year - so I think we are."

    Though the 36% compliance rate for meeting the ratios is more than the hospital association found, it is far less than the 80% estimated by the nurse union that pushed for the law.

    Though both sides stand behind their statistics, they acknowledge that the state's inspections are a useful snapshot of hospital compliance.

    Jan Emerson, spokeswoman for the California Healthcare Assn., said state reports don't tell the whole story.

    Inspectors pulled only selected records during their visits and looked at just a fraction of the 450 hospitals licensed in the state, she said.



    Jill Furillo, who is Southern California director for the California Nurses Assn. and lobbied for the ratio law, said nurses monitoring 175 hospitals have told her that far more facilities were in compliance than the state found.

    "What the data is showing and what our information is showing is, where there is a will, there is a way to meet the ratios," she said.



    Hospital staffing

    A Times review of state data from the first 10 months of 2004 revealed that 10 of 28 hospitals inspected for nurse staffing were complying with the law:

    Desert Regional Medical Center in Palm Springs

    Petaluma Valley Hospital in Petaluma

    Riverside Community Hospital in Riverside

    San Gorgonio Memorial Hospital in Banning

    Scripps Memorial Hospital in Chula Vista

    Sharp Grossmont Hospital in La Mesa

    Sharp Mary Birch Hospital for Women in San Diego

    Sutter Solano Medical Center in Vallejo

    Ukiah Valley Medical Center in Ukiah

    UC San Diego Medical Center

    Source: California Department of Health Services
  11. by   tridil2000
    Quote from trita
    [font=Comic Sans MS]undefined
    Just wondering if people know about the staffing disclosure bill that was passed by the NJ state legislature last month. Also, staffing ratio bills have been introduced in both the state Senate and state Assembly, but nurses are needed to write letters, postcards, and emails to legislators, etc. so we can get this passed.

    fyi...
    this goes into effect on sunday! 7.24:hatparty:
  12. by   HealinghandsRN
    Quote from trita
    that is great that you are writing a letter about this! the legislators need to hear from more nurses. of course, the hospital association opposes ratio legislation - and they make that known to the legislators.

    i know nurses who have sent post cards and testified and can get more information about that if anyone wants. let me know.

    the proposed legislation in nj is similar to california as far as no more than 6 patients for med-surge per rn to start, then going to 5 patients per rn after one year. this is at all times - so that means more than the minimum scheduled to cover for breaks, etc.

    let me know if you know anyone who would actually like to testify.
    also, fyi, for anyone who lives near philadelphia, author suzzanne gordon, who writes about nurses will be speaking at a free forum to help nurses learn how to speak better about nursing issues to the general public -- in order to get more support for better laws, contracts, and policies to improve conditions for nurses and patients.
    yes, please i want more information. i am definetly for the lowering of nurse patient ratio as i am a bedside nurse. if we don't act, this issue will be swept under the carpet as no one else is going to defend us. please send me more information on what i need to do to contribute in speaking our concerns and opinions. thank you.
  13. by   tridil2000
    Quote from trita
    undefined
    Just wondering if people know about the staffing disclosure bill that was passed by the NJ state legislature last month. Also, staffing ratio bills have been introduced in both the state Senate and state Assembly, but nurses are needed to write letters, postcards, and emails to legislators, etc. so we can get this passed.
    i think they have until march to implement it.
    let's talk again then!
  14. by   lee1
    Quote from tridil2000
    i think they have until march to implement it.
    let's talk again then!

    this March 2006??? Has the language been created to even implement this??? And then, does that language have to be passed by the legislature???
    So basically, pass a law, never implement the language, then forget about it

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