Letter to Congress: ANA "Safe Staffing Saves Lives" campaign - page 4
Just a reminder that you can submit the following letter on safe staffing to the ANA, who will then send it to your Congress people. It's really easy - you can even modify the letter if you like. ... Read More
Apr 14, '08i urge all of my sisters and brothers in this disintegrating healthcare system to research ALL of these staffing plans. i've been a direct care nurse for 15 years. i have worked in many hospitals in different parts of the country. i have many nurse friends who have left the bedside due to the deplorable conditions we have to face each day. i have witnessed "sentinal events" that could have been avoided with safe nurse-to-patient ratios.
the ONLY logical solution can be found at www.CalNurses.org
please check this out. CNA/NNOC is unique in that it empowers DIRECT CARE RN'S. CNA/NNOC advocates for nurses and patients NOT administration! its time we stand together. let the suits and high heels remain comfortable in there offices as WE make the decisions on OUR work environment!!!!
Apr 15, '08So, based on the (very helpful!) responses of everyone...
Below is a consolidated list of the various pieces of potential legislation/initiatives regarding nurse-patient ratios that were mentioned in this thread.
QUESTION: Do you all think we should replace the current sticky with this expanded list, so that nurses can read over the various proposals/initiatives and support the one(s) they agree with?
LEGISLATION TEXT FOR ABOVE LINK:
LEGISLATION TEXT FOR ABOVE LINK:
Regarding the above link: One post noted NNOC is working on The United States Nursing Shortage Reform and Patient Advocacy Act.
Apr 16, '08Thanks for all the additional information here.
It helps to post all the options to compare and decide. Even if all of them are voted for just to get the signatures to the politicians.
Apr 24, '08seiu and aft also support this bill. anyone know why cna/nnoc is not supporting this and wants to introduce another bill? the only thing missing in this one is the "kentucky river" issue, which the respect act covers. as h.r. 2123 already has broad support, why start over?
these are the reason's cna/nnoc are not in agreement with the bill:
[color=#333333] "the safe nurse staffing for patient safety and quality care act of 2007"
[color=#333333]- [color=#333333]no national standards[color=#333333]
[color=#333333]- [color=#333333]total silence on the direct care rn duty and right[color=#333333] to advocate in the exclusive interest of her/his patient and rn use of independent professional judgment without fear of retaliation.
[color=#333333]- [color=#333333]silent on addressing the nlrb kentucky river decision making direct care rns supervisors. [color=#333333]
[color=#333333]- [color=#333333]silent on the rn professional duty and right to act as patient advocate and that collective advocacy and free speech are protected activities.[color=#333333]
[color=#333333]- [color=#333333]no prohibition on the use of technology that overrides rn judgment.[color=#333333]
[color=#333333]- [color=#333333]weak [color=#333333]minimum direct care registered nurse-to-patient ratios.
[color=#333333]- [color=#333333]no requirement of current demonstrated competency.
[color=#333333]- [color=#333333]the offensive practice of averaging the number of patients is not prohibited. (example: the icu ratio is 1:2; when a patient is classified as a 1:1 a second direct care rn can be assigned 3 icu patient because 1+3=4. four patients divided by two rns is two; therefore the hospital is in compliance.[color=#333333]
[color=#333333]- [color=#333333]nurse administrators and other management personnel are included in the ratios.[color=#333333]
[color=#333333]- [color=#333333]nurse administrators and other management personnel are allowed to relieve for breaks.[color=#333333]
[color=#333333]- [color=#333333]there are no definitions of hospital units.[color=#333333]
-no restrictions on the use of video cameras/monitors or any form of electronic visualization of a patient as a substitute for the direct observation required for patient assessment by the direct care registered nurse and for patient protection required by an attendant (sitter). [color=#6f326a]
[color=#333333]- [color=#333333]no national acuity tool, the hospital approves the acuity system[color=#333333]
[color=#333333]- [color=#333333]establishes lvn or lpn ratios. minimum ratios must be rn. [color=#333333]
[color=#333333]- [color=#333333]no restrictions on the use of unlicensed assistive personnel (uap)[color=#333333]
[color=#333333]- [color=#333333]no "zero lift" policy mandate no strengthening of national emergency preparedness [color=#333333]
[color=#333333]- [color=#333333]no nurse title protection or license status disclosure requirements[color=#333333]
[color=#333333]- [color=#333333]no registered nurse workforce initiatives to achieve immediate short and long term mitigation and remedy of the nationwide nursing shortage [color=#333333]
[color=#333333]- [color=#333333]no specific monetary fines against the employer or an employee of the employer for violating employee's rights[color=#333333]
[color=#333333]- [color=#333333] no specific monetary fines for violating ratios.[color=#333333]
- [color=#333333]allows for hospitals to receive additional medicare and medicaid reimbursement related to costs incurred related to compliance with this bill.
Apr 29, '08RN Power-
I don't have your legal training, and perhaps lack the patience to read a bill that is 20 pages long...but I'm not sure that our legislators would either. (And many judge bills based on their summaries because reading the entire text takes time)
I disagree on many of the issues you raise with 2123: "averaging" is barred by the language, competency is addressed, and there are $ penalties as reimbursement is tied to it. While there are no set fines for violating the nurses right to report the hospital, the language gives the nurse the right to sue the hospital for lost wages, attorney's costs and damages. Some of the issues you raise deserve their own bill and many of these issues are addressed in separate bills already- zero lift, Kentucky River (RESPECT ACT). The title and scope of practice issues belong in state legislation as that is where they already live.
And why not work together with other nurses on this legislation if you want to improve it?? Does it always have to be by "CNA" to be worthwhile?
Apr 29, '08Interesting..
I just read the Californis bill from 99- I didn't realize that it did not specify the ratios and that the numbers were really up to the DHS.
Apr 29, '08No it does not have to be CNA to be good.
There are big prolems with the state nurse practice acts in most states and this is driving the need for effective legislation elsewhere. State BON will not get involved in employer- employee relations this creates big problems for vocal nurses.
We already have the right to sue for lost wages but are not protected to blow the whistle... ask all the nurses on the threads re: retaliated against for speaking up etc.
Read Accountable but Powerless by Barry Adams, RN.
Examine the effectiveness of provisions of other state level bills or lack there of.
I just know that the language needs to be very strong with NO room for wiggle or the hospital WILL wiggle.
I agree it is better than most state staffing ledislation and JCAHO but not quite strong enough to prevent violations. It has to hurt to violate the law or it will be easy to ignore. Sad but true in this bottom line focused world.
We have a great shot at "getting it all" why not try?
Apr 29, '08I found it! This document - though long is worth reading. It describes how the ratio's were devised.
STATEMENT OF REASONS:
May 17, '08Quote from RN Power OhioThanks, and you're so right. A twelve year fight, involving thousands of our members who lobbied, wrote letters, and visited their legislators and attended hearings to provide testimony to expose unsafe industry staffing that harms patients; and, about why legal, minimum standards are necessary. Also, it's important to note, that the ratio fight is a collective, dues supported advocacy campaign that altruistically benefits all nurses and all patients.JuliaRN,
There was a very long process involved in coming up with the ratio's.
Here's a link to the timeline:
Julia asked a question in a previous post on this thread, "Does it have to be CNA to be good?" You provided a thoughtful reply, and I would hope that the powers that be in the ANA would make a conscious attempt to avoid being the handmaidens of the healthcare industry. Hopefully they'll consider the constructive criticisms you've posted and recognize the fundamental flaws in their (UAN/SEIU) bill. Patients and direct care registered nurses will derive no real benefit from it, as written.
The danger of poorly worded, incremental attempts at reform, such as the ANA/2007 legislation, is that it holds little promise for promoting effective staffing; it merely codifies current practices in hospitals, that gives administrators supreme flexibility to maintain the status quo. As you've pointed out, there are no genuine, enforceable, universal standards.
It may be a well-intentioned attempt to "do something", but the ANA bill is like putting a fresh coat of paint on an old house. It does nothing to repair the delapidated infrastructure, so it remains unsafe for patients, and unsafe for nurses. It delays and hides the need for real repairs. It's like a placebo, a sugar pill that won't be effective in restoring optimum wellness to a diseased system. Individual nurses will continue to be blamed for errors that are the result of this system problem. The ANA's so-called "reform" bill perpetuates, for all intents and purposes, a bottom line driven staffing "system" that increases risks and costs of preventable harm, complications, and death for patients, while maximizing profits for hospitals.
May 17, '08Quote from rn4mercyyou're talking about two different bills here-julia asked a question in a previous post on this thread, "does it have to be cna to be good?" you provided a thoughtful reply, and i would hope that the powers that be in the ana would make a conscious attempt to avoid being the handmaidens of the healthcare industry. hopefully they'll consider the constructive criticisms you've posted and recognize the fundamental flaws in their (uan/seiu) bill. patients and direct care registered nurses will derive no real benefit from it, as written.
the danger of poorly worded, incremental attempts at reform, such as the ana/2007 legislation, is that it holds little promise for promoting effective staffing; it merely codifies current practices in hospitals, that gives administrators supreme flexibility to maintain the status quo. as you've pointed out, there are no genuine, enforceable, universal standards.
it may be a well-intentioned attempt to "do something", but the ana bill is like putting a fresh coat of paint on an old house. it does nothing to repair the delapidated infrastructure, so it remains unsafe for patients, and unsafe for nurses. it delays and hides the need for real repairs. it's like a placebo, a sugar pill that won't be effective in restoring optimum wellness to a diseased system. individual nurses will continue to be blamed for errors that are the result of this system problem. the ana's so-called "reform" bill perpetuates, for all intents and purposes, a bottom line driven staffing "system" that increases risks and costs of preventable harm, complications, and death for patients, while maximizing profits for hospitals.
i agree with all your comments concerning the ana staffing bill- s.73/hr.4138. i like to call it the "ana/aha" bill.
i am lobbying for h.r. 2123- which you refer to as the uan/seiu bill. h.r. 2123 is nothing like the ana bill. it has mandated minimum ratios for direct care registered nurses- the numbers are in the bill. ana had nothing to do with this bill and most likely won't have anything to do with it. (perhaps that's part of the story behind their wanting nothing more to do with the uan?)
i appreciated rn power's suggestions and think some of the "perfecting" can take place in either the regulations process or be added for the next congress. my suggestion was that the organizations that believe in real staffing legislation work together to achieve it. much as management dominated organizations have worked together (and are succeeding) at getting their "status quo" staffing legislation in states like washington, oregon and ohio (they left the uan, btw).
there are progressive states and progressive nurses in the ana who have fought for change from within and they have fought us back (a whole other story). some of these states have introduced real staffing legislation- mn, mi, ny and others.
but please, recognize that there are two bills and states within ana that support a different bill than ana does. many nurses fought hard to be able to do this. acknowledge their determination and victory- almost double the co-sponsors of the ana bill!
get more information about h.r. 2123, the safe nurse staffing for patient safety and quality care act of 2007 here:
bill summary and status http://thomas.loc.gov/cgi-bin/bdquery/z?d110:h.r.02123:
bill text http://thomas.loc.gov/cgi-bin/query/z?c110:h.r.2123:
see also: http://capwiz.com/criticalcare/issue...?bill=10365041
May 29, '08I too support this bill and am in the process of writing several of my legislators. I also posted a request to gather stories about what it has been like to work with high patient ratios. I want to use some of these stories to emphasize the need for safe nurse patient ratios. I've only gotten 2 responses and I've been deeply disappointed.
I've read everyone's responses here and I'm very surprised at some of the discussion. Don't you all want a safer work environment? Don't you want to provide the best care possible? Why are we picking apart wording and complaining about what's not in the bill. Some of these things already have their own bills. We are getting off track. Nurses are the largest healthcare professional group and numbers mean power. We need to ban together and fight for safe ratios. I've been a nurse for 14 years and I was very tired of running around the entire shift trying to care for as many as 10 patients at times. We all now that each patient comes with family members that also take up your time. Not to mention juggling doctors, labs, radiology, OR etc etc. for each patient and if one goes bad forget it...the rest might be neglected, heaven help you if 2 go bad at the same time (I've had that happen).
Some of you mentioned California and their ratio law. I currently work in California. This took a long time to implement and we are still working out the kinks but it is sooo much better. I can actually do med pass, treatments etc. on a timely bases, I can spend quality time with my patients and their families. I've been able to see early signs of patients deteriorating and have been able to intervene before things went bad. I'm able to get off work on time, take lunch and yes even go to the bathroom :chuckle. I feel like I can breathe and I don't dread going to work. I'm not saying everyday is perfect but its about 95% better.
This bill is a start. We can always ask for amendments if needed. Instead of being picky about wording and worrying about which group (ANA, CNA SEIU) is backing this bill and their true motives...do this for you! Nursing is hard back breaking work and the new generations are being turned off by what they see us go through now. If we implement safe ratios it can indeed help with the nursing shortage. California is already seeing more nurses come here to work and more students going into nursing.
If you don't like this bill suggest a bill that you do like and write your representatives. I'm not hearing that here. There's a lot of critisim but I'm not hearing solutions. Lets work together to make nursing safer not only for ourselves but for our patients as well. (sorry this is so long...just really suprised and disappointed).
Oct 22, '08God bless you for your insight and courage! I am a Licensed Practical
Nurse in the 2009 graduating class for my RN. The patient to nurse
ratio in my long term care facility is 40-1 for myself and the charge
nurse. I will be sending the letter but frankly I must admit I am scared
and discouraged. I loooove nursing but it must get better!