Registered Nurse Safe Staffing Act (THIS ONE IS IMPORTANT!)

Nurses Activism

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The House has introduced the Registered Nurse Safe Staffing Act of 2007 on November 9th. It is important that we speak out on this issue and not let it fall through the cracks!

You can view the bill in it's entirety here.

I've also posted some other helpful links here.

Let your voices be heard, nurses!

Specializes in Vents, Telemetry, Home Care, Home infusion.

law specific to hospitals:

h. r. 4138to amend title xviii of the social security act to impose minimum nurse staffing ratios in medicare participating hospitals, and for other purposes.

ana has been spearheading this legislation since 2005:

read the april 4, 2005 capitol update article on the rn staffing act

ana applauds introduction of registered nurse safe staffing act (11/13/07) [pdf]

once legislation adressed for hospitals (biggest impacet on staffing), will be able to then work on crafting legislation for skilled nursing facilities, rehab and other type units.

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I thought I read this facility based "flexibility" in the Capps bill.

What is the reason for different minimum ratios at each facility?

Critical care patients should never have to share their nurse with more than one other patient. Critical care patients held in the ER must be staffed at this level too.

A circulating nurse must never leave the OR when a patient is present.

The hospitals have had supreme flexibility and many if not most have failed to staff according to the needs of their patients. SO staffing by acuity with legally mandated minimum nurse to patient ratios must be the standard.

No hospital will be able to assign more patients to a nurse than the ratio for that patient. They will have the flexibility to assign fewer patients and add staff.

This bill is not what it seems.

The American Nurses Association (ANA) supports the establishment of nurse-patient

ratios to address the current staffing crisis, but feels strongly that these ratios must be

set, not by legislators or government officials, but in the workplace in direct

coordination with nurses themselves, and based on unit-by-unit circumstances and

needs.

ANA supports efforts to mandate establishment of valid and reliable nurse

staffing systems in acute care and to require standard, public reporting of nurse staffing

levels and mix and patient outcomes.

http://nursingworld.org/MainMenuCategories/ANAPoliticalPower/Federal/LEGIS/AppropriateStaffing.aspx

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I'll be the first to admit it's not perfect. But what I REALLY like in the bill (other than it's at least a start) is the little thing about having to post how many licensed personnel are on the unit. I would adore having my patients see how many other patients I'm taking care of. Especially if I'm working at a hospital that has me scripting, "Is there anything else I can get for you, I HAVE THE TIME!"

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Specializes in Biomedical, Hospice, LTC, Office.

Heh, sorry to be kinda doubtful about how well it will work, I just think the facilities will forget opting for RN's and hire LPN's who aren't protected by law and continue playing the same old game. Maybe I'm jaded, or maybe I've just seen too much.

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So when do we know if it passed or not?

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I looked really hard, and I can't find the section where this bill requires the nursing fairy godmother to wave her magic wand and produce RN's in the marketplace sufficient to meet the staffing standards.

There are X number of nursing positions required for full staffing nationwide. Every current study indicates that there are fewer available nurses than there are positions to fill. Mandating lower nurse to patient ratios isn't going to do *anything* to address the problem. The nurses simply don't exist to fill these positions no matter how many laws you pass requiring them to be filled.

What I do see is yet more paperwork, more record keeping and more administrative obligations. Guess what? That means the hospital has to hire more people to manage the data which means less money to hire nurses.

Sorry about your next pay raise, but we needed it for more office staff to maintain our staffing records for three years.

:angryfire

Breathe....Breathe.... Ah. I'm better now.

I beg to differ with you. There are 500,000 nurses in this country who have left the profession. It has been shown that when hospital pay nurses more and improve staffing, they come back to work. It is as simple as that. It is also called, SHOW ME THE MONEY!!

The problem is that hospitals do not want to pay more money to bring these nurses back to work, do not want to improve working conditions, and benefits. Why do we allow them to play these games? They will continue until we DEMAND HIGHER PAY, AND BETTER STAFFING. It is also called, the squeaky wheel gets the grease.

This will continue until nurses get serious about controlling our profession. The hospitals are hoping that they can delay any of the above improvements, until they can pressure law makers to dumb down and de skill our profession more than it already has. Then they can run a hospital with a skeleton crew of licensed staff, just like nursing homes do.

Lindarn, RN, BSN, CCRN

Spokane, Washington

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Regarding how ratios help solve the nursing shortage:

http://www.calnurses.org/assets/pdf/ratios/ratios_solve_rn_shortage.pdf

The problem with this bill is that it does not require minimum safe staffing. I allows hospital administrations supreme flexibility so long as direct care nurses provide "input".

Hospitals have always had flexibility and too many fail to provide sufficient nursing staff

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Specializes in Vents, Telemetry, Home Care, Home infusion.

Federal govenment regulations involving Medicare payments to facilities already has language re staffing.

42 Code of Federal Regulations (42CFR 482.23(b)) requires hospitals certified to participate in Medicare to "have adequate numbers of licensed registered nurses, licensed practical (vocational) nurses, and other personnel to provide nursing care to all patients as needed".

The legislation being reintroduced will strenghten the existing regs while allowing for staffing based on type of hospital and patient acuity AND giving bedside nurses input into the staffing guidelines, rather than management alone.

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Hospitals will claim the do, "have adequate numbers of licensed registered nurses, licensed practical (vocational) nurses, and other personnel to provide nursing care to all patients as needed".

We know all too many do not.

I know facilities that have a meeting whetre they dictate to nurses after "listening" to us. They use the sign in sheet as evidence that we had input. But they had already created the policies.

SO we in California worked for specific ratios.

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Specializes in CCRN, ATCN, ABLS.
I looked really hard, and I can't find the section where this bill requires the nursing fairy godmother to wave her magic wand and produce RN's in the marketplace sufficient to meet the staffing standards.

There are X number of nursing positions required for full staffing nationwide. Every current study indicates that there are fewer available nurses than there are positions to fill. Mandating lower nurse to patient ratios isn't going to do *anything* to address the problem. The nurses simply don't exist to fill these positions no matter how many laws you pass requiring them to be filled.

What I do see is yet more paperwork, more record keeping and more administrative obligations. Guess what? That means the hospital has to hire more people to manage the data which means less money to hire nurses.

Sorry about your next pay raise, but we needed it for more office staff to maintain our staffing records for three years.

:angryfire

Breathe....Breathe.... Ah. I'm better now.

You are absolutely mistaken. Hospitals will have to make nurse administrators start going back to the floors (haha, I would like to see you do that). In fact, if this passes, bedside nursing will be the highest paid nursing specialty, to the detriment of desk jobs (cleaning poo will finally be a glorified and highly paid task, as it should be).

BTW, this issue is about safety, not data management. Where did you come up with that idea??

Regardless, what is true about staffing ratios is that they will increase healthcare costs, because hospitals won't be able to make money (or as much money, lol) and will have to raise the fees. That is the biggest hurdle in congress, and why this bill will probably not go anywhere anytime soon (I'll believe it when I see it).

I suggest that congress amend the bill to include caps on salaries for hospital CEO's, CFO's, and DON's. The hospital CEO where I work makes 900K a year BEFORE BONUSES (this is published in the local newspaper) That pays for 20 new grads. (I'd do it for 1/3, lol)

wayunderpaid

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This bill does not have mandatory minimum RN to patient ratios with the requirement to add staff according to the needs of the patients.

I am afraid it is a waste of effore.

In addition hasn't it been proposed many times already?

Why aren't the organizations suporting it working it?

Are there rallys? Classes? True letter writing campaigns? Petitions?

But the spirit of it is great! NURSING CARE is why there are hospitals.

We who provide direct patient care are the indespensable people 24/7. Who else?

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Specializes in Med/Surg/Tele, Hem/Onc, BMT.

This national bill looks a lot like the ineffective bills put forward in several states that require staffing plans but do not mandate minimum ratio's and then adjust for acuity. Did I miss something? If you read how the ratio is determined (acuity only) there is still no real protection for patients. Without an established minimum guarantee the hospital can still determine what they consider to be safe! Again I see the nursing committee to provide input..but nothing to hold the hospital accountable.

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