why can't nurses get safe staffing laws passed - page 2

Why does it seem that nurses here in the USA cannot get safe staffing laws passed. Only California has been able to do this... Read More

  1. by   juan de la cruz
    I've seen how the California law have impacted nursing care in hospitals in California as someone who also have a perspective of working in another state. It's made a huge difference in nursing staff satisfaction and hence, the surplus of hospital nurses in California. However, does anyone think that because the results of the outcome studies on the California staffing law have been mixed in terms of patient specific outcome results which has made it harder for similar laws to be passed in other states? Does it also have to do with the fact that ANA does not endorse specific staffing ratios at all?
  2. by   not.done.yet
    Because our government is controlled by big business lobbyists and healthcare is one of them. Staffing ratios eat into profit.
  3. by   Danielle9515
    I absolutely agree that nurses should have staffing ratio laws! I am in school for my BSN and recently did an assignment about this topic. Unfortunately, hospital administrators are going to try and stop any legislation change that will cost them more money, even if it is at the cost of the patients. Healthcare systems are being pushed more than ever to be efficient with their spending- which they do by cutting staffing.

    I think it is senseless for nurses to work with high patient loads. The research that supports low nurse to patient ratios has been around since 1990s! In 1999 it was found between 168 hospitals in Pennsylvania, “investigators reported that for each additional patient a nurse was assigned, there was a seven percent increase in the likelihood of dying for a patient under that nurse’s care” (f/ Nursing World).

    I don't see how mandated staffing ratios could be in the near future for areas that are more conservative like Ohio. I think it is great that California and New York have passed laws. Hopefully, in the years to come more research will be published that shows how safe nurse ratios help patients and hospitals!

    Realistically, one step towards safe ratios would be if hospitals had to report their staffing ratios as one of their public statistics. Right now, "hospitals aren’t required to disclose staffing ratios at all, which makes it difficult to track whether they’re improving or to compare one hospital with another. If nurse-to-patient ratios became one of the public metrics that go into rankings and evaluations" (Washington Post). The statistics could also be used to prove that hospitals with horrible nurse-to-patient ratios have poorer patient outcomes and cost hospitals more money in the long run.

    Washington Post: More nurses are better for patients. Why is it so hard to get hospitals to hire them? - The Washington Post

    Nursing World: Mandatory Hospital Nurse to Patient Staffing Ratios: Time to Take a Different Approach
  4. by   RNOTODAY
    Because hospitals have lobbyists, many many of them with unlimited $$$ behind them.
    california did because, well California should be considered its own country, plus the CNA-- their union, is the best and most powerful in the country
  5. by   herring_RN
    Quote from RNOTODAY
    Because hospitals have lobbyists, many many of them with unlimited $$$ behind them.
    california did because, well California should be considered its own country, plus the CNA-- their union, is the best and most powerful in the country
    I believe other states can do it too. It took us a long time in California.
    In 1995 we voted at our CNA Convention by 92 percent to leave the American Nurses Association (ANA) because the national organization was not yet ready to insist on safe staffing with minimum ratios.
    We adopted a program to reallocate resources to organize RNs, strengthen contracts, confront hospital industry attack on RN jobs and practice, and enact legislative and workplace protections.
    Last edit by herring_RN on Apr 12, '17 : Reason: typos
  6. by   SobreRN
    And we had an ally in democratic governor Gray Davis at the time.
  7. by   Orca
    People who live in states in which Republicans hold sway - and that is most of us - can forget about anything being done that cuts into corporate profits. That isn't a statement on partisan politics, just how it is.
  8. by   music42RN
    ANA relies on funding from RNs, there are initiatives to un-bundle RN care from billing so higher needs patients are billed more, but nothing is really happening. California made progress because of the powerful union. From my perspective ANA is more focused on expanding NP roles, and does not appear to have meaningful activities on improving acute care or LTC RN nursing environment or workload. I'm not a good organizer, I've only been a nurse for 2 years - I have no clue what my charge or manager does, but they are almost never on the unit but they are considered "available resources". Things just keep getting worse every 6 months. In two years the amount of charting I'm required to do has increased by OVER 450%. If I have to work late to get my charting done that is part of my job, I still am required to take a lunch (even if I can't), and if I have to stay 2 hours late to chart and I'm on the floor the next night, that's my problem because I asked shifts in a row. I am just a number and my dedication is used against me for the hospitals gain. No wonder we can't organize - we are exhausted. Allnurses is the only hope I can see for helping change this.

    I don't want to move to Ca, but I'm not seeing many other choices. Is anyone else out there willing to donate a few hours a month for use to form our own lobby. We have to start somewhere, what other professions work in similar conditions. This can be stopped, much of the workload is form patients who should not have been admitted and take huge amounts of our time because they want hotel service. We can form a lobby, we can eliminate or modify HICAPS - but we need vast numbers of changers not just complainers.
  9. by   herring_RN
    A great positive step is the ANA sponsoring a very public event in our nation's capitol. The announcement has already been posted here:
    Nurses' march in DC?
    The 2017 Rally for Nurse-Patient Ratios , will take place on May 5th 11a-4p at the Capitol Building, in Washington, DC.
  10. by   herring_RN
    Quote from SobreRN
    And we had an ally in democratic governor Gray Davis at the time.
    He was the only candidate of any party willing to promise to sign the bill if it passed.
    So hundreds of us worked on his campaign.

    Our major elected hero was non LA County Supervisor Sheila Kuehl.
    This is from the bio on her Supervisor's page regarding her time as a state senator:
    She authored 171 bills that were signed into law, including legislation to establish paid family leave, establish nurse to patient ratios in hospitals; protect the Santa Monica Mountains and prohibit discrimination on the basis of gender and disability in the workplace and sexual orientation in education.
    She fought to establish true universal health insurance in California.

    Meet Supervisor Sheila Kuehl
    Last edit by herring_RN on Apr 16, '17
  11. by   nurseburst
    Quote from Wlaurie
    These bills never include ltc. That can be very unsafe. At times I was left with 54 patients and I worked 2nd shift not midnights. Then they want to tell me I don't have good time management. One night I had a doctor wanting to give me orders, a patient's daughter on the phone complaining about care, meds I still had to pass, phones ringing off the hook, another patient at the desk making a phone call, mysteriously no cenas around to help. Then I got called in the office at a later date and was told I don't have good time management skills. Their solution was to make the doctor wait, pass my meds and take the portable phone with me to answer calls while I pass out meds.....right. Nothing unsafe about that. How about an extra nurse, that's what I would tell them now. Patient care is first priority. Answering the phone is not at the top of my list but it was theirs. People were complaining bc they couldn't get ahold of their loved ones....geesh.
    Wlaurie, do we work at the same facility? I think we got the same managers too...work same shift too!!!

    Anyway, someone want to let me live with them while I try to move to Cali?

    I would really like to get involved and try to push similar laws that in Cali and NY to other states (starting with Florida!!!) but I do not know where to start... and I definitely see where it is needed in LTC too. I cannot say how often I have been told, "You are not short staffed... per the law you can have (insert number here) on this shift" but no one is taking into account acuity, emergencies, family members, THE WORKLOAD...
  12. by   vyecheverria
    I don't know about the numbers but I can guess that the US does not have high union membership rates.

    I've worked in both Australia and NZ and union membership rates are very high. It is hard to come by a nurse colleague who is not a union member. As a result, all hospitals are unionised. The unions negotiate pay rises every year, weekend penalties of 50-75% of the hourly rate, night shift penalties of 20 to 25%, afternoon shift penalties of 12.5 to 25%, 6 weeks of paid vacation leave for everyone regardless of seniority (you get long service leave after a certain number of years of service), double pay for public holidays (x1.5 to x2.0 for Australia depending on the holiday) 10 days of paid sick leave, generous professional development leave, professional development allowances, and the list goes on and on and on. And there are some Australian states that have legislated nurse-patient ratios (not sure about NZ but we never get more than 6 on a PM shift, or more than 5 on an AM shift). The union actually holds the power and as such enterprise bargaining almost always results in a positive result for nurses (the negative being pay rises will sometimes only reflect CPI changes and inflation).

    The glaring difference between the USA and NZ and Australia is publicly-funded healthcare which is seen as a right in NZ and Australia so they don't have a user pays system.

    Are American nursing unions actively promoting their union and recruiting members? Sometimes it can get very political as well and the union leaders will only look out for their own interests.
  13. by   herring_RN
    In the early 1990s when we were beginning the struggle to achieve nurse-t-patient ratios in California our role models were the Victoria, Australia nurses who were the first in the world to get safe staffing ratios. Our is a state law and theirs were first achieved for their union contract. In 2015 they became law!

    National Nurses United (NNU) and National Nurses Organizing Committee (NNOC) are unions started by California nurses for the entire United States.
    Recent Victories:
    Organizing Victories | National Nurses United

    Here is contact information:
    Who We Are | National Nurses United