Ill: Proposed legislation negates nursing discipline, professionals say

  1. Patient safety is best determined by the nurses, not the state, local professionals said in response to proposed legislation that would mandate nurse-to-patient ratios.

    More... Proposed legislation negates nursing discipline, professionals say (St. Clair County Journal)
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  2. 11 Comments

  3. by   Jolie
    Oh Puhleessee! Can anyone name an IL hospital where staffing ratios are actually determined by Registered Nurses now, especially RNs who are bedside care givers? I bet not. They are determined by administrators and bean counters.

    This article insults my intelligence. It implies that RNs now have the authority to set staffing ratios, which we all know to be largely false, and would lose that autonomy should this safe staffing law pass. So thank goodness the INA compromised with the IHA to insure that RNs can continue to set their own staffing ratios...not! Just another example of the INA caving in and failing to protect the interests of the nurses and patients they claim to represent. Glad I cancelled my membership 19 years ago!
  4. by   pickledpepperRN
    "Peverly said she appoints staff based on patient acuity"

    SHE is not the direct care nurse responsible for patient care! I doubt SHE assesses all the patients and doubt she listens to the nurses SHE assigns to more than six patients.

    "If you have a mandated ratio, that means that you must have, for example, six patients to one nurse," she said. "If you look at the needs of those patients, you have to assume that all those patients have the same needs, and that's not true."

    Peverly said she appoints staff based on patient acuity, or the level of care that is required to meet the needs of each patient. Staffing numbers are in constant fluctuation as a result.

    http://stclairjournal.stltoday.com/a..._nurse.ii1.txt
    Chicago Tribune
    January 31, 2006
    Saying better nurse-staffing levels would protect patients, officials from two Chicago-area unions vowed Monday to step up their drive for state approval of mandatory nursing ratios at Illinois hospitals.

    http://www.reformresurrection.org/im...urse%20r...pdf
    Last edit by pickledpepperRN on May 1, '07 : Reason: typo
  5. by   pickledpepperRN
    Here is the bill:

    http://www.ilga.gov/legislation/full...Sess=&Session=

    Synopsis As Introduced

    Creates the Nurse Staffing Standards for Patient Safety and Quality Care Act. Provides that every hospital must implement a staffing plan that:
    (1) provides adequate, appropriate, and quality delivery of health care services and protects patient safety; and
    (2) is consistent with the requirements of the Act concerning minimum direct care registered nurse-to-patient ratios.

    Sets forth minimum direct care registered nurse-to-patient ratios, according to the type of hospital unit. Provides that the Department of Public Health may apply those minimum direct care registered nurse-to-patient ratios to another type of hospital unit if that other unit performs a function similar to the function performed by the unit referred to in the minimum ratio standards. Provides that the minimum direct care registered nurse-to-patient ratios do not apply during a declared state of emergency if a hospital is requested or expected to provide an exceptional level of emergency or other medical services.
    http://www.ilga.gov/legislation/Bill...ionID=51&GA=95
  6. by   Jolie
    "If you have a mandated ratio, that means that you must have, for example, six patients to one nurse," she said. "If you look at the needs of those patients, you have to assume that all those patients have the same needs, and that's not true." Quote from Peverly, in spacenurse's post above
    So she's trying to tell us that it would not be permissible for the nurse to have LESS than 6 patients?


    Peverly said she appoints staff based on patient acuity, or the level of care that is required to meet the needs of each patient. Staffing numbers are in constant fluctuation as a result.
    Quote from spacenurse's post above

    I'm quite sure that those fluctuations are upward, not downward based on acuity.
  7. by   pickledpepperRN
    Quote from Jolie
    "If you have a mandated ratio, that means that you must have, for example, six patients to one nurse," she said. "If you look at the needs of those patients, you have to assume that all those patients have the same needs, and that's not true." Quote from Peverly, in spacenurse's post above
    So she's trying to tell us that it would not be permissible for the nurse to have LESS than 6 patients?


    Peverly said she appoints staff based on patient acuity, or the level of care that is required to meet the needs of each patient. Staffing numbers are in constant fluctuation as a result.
    Quote from spacenurse's post above

    I'm quite sure that those fluctuations are upward, not downward based on acuity.
    I don't see anything in the bill stating she can't assign LESS than six patients to a nurse because the acuity is high.(to use her example).
    http://www.ilga.gov/legislation/full...ss=&Sessio n=
  8. by   RN34TX
    Quote from Jolie
    Oh Puhleessee! Can anyone name an IL hospital where staffing ratios are actually determined by Registered Nurses now, especially RNs who are bedside care givers? I bet not. They are determined by administrators and bean counters.

    This article insults my intelligence. It implies that RNs now have the authority to set staffing ratios, which we all know to be largely false, and would lose that autonomy should this safe staffing law pass. So thank goodness the INA compromised with the IHA to insure that RNs can continue to set their own staffing ratios...not! Just another example of the INA caving in and failing to protect the interests of the nurses and patients they claim to represent. Glad I cancelled my membership 19 years ago!
    Excellent post!
    Just like INA in your neck of the woods, TNA down here just did the same thing by dogging efforts in Texas to mandate patient ratios with some of the most weak excuses I've ever heard such as the bill only covered hospital nurses and didn't include other practice areas so we can't support it.

    Just who exactly are these nurses associations supposed to be representing? That article does indeed insult our intelligence as nurses.
    The day that the bedside care staff nurse determines the staffing ratios at any hospital is the day I return to med/surg floor nursing.
  9. by   Simplepleasures
    Nursing associations without any power behind them are as useless as...... well anywaywhy do these hospital and so called nurses associations continue to underestimate the intelligence of nurses? It is up to us to get the state or federal mandate that gives us the REAL clout that is required to affect change.And even then it is a fight to get the hospitals to honor the law, requiring STIFF penalties and BRAVE nurses that are willing to report it.We need to recognize that there is power in numbers and put our trust in associations or unions that PROVE they can back us up with LAWS.
  10. by   lindarn
    Quote from ingelein
    Nursing associations without any power behind them are as useless as...... well anywaywhy do these hospital and so called nurses associations continue to underestimate the intelligence of nurses? It is up to us to get the state or federal mandate that gives us the REAL clout that is required to affect change.And even then it is a fight to get the hospitals to honor the law, requiring STIFF penalties and BRAVE nurses that are willing to report it.We need to recognize that there is power in numbers and put our trust in associations or unions that PROVE they can back us up with LAWS.
    nursing associations without any power behing them are as useful as tits on a bull, as we say in NY. Washington State is the same.

    Lindarn, RN, BSN, CCRN
    Spokane, Washington
  11. by   Jolie
    I expect the American and Illinois Hospital Associations to undermine nurses' efforts to secure safe staffing ratios. They are (very short-sightedly) looking out for the financial interest of their clients, hospital organizations and administrators.

    But it galls me to see the INA hop in bed with them. INA actively solicits nurses as members, accepts their dues, and then fails to represent their interests.
  12. by   glasgow3
    When one of the nursing executives complained of the difficulties they would have providing relief for lunches and breaks while at the same time maintaining fixed staffing ratios, it occured to me that in such articles the "tough" follow-up questions never seem to be asked.

    Why is it she wasn't asked how breaks are currently addressed in her facility? Odds are that for those periods, some nurse with a full patient assignment of their own is "covering" the nurse on break. Do patient "needs" magically drop by half during such periods?

    And why are these executives never pressed about the methodology/evidence supporting their current staffing practice and why evidence demonstrating that staffing below specified levels adversely affects complication/mortality rates should be ignored in favor of their systems? And why don't the journalists ask permission from these executives to question their direct care nurses as to whether or not their so-called needs/acuity based staffing system is "working?"

    The sad truth is the continued existence of most so-called professional nursing organizations is far more important to the hospital administrators/executives than the average direct care nurse-------they provide the muted and ineffective counterpoint to the hospital industry's half truths and outright lies regarding an obviously broken system.
  13. by   oramar
    Boy I really like you guys. Don't hold back, say what you really think. I was going to write something caustic myself but I don't need to it has all been said in previous post. All of which are insightful and totally correct.

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