Pennsylvania Lawmakers Consider Nurse-Patient Ratio Legislation - page 2

by geekgolightly

I am moving to Erie by fall this year, and am wondering what the staffing ratio is in med-surg, tele and ICU. Erie area numbers are perfect, but I am curious about any ratios in PA. Thanks! kathy... Read More


  1. 0
    Quote from K98
    That's news to me. My daughter was mandated last week. Twice.
    I would suggest you encourage her to check her policy and procedure manual on the topic. My boss would try to mandate, but we knew that it was against "darkside" policy and did not fall for it.
  2. 0
    I interviewed with the two major hospitals in Erie and one of them has a medsurg ratio of 8+ on nights and 6+ on days. I don't know the numbers for the other hospital; I never asked. I was interviewing for ICU positions at both hospitals.

    The ICU's, OTOH are 1:2 unless they are on CRRT or other intensive monitoring and needs and then it's 1:1. They do stack higher, but only with tele or floor orders that are awaiting transfer. One of the hospitals has a charge nurse without patients and one has the charge nurse take patients. I chose the one with a free charge nurse. That hospital also seemed to be more into teaching in general, which I appreciate and need at this point as I will be new to ICU nursing.
  3. 0
    i work in a hospital about 2 hours outside of pittsburgh. normally our ratio is 5-6 per nurse. the other night i did have 6 patients and covered 4 patients for an LPN
  4. 0
    Pennsylvania Lawmakers Consider Nurse-Patient Ratio Legislation

    Rest of the story here…

    http://www.rwjf.org/humancapital/digest.jsp?id=9562

    Source: http://www.afscme.org/workers/68.cfm
  5. 0
    My gripe is that SEIU is trying to make the numbers cut and dried, black and white. The objective of ancilarry staff is not being addressed. Yes, I may only have five patients, but there's no aide, one person in pharmacy (for the whole 800+ bed hospital), only one person in central supply and he can't leave to deliver your equipment (Yet, when there were three people earlier when the supplies were ordered, why didn't they send it then? ), no secretary, etc. I still won't be able to provide good care to those patients b/c I'm forced to wear too many other hats. When the hospital has to comply with specific ratios for nurses, they just cut corners somewhere else. Until that issue is addressed, the ratio numbers won't mean a lot and SEIU refuses to aknowledge that.
  6. 0
    Quote from NurseyBaby'05
    My gripe is that SEIU is trying to make the numbers cut and dried, black and white. The objective of ancilarry staff is not being addressed. Yes, I may only have five patients, but there's no aide, one person in pharmacy (for the whole 800+ bed hospital), only one person in central supply and he can't leave to deliver your equipment (Yet, when there were three people earlier when the supplies were ordered, why didn't they send it then? ), no secretary, etc. I still won't be able to provide good care to those patients b/c I'm forced to wear too many other hats. When the hospital has to comply with specific ratios for nurses, they just cut corners somewhere else. Until that issue is addressed, the ratio numbers won't mean a lot and SEIU refuses to aknowledge that.

    Yeah, I think any legistlation needs to be mindful of all that. I also think that ratios should be determined based on acuity. We have functioned without a secretary on nights and we sometimes don't even have an aide or the aide has 21 pts to care for. We may have as many as 3 vented patients with all that goes along with those pts such as isolation, diarrhea, bed sores, tube feedings and our managers seem to have little concern about the ability of one nurse to handle such a load. Another nurse may have 3 patients who are only on our unit because they need monitored beds and are up with bathroom privileges. Something is bad wrong with this, I keep putting it in my comments everytime they give us one of those surveys to fill out, but seems to go unnoticed. I could take care of 3 vented pts with issues if I have good tech support, but if the tech is non existent or has 21 pts to care for, then it is next to impossible. Thank goodness we do have great respiratory support.

    I wouldn't even begin to know how to utilize a secretary because we never have had one.

    Mahage
  7. 0
    I just finished doing a paper on PA nurse-to-patient ratios for my ethics class. It's interesting how at first ratios seem like such a great idea (especially if you have 8-10 or more patients), but once you realize that they may not be thinking about secretaries, CNA's, or other ancillary staff, you begin to realize there could be problems. I think that in order for a law to be passed that will actually work, there needs to be good input from floor nurses telling Harrisburg that we need our support staff, and we need a flexible ratio (flexible based on acuity).
  8. 1
    prior hb171 introduced in 2007-2008 legislative session introduced by rrp. solobay, never made it out of health and human services (hhs) committee:

    hb 171 amends the health care facilities act, further providing for purposes & duties of the dept. of health, for admin & licensure; for public disclosure of staffing requirements; for license standards; & for medical assistance payments. sets specific patient-to-nurse staffing ratios based on the type of care needed in a particular hospital or care unit. ratios would range from 1:1 in emergency trauma room and or; 1:2 in critical care, pacu and l+d units; 1:3 ed; 1:4 med surg/ acute psych; 1:5 rehab, up to 1:6 in postpartum and well-baby nursery units.
    solobay’s legislation includes grant programs to encourage more students in nursing education programs.
    hb 147 health care facilities act, again referred to hhs committee.
    the staffing plan must incorporate, at a minimum,
    the following direct-care nurse-to-patient ratios:
    (i) one nurse to one patient: operating room and
    trauma emergency units.
    (ii) one nurse to two patients: all critical care
    areas including emergency critical care and all intensive
    care units, labor and delivery units and postanesthesia
    units.
    (iii) one nurse to three patients: antepartum,
    emergency room, pediatrics, step-down and telemetry
    units.
    (iv) one nurse to four patients: intermediate care
    nursery, and medical/surgical and acute care psychiatric
    units.
    (v) one nurse to five patients: rehabilitation
    units.
    (vi) one nurse to six patients: postpartum (three
    couplets) and well-baby nursery units.
    (vii) for any units not listed above, including
    psychiatric units in facilities other than acute care
    hospitals, the direct-care nurse-to-patient ratio as
    established by the department.
    (3) the ratios set forth in paragraph (2) shall
    constitute the maximum number of patients that may be
    assigned to each direct-care nurse in a unit during one
    shift. a nurse, including a nurse administrator or
    supervisor, who does not have principal responsibility as a
    direct-care nurse for a specific patient shall not be
    included in the calculation of the nurse-to-patient ratio....


    appropriate license required.--for purposes of
    compliance with the minimum staffing requirements standards set
    forth under section 806(h), no nurse shall be assigned, or
    included in the count of assigned nursing staff in a nursing
    department or unit or a clinical area within the health facility
    unless that nurse has an appropriate license under the
    applicable registered nurse law, received prior orientation in
    that clinical area sufficient to provide competent nursing care
    to the patients in that area, and has demonstrated current
    competence in providing care in that area. hospitals that
    utilize temporary nursing agencies shall have and adhere to a
    written procedure to orient and evaluate personnel from these
    sources to ensure adequate orientation and competency prior to
    inclusion in the nurse-to-patient ratio....

    2/26/09, pasnap press release
    state senate introduces bill to protect pennsylvania's patients and nurses,
    herring_RN likes this.
  9. 0
    to bad the legislation here in good ole mississippi don't seem to care about this issue unless it's their family member in the unit. But it wont affect them, cause the hospital will be pulling nurses and techs,clerks etc.. from all over to make a strong showing.
  10. 0
    Eight to Ten Patients....I had 20 Rehab patients the other night. One new admit, new orders for over 1/2 of the patients and a night nurse that came on and said that if she had to do all the orders she was leaving. So I didn't get out of there until 1am...no breaks and no lunch...and again I question...what is safe standards???? Oh sure, they can tell us what is safe for the patient...What I want to know is...WHAT IS SAFE FOR US, THE NURSES???...
    Also, if I am mandated to stay an extra 8...so I would be there from 2:30pm to 7:30 or 8:00am...should I have to come back in at 2:30pm??? Isn't there a law that we are to have as much time off between shifts as we have worked...example...worked 16+...should we have at least that much off before the next shift??? Maybe I'm just getting old...lol

    Quote from ChristineN
    I just finished doing a paper on PA nurse-to-patient ratios for my ethics class. It's interesting how at first ratios seem like such a great idea (especially if you have 8-10 or more patients), but once you realize that they may not be thinking about secretaries, CNA's, or other ancillary staff, you begin to realize there could be problems. I think that in order for a law to be passed that will actually work, there needs to be good input from floor nurses telling Harrisburg that we need our support staff, and we need a flexible ratio (flexible based on acuity).


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