Federal Nurse Staffing Bill Comparison

The legislators may raise the question of another nurse staffing bill nurses are lobbying.

It is very confusing for legislators to navigate WHY these bills are different. You can assist them!

Our RN Ratio bills S. 1063/HR 2392 has the mandatory minimum nurse staffing ratios. The American Nurses Association bills S. 2446/HR 5052 share the importance that patient outcomes are directly affected by numbers of RN staff, but that is where the similarities seem to end.

Bottom line difference is in the ANA bill, no regulatory mandate that the employer to commit to a staffing plan in writing to begin any shift. Look at the Side by Side and you can always read each bill fully to get the flavor of the missing employer commitment to staff even though they agree fully with the research as we do: adequate numbers of nurses and support staff provides the patient with better outcomes.

Visit nursestakedc for information on the movement #NursesTakeC

~Pam Robbins MSN, RN

[bgxyrnf, MSN, RN]

ANA is worthless

#NursesTakeDC

[pmabraham, BSN, RN]

The one has mandated ratio's the other DOES NOT, and furthermore, it doesn't give the actual bedside nurse performing the care a say. We need mandated ratios!

Links to all four bills.

H.R.2392 - Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act of 2017

S.1063 - Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act of 2017

H.R.5052 - Safe Staffing for Nurse and Patient Safety Act of 2018

S.2446 - Safe Staffing for Nurse and Patient Safety Act of 2018

Isn't the ANA supposed to be on our side? A giant pile of nothing is what their bill looks like. Without objective testable ratios these bills mean nothing

[tnbutterfly - Mary, BSN, RN]

As you can see, there are major differences. This is why it is important to contact your legislators and educate them --- tell them which bill to support. Don't assume they know the differences.

Why would anyone support the ANA if they don't look out for their own people and profession. That is very disappointing

I most certainly will NOT be giving any money or signing up as an ANA member after reading this!

[klone, MSN, RN]

pmabraham said:

The one has mandated ratio's the other DOES NOT, and furthermore, it doesn't give the actual bedside nurse performing the care a say. We need mandated ratios!

Mandated ratios are meaningless unless you also develop an acuity rating.

Oregon has new staffing laws that require the hospital create a staffing plan, based on acuity as well as census, preferably using the recommendations of applicable professional organization. I feel very fortunate that women's health already has a very robust and specific staffing recommendation that we can use.

[pmabraham, BSN, RN]

And if the one's at the bedside ACTUALLY doing the work don't have a say in the matter, then acuity staffing is meaningless.

And this is why I do not support the ANA. They do nothing for the nurses at the bedside. In fact they are condescending toward those nurses. But you can bet they want everyone to join so they can rake in the money.

As a general rule I would say that everyone should be a member of their professional association. BUT when that association ignores the rank and file members and makes decisions for them instead of with them I really can't support it.

pmabraham said:

The one has mandated ratio's the other DOES NOT, and furthermore, it doesn't give the actual bedside nurse performing the care a say. We need mandated ratios!

With mandated ratios, the bedside nurse wouldn't have any say either. They are going to get the max allowed, regardless of the complexity and need of the patients.

[klone, MSN, RN]

SC_RNDude said:

With mandated ratios, the bedside nurse wouldn't have any say either. They are going to get the max allowed, regardless of the complexity and need of the patients.

Exactly. Which is why it's important to staff based on acuity, not nurse/patient ratios.

On my unit alone, we could have 6 patients and need 1 nurse, or 6 nurses.

Who actually read the ANA's position on this? Where do you disagree?

Quote

To explore the clinical case for the effect of nurse staffing models, we collaborated with health care insight leaders Avalere and a panel of top nurse researchers, thought leaders and managers. The white paper concludes that staffing levels in a value-based health care system should not be fixed, as day-to-day hospital requirements are constantly in flux.

Nurse Staffing

[bgxyrnf, MSN, RN]

SC_RNDude said:

With mandated ratios, the bedside nurse wouldn't have any say either. They are going to get the max allowed, regardless of the complexity and need of the patients.

That's not my experience in our ICUs. We do have mandate ratios, of course, here in California. But often times, the nurses in our ICUs are singled because the patients are too "busy" to permit the nurse to effectively care for a second patient.

bgxyrnf said:

That's not my experience in our ICUs. We do have mandate ratios, of course, here in California. But often times, the nurses in our ICUs are singled because the patients are too "busy" to permit the nurse to effectively care for a second patient.

Fair enough. There are places like yours, and mine, that don't need mandated ratios.

What those places do is more in line with the bill that the ANA is supporting.

Exactly. Which is why it's important to staff based on acuity, not nurse/patient ratios.

On my unit alone, we could have 6 patients and need 1 nurse, or 6 nurses.

The bill only sets up mandatory minimum standards. There is nothing that prevents management from bringing in more nurses if that is what is required

[MunoRN, RN]

SC_RNDude said:

Who actually read the ANA's position on this? Where do you disagree?

I agree that workload based staffing requirements would be better than simple ratios, but the ANA doesn't require that either. The ANA proposal at the federal level is the same as what they've backed at the state level, which is generally worthless. It only required that facilities create a safe staffing committee, the committee comes up with staffing recommendations, which the facility is then completely free to outright ignore.