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Just Say “NO” to Nurse Staffing Laws

Nurses Article   (8,764 Views | 98 Replies | 1,369 Words)

SafetyNurse1968 has 20 years experience as a ADN, BSN, MSN, PhD and specializes in Oncology, Home Health, Patient Safety.

12 Followers; 54 Articles; 17,874 Profile Views; 340 Posts

What Do Nurses Really Feel about Nurse Staffing Laws?

Mandated nurse-patient ratios may be saving lives, but at what cost? This article presents evidence against the idea of nurse staffing laws. If you feel strongly about the topic, give this a read and weigh in. I’d love to have your opinion on the subject. You are reading page 8 of Just Say “NO” to Nurse Staffing Laws. If you want to start from the beginning Go to First Page.

Safe Staffing Laws

  1. 1. Were you taught about safe staffing laws in nursing school?

    • 63
      Yes
    • 163
      No
  2. 2. Do you work in California?

    • 28
      Yes
    • 198
      No
  3. 3. Have you ever been asked to take on more patients than you thought you could handle safely?

    • 196
      Yes
    • 30
      No
  4. 4. Do you think safe staffing laws are a good idea?

    • 214
      Yes
    • 12
      No

227 members have participated

myoglobin has 12 years experience as a ASN, BSN, MSN and specializes in ICU, trauma, neuro.

710 Posts; 4,768 Profile Views

My solution starts with California ratio laws and related legislation like mandatory lunch breaks. California laws are good enough that even HCA follows them. If you can get Charles Manson to obey the rules then most others will likely follow.

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morelostthanfound has 27 years experience as a BSN and specializes in CVOR, General/Trauma Surgery.

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1 hour ago, Asystole RN said:

I think most everyone supports a certain staffing minimum. The question though is how you account for all of the myriad of variables just within hospitals alone and do you stop at just a staffing minimum instead of planning for the optimum? LTACHs, Critical Access Hospitals, etc. 

I’ve worked in California and its staffing model works well.  As such, it could serve as a template for other states until the current system can be overhauled or drastically revamped.  Other states’ experiences with the flexible model (as advocated by the ANA), prove that it is ineffective and untenable!

Edited by morelostthanfound

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SafetyNurse1968 has 20 years experience as a ADN, BSN, MSN, PhD and specializes in Oncology, Home Health, Patient Safety.

12 Followers; 54 Articles; 340 Posts; 17,874 Profile Views

The second part of this article just came out. I think you'll find it interesting. Many of you have made some fantastic, well-supported comments on this thread about what we as nurses can do to make a difference. Please take a look: 

 

 

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Older Male LPN has 17 years experience as a LPN and specializes in Neurology.

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regulation and Imposed standards are never perfect - however, imperfection must be imposed when corporate Health Care is more corporate than healthcare.  Before 1973 Healthcare could not legally make a profit - we had non-profit county Hospitals I don't think that profit-making Health Care has improved anything. In Addition to absurd salaries for senior managers, they also get bonuses earned on the back of nurses and medical staff.  YES - I say regulate and legislate away -- it can't be worse than the profit motive    

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On 1/2/2020 at 10:25 AM, Asystole RN said:

You hit the nail on the head with that statement I highlighted. The PPS (Prospective Payment System) which is the foundation of our current healthcare reimbursement system does just the opposite of this, intentionally financially penalizes hospitals for staffing adequately.  

Nursing leadership is generally middle management, they rarely are the decision makers for items this large and significant. These are decisions, motivations, and strategies crafted on a national level.

Thank you for bringing up the origins of this whole issue. I had no idea but it makes a lot of sense. If healthcare became more expensive in the 70s and the government wanted to cut the costs it was going to have to pay, of course it would do whatever it took to offset that expense onto somebody else - regardless of the mess it would cause later. Just like you, I'm weary of putting a bandaid on an issue and hoping that it will cure the disease. I'm not against government but I'm also sceptical of its good intentions and am hesitant to give it any more power/oversight of society than it already has. Thus I don't think government-mandated staffing laws are the answer. The PPS as you described it seems to have done enough damage that we don't need to dig the hole any deeper through more government regulation. Personally, I'm of the mind that there needs to be a nationwide nursing walk-out. I know that is a very big thing to ask of people when we all have mouths to feed and bills to pay. But that, imo, is the only way we're going to get the attention we desperately need to make our case. We need to stop hiding behind middlemen - the govt, lobbyists, interest groups, etc - and start advocating for ourselves and our patients by ourselves. If we're not willing to put our money where our mouth is, that shows where our loyalties really lie. If blacks and whites hadn't practiced civil disobedience in the 60s and 70s consequences be damned, I would not be where I am today - a black female BSN RN. At the very least we should all abandon the hospital in droves, find other work, and refuse to return until they implement our suggestions for improvement. 

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367 Posts; 1,917 Profile Views

On 12/30/2019 at 10:26 AM, Bumex said:

How about cutting CEO salary instead of supplies? 

How about cutting their salary AND bonus?  I worked at a major non-profit hospital in St Louis and the CEO's bonus was over 5 times my salary!  And WHY was his bonus so high?  Because all us "little people" were doing great jobs!

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Older Male LPN has 17 years experience as a LPN and specializes in Neurology.

13 Posts; 442 Profile Views

Damn Straight and other administrators as well - CEO Isn't the only one - how can they say there is no money

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Jaipossible specializes in PACU/Cardiac.

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Of course the AHA and all in bed with them are going to fight back on safe ratios, no surprise there....think it's a load of bunk that it will lead to shorter staffing ratios. Weak argument on points against safe staffing.   Nurses would stay in the profession longer and not leave if they thought they could work safely and humanely.   Less burnout.  Would rather wait longer in the ER than have my mortality rate go up by 33%.  Duh....

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pmabraham has 3 years experience as a BSN, RN and specializes in Hospice, Palliative Care.

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IF you want more and more nurses running away from hospital and LTC nursing, keep going against mandated safe staffing ratios.  There's textbook, and there's real life.  Real-life unsafe staffing costs lives contribute to burn out and contributes to turnover which results in unsafe levels of care because those who remain may only do so out of necessity vs. love.

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Kim Wallace is a RN and specializes in ER, ICU, PSYCH.

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The argument that staffing ratios will cause a decrease in ancillary staff is moot.  It's happening in most places anyway.  In the ER we now have to scan and account for a non-sterile 4x4 for a patient, so the lack of funds for equipment is also a non-flyer.  

The bottom line is the more patients per nurse the less care per patient and the greater the risk for a nursing error.  

I have commented numerous times on this site that the issue is simple, there is no charge for nursing care.  Everyone from respiratory to x-ray techs, to MDs, all charge a fee for their time that is billed to the patient.  Nurses are included in the room charge like bedpans and curtains.  Since there is no charge for nursing. increasing nurse to patient ratios consequently becomes one of the easiest ways to cut costs.  4 nurses for 30 patients is less money than 6 nurses so why not.  The nurses complain, but they suck it up.  

Nurses will never get the respect they are due until we have a spot on that patient bill under the heading "Nursing Care".  Nobody can change this but us.

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myoglobin has 12 years experience as a ASN, BSN, MSN and specializes in ICU, trauma, neuro.

710 Posts; 4,768 Profile Views

Here's the thing I support both measures (billing that reflects nursing care and staffing ratio's).  However, from a "political" standpoint staffing ratio's can be passed easier as evidenced by the fact that California has implemented this policy, and other states have come close.  Perhaps, that is because "nursing care billing" (for lack of a better term) faces greater opposition from the government both at the federal and state levels (where Medicare and Medicaid are already heading towards trouble) and ratio laws face most of their opposition from hospitals (and the ANA).  However, on both issues the ANA should be on the side of the nurses, a when they are not they should be called out for it and face "competition" from advocacy groups that better reflect issues that most nurses support.

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This article like many others presented by “highly educated” managers fails to look at the depth of the problems and layers of regulation that stagnate things far more than laying blame on the scape goat of nurses. 
 

ENA is very much in bed with corporate hospitals. Medicine has progressed to business and share holders rather than patient care. Government involvement and the establishment of pay based on customer satisfaction has also handicapped the medical system.  The entitlement and expenses wasted on repeat offenders, unwarranted admissions for fear of litigious outcomes more than patient outcomes cost hospitals billions of dollars every year.  The mere implications that nurses should just be expected to take more work and and responsibility; then close the article with a guilt trip, that if we, the nurses, do this it burdens hospitals and takes away from resources is beyond ludicrous. 
 

We as a working society are constantly being squeezed harder and told to do more with less to pay for those that do nothing but take from the system. A government and system that only adds layers by additional regulations and rules makes operations more costly vs placing appropriate accountability where it belongs fails the society as a whole. 
So yes the reason nurses are fighting back is to protect our careers, livelihood, stress levels and ability to work within the field for the length of our careers. I found this article to be nothing more than false propaganda.  Eventually the working will speak loud enough to start swinging the pendulum back.

Want to keep that bottom line, hold all people accountable not just the workers. 
 

Who will take care of patients when the businesses and government results in nurses sticking their arms in the air and say enough? And mass exodus occurs. Hospitals complain about paying nurses now, what happens when there are 20 or 30,000 less nurses because bartending Is less stressful. Or nurses move on to work in other countries. 

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