Nurse Staffing Laws: Should You Worry?

[NRSKarenRN, BSN, RN]

from aha's hospital & health networks:

nurse staffing laws: should you worry?

terese hudson thrall

for hospitals, bills range from onerous to ok

leading advocate

nursing groups nearly always lead the legislative charge. zenei cortez, r.n., traces the efforts back to the 1990s when cash-crunched hospitals cut back their nurses and hired more unlicensed personnel. nurses have been trying to gain more say on the staffing issue ever since, says cortez, a member of the president’s council created by the oakland-based california nurses association and the national nurse organizing committee.

on the other hand, jean moore, director of the center for health workforce studies at the state university of new york’s albany school of public health, says pressure to improve quality of care, bolstered by reports from the institute of medicine and others that indicate a relationship between staffing and outcomes, has made staffing a priority with state legislatures. “when you cut to the chase, it’s about preserving quality and not putting nurses in a situation where they are likely to do harm,” she says.

the ongoing shortage of nurses also has focused attention on the staffing issue.

[RN Power Ohio]

This quote from the article really highlights the fundamental disconnect between adminstrators, executives anddirect care nurses.

At Ohio Health & Sciences University, Jason says the hard work of setting up staffing committees could bear even more fruit. Committee members might next consider reengineering bedside care to improve nurse performance. “What is making the nurses so busy? Is it how they interact with doctors? The documentation they prepare?” she asks.

What makes nurses so busy? The high volume of very sick patients they have to care for! I will never understand why hospitals cannot figure this out. They will spend millions on technology to increase efficiency yet refuse to staff safely. Carrying cell phones that interupt patient care so that we can efficiently take calls from physicians and canned electronic charting that fails to effectively communicate patient care issues is neither going to improve patient safety or nursing efficiency.

So many research dollars are wasted looking for alternatives to safe staffing.

[lindarn]

Every one is missing the point- hospitals DO REALIZE THAT SHORT STAFFING IS DANGEROUS! IT IS MORE IMPORTANT FOR THEM TO CONTROL THE NURSING STAFF THAN TO STAFF SAFELY!

Yes, as long as they short staff, make you work mandatory OT, prevent you from unionizing and gaining control over the workplace, can fire you because you work in an "at will state", or "right to work state", they control you. Nurses are 100% responsible for this because, when nurse were first allowed to organize in the 60's nurses rejected unions, under the excude that unions were "unprofessional'. That baloney was of course, fed to nurses by hospital administrations, who were then, and now, still TERRIFIED OF NURSES FINALLY CALLING THEIR BLUFF, AND ORGANIZE EN MASSE! And nurses, then and now, bought that nonsense hook, line, and sinker. If nurses had organized then and taken control of their profession, 2008 would be a very differant picture. JMHO, and my NY $0.02.

Lindarn, Rn, BSN, CCRN

Spokane, Washington

[RN Power Ohio]

Years ago one study was done that demonstrated if a physician was present in the ICU more people lived. Within one year physicians were in our ICU. Over 45 studies have been done over the past 15 years demonstrating patients die because there are not enough nurses at the bedside....where are all the nurses?!

[Altra, BSN, RN]

So many research dollars are wasted looking for alternatives to safe staffing.

Amen. :stone

[KaroSnowQueen, RN]

Amen. :stone

:yeahthat:

[nicurn001]

So many research dollars are wasted looking for alternatives to safe staffing.

Because the research keeps coming up with the wrong answer . MORE STAFF is needed , Not the answer management wants !

[mdfog10]

Yes, MORE RNs at the bedside is the answer. Not elitist and disconnected nursing management. My hospital claims they have a "lean" management team. I feel like I have to fight to deliver basic care to my patients. Constant interruptions from phone calls, arguing my acuities to my manager, computer charting, communicating with everyone under the sun, being updated on the latest policy change and what to say to state auditors. Hurry up, do it all and don't make a mistake!!!!!:banghead:

[kjnorris]

Gosh isn't the appropriate answer "lets get a 6 sigma group on". Just another stupid response that i hear when the solution is in your face. Hire more nurse staff according to acuity ... But then there is the question who chooses the acuity nurses of management. Obviously if management allows the nurse to do it they make the accuity tool.

[Julia RN]

Another quote from the article:

"Even in states with no staffing legislation in the works, Dodge urges hospitals to pay attention to the trend. She recommends that all hospitals start staffing plan committees with nurse input. "Staffing committees are a great opportunity for hospitals to engage their nurses. Get them involved in the process and the solution on individual units," Dodge says. "You'll make your nurses happy, remain competitive, be better able to recruit nurses. And a union is not likely to come knocking if your nurses are touting your hospital."

Apparently, Dodge's law firm, Drinker Biddle, helps hospitals "avoid" unions- I know I am restating the obvious- but Dodge's interest as well as the AHA's interest in this issue is not improving quality or patient care- it's about avoiding staffing ratios and unions.

Interesting that the "map" concerning staffing legislation is from the American Nurses Association- I recognized it from their website, and if you look really closely at the small print, you'll see it.

ANA had to have given permission for the AHA to reprint this data for the article.

Imagine that- ANA- the supposed champion of the staff nurse- a bona-fide "labor organization" itself- helping the AHA avoid ratios and unions.

So what else is new?

[~nurse~]

I have read some great responses in this thread as well as others and there seems to be a great general theme: If we come together we are strong!

We need to make the rules! There should be an acuity tool that makes sense and is simple to use, even for an administrator. Then a nurse's assignment should be based on this acuity tool and no nurse should ever exceed a certain acuity on their assignment, whether with one patient or with six.

Hospitals are making money hand over fist while we work overtime just to make ends meet. Without us there are no hospitals. Without nursing there are no $10 million bonuses for hospital administrators.

If you take the administration out of the hospital healthcare improves. If you remove nurses it stops altogether!

They tell us starting in nursing school that we do this from the heart. We shouldn't do it for the money. Asking for more is just greedy. You should feel guilty cashing your paycheck! And you want MORE???

I agree that we should do this from the heart. Who would want to do it if your heart wasn't in it? But why should I worry about my finances while I adjust your drip? Why shouldn't my children go to the college of their choice after I kept you alive? I AM WORTH IT! And so are you!

[twistednut]

I think more staff are needed.