Registered Nurse Safe Staffing Act (THIS ONE IS IMPORTANT!)

Nurses Activism

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The House has introduced the Registered Nurse Safe Staffing Act of 2007 on November 9th. It is important that we speak out on this issue and not let it fall through the cracks!

You can view the bill in it's entirety here.

I've also posted some other helpful links here.

Let your voices be heard, nurses!

Does anyone work for the state? I am currently employed by the state of Tennessee as an RN at a mental facility. I have to say I find the work interesting to say the least. My comment is in regard to laws and how they differ for state facilities. Several nights I have worked as the only nurse on my floor with 20 Plus mental patients. New years eve I had 24 patients 4 techs and me! Night before last I worked the same and had a patient fall and end up in the hospital because I could not give meds and handle the techs and everthing else at the same time ! I know this can't be legal but I don't know who to complain to. This facility also requires mandatory overtime 4 days a month. We are already exhausted,have to work every other weekend and are harrased to work MOTS. THey have us fill out our sheduled a month in advance and put down our MOTS so legally for them we have already said we would work the MOTS when in actuallity we have no choice. Any views,comments would be appreciated as I am at a loss here.I am looking far another job.

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There is another federal staffing bill that has been introduced this year by Rep. Jan Schakowsky (D-IL)-The Safe Nurse Staffing for Patient Safety and Quality Care Act of 2007- H.R. 2123

From the comments in this thread, I think many nurses would find HR 2123 to be the better choice. The Schakowsky bill currently has about 40 cosponsors. The Capps bill has about 20.

Like the Capps bill, HR 2123 also requires staffing plans to be developed with input from staff nurses. The bill allows for adjustment in staffing levels for acuity and skill mix in consultation with staff nurses. The major difference is that it provides minimum staffing standards each hospital must meet.

Hospitals will be required to develop staffing plans no later than one year after the passage of the act, and must involve direct care nurses and other health care workers or their representatives in the development and the annual re-evaluation of those plans. The staffing plans must meet newly-established minimum direct care registered nurse-to-patient ratios, adjust staffing levels based on acuity of patients and other factors. Two years after passage-and four years for rural hospitals-hospitals will be expected to implement the nurse staffing plans.

Minimum direct care registered nurse-to-patient ratios: A hospital would be required during each shift, except during a declared emergency, to assign a direct care registered nurse to no more than the following number of patients in designated units:

  • 1 patient in an operating room and trauma emergency operating room and trauma emergency unit
  • 2 patients in all critical care units, intensive care, labor and delivery and postanesthesia units
  • 3 patients in antepartum, emergency, pediatrics, step-down and telemetry units
  • 4 patients in intermediate care nursery, medical/surgical and acute care psychiatric care units
  • 5 patients in rehabilitation units
  • 6 patients in postpartum (3 couplets) and well baby nursery units

Based on the outcome of a required study, staffing requirements will be established for licensed practical nurses and will be required to be implemented in all hospitals within 18 months of the act's passage.

HR 2123 is supported by the UAN, SEIU and AFL-CIO unions that represent nurses. UAN and SEIU have an active campaign to get more nurses involved in lobbying for the bill called "Patient Care Emergency: RNs Needed Now". Look for an increase in activity in the next few months including a dedicated website.

Here's a link to send a letter to your Representatives- one caveat- it hasn't been updated for the 2007 legislation. You need to edit the letter to say "HR 2123" in the subject line and "Nurse Staffing Standards for Patient Safety and Quality Care Act of 2007 (H.R. 2123) in the body: http://seiuaction.org/campaign/safestaffing2005

If you want to stay informed about this campaign and others, you can sign up for emails from Value Care, Value Nurses- no membership required.

http://www.valuecarevaluenurses.org/Default.aspx

More info on HR 2123 here: http://www.uannurse.org/legislative/pdfs/schakowskysummary053007.pdf

http://www.uannurse.org/legislative/pdfs/RNratioIssueBrief110Congress.pdf

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I do believe- If you build it, they (nurses) will come. If the Bill is passed, it will be at least five years before it is implemented and more will be attracted to the profession.

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Specializes in Med Surg, Tele, PH, CM.
The only bad thing I can see coming of this is that some hospitals might not want to participate in this albeit prudent exercise and decide to not take medicare patients or set themselves in a 'Private vs. public' status so they don't HAVE to take patients.

Despite all the grumbling over payment by Medicare and Medicaid, few hospitals could afford to remove themselves from the government payee list. Fact is, private insurance wouldn't pay enough to keep a hospital financially sound, especially since most have spent the last decade expanding their infrastructures and services. This would especially impact Emergency Room services. Under EMTALA, and ER cannot turn anyone away. Getting paid by Medicare is better than not getting paid at all....

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Specializes in Med Surg, Tele, PH, CM.

Regardless, what is true about staffing ratios is that they will increase healthcare costs, because hospitals won't be able to make money (or as much money, lol) and will have to raise the fees.

Hospitals cannot just sit down at a conference table and raise fees. Insurance payors, including CMS have contracts with hospitals and other providers as a result of months of negotiations. Also, in most states, fees are regulated by both State and Federal agencies. Hospitals bill high, but they are never paid the face amount, except by private pay patients, and then they are usually not paid at all.

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Specializes in Med Surg, Tele, PH, CM.
Does anyone work for the state? I am currently employed by the state of Tennessee as an RN at a mental facility. I have to say I find the work interesting to say the least. quote]

I'm not familiar with Tennessee, but in most states it is not a matter of State facilities following different rules as it is Mental Health facilities following different rules. In my I have worked for both Maryland and NC, and in those states. Mental Health is regulated by a totally different branch of the State Depts of Health than acute care hospitals. States throw huge amounts of money at Mental Health, and for the life of me, I cannot figure out where it goes. NC just completely "revamped" their MH delivery system, and from my vantage point, all that has happened is that those providers that operated under the old system simply changed their names and now deliver the same less than optimum care under the new system. Sounds like you have good skills, I would look to the private sector for a job.

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There is another federal staffing bill that has been introduced this year by Rep. Jan Schakowsky (D-IL)-The Safe Nurse Staffing for Patient Safety and Quality Care Act of 2007- H.R. 2123

From the comments in this thread, I think many nurses would find HR 2123 to be the better choice. The Schakowsky bill currently has about 40 cosponsors. The Capps bill has about 20.

Like the Capps bill, HR 2123 also requires staffing plans to be developed with input from staff nurses. The bill allows for adjustment in staffing levels for acuity and skill mix in consultation with staff nurses. The major difference is that it provides minimum staffing standards each hospital must meet.

Hospitals will be required to develop staffing plans no later than one year after the passage of the act, and must involve direct care nurses and other health care workers or their representatives in the development and the annual re-evaluation of those plans. The staffing plans must meet newly-established minimum direct care registered nurse-to-patient ratios, adjust staffing levels based on acuity of patients and other factors. Two years after passage-and four years for rural hospitals-hospitals will be expected to implement the nurse staffing plans.

Minimum direct care registered nurse-to-patient ratios: A hospital would be required during each shift, except during a declared emergency, to assign a direct care registered nurse to no more than the following number of patients in designated units:

  • 1 patient in an operating room and trauma emergency operating room and trauma emergency unit
  • 2 patients in all critical care units, intensive care, labor and delivery and postanesthesia units
  • 3 patients in antepartum, emergency, pediatrics, step-down and telemetry units
  • 4 patients in intermediate care nursery, medical/surgical and acute care psychiatric care units
  • 5 patients in rehabilitation units
  • 6 patients in postpartum (3 couplets) and well baby nursery units

Based on the outcome of a required study, staffing requirements will be established for licensed practical nurses and will be required to be implemented in all hospitals within 18 months of the act's passage.

HR 2123 is supported by the UAN, SEIU and AFL-CIO unions that represent nurses. UAN and SEIU have an active campaign to get more nurses involved in lobbying for the bill called "Patient Care Emergency: RNs Needed Now". Look for an increase in activity in the next few months including a dedicated website.

Here's a link to send a letter to your Representatives- one caveat- it hasn't been updated for the 2007 legislation. You need to edit the letter to say "HR 2123" in the subject line and "Nurse Staffing Standards for Patient Safety and Quality Care Act of 2007 (H.R. 2123) in the body: http://seiuaction.org/campaign/safestaffing2005

If you want to stay informed about this campaign and others, you can sign up for emails from Value Care, Value Nurses- no membership required.

http://www.valuecarevaluenurses.org/Default.aspx

More info on HR 2123 here: http://www.uannurse.org/legislative/pdfs/schakowskysummary053007.pdf

http://www.uannurse.org/legislative/pdfs/RNratioIssueBrief110Congress.pdf

I like the above layout for staffing, but I do not think it is very realistic, especially in the ER setting. There is absolutely know way of knowing how many patients will present in a shift. Especially in a rural setting. You may have a night with no patients at all or you could have a night where all the beds are full and you have overflow patients to deal with. All can be just as seriously ill. Other than having nurses on call constantly, I don't see how this can work. And many times when you have a crisis going on, by the time the on-call nurse arrives, the worst is over and she would not be needed any longer. I was a night ER nurse for many years, so I have seen both sides of the coin. I wish there were an easy answer.

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you need to REPORT your hospital! NO WAY would I be the only nurse, let alone in a mental facility. Trust me, the money is just going somewhere else while you help them cut corners. If YOU were the one injured, do you think anything would change? I'll tell you--NO! They do not care about you, just their checks.

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minimum direct care registered nurse-to-patient ratios: a hospital would be required during each shift, except during a declared emergency, to assign a direct care registered nurse to no more than the following number of patients in designated units:

  • 1 patient in an operating room and trauma emergency operating room and trauma emergency unit
  • 2 patients in all critical care units, intensive care, labor and delivery and postanesthesia units
  • 3 patients in antepartum, emergency, pediatrics, step-down and telemetry units

we already have this type of staffing, and the problem with this is, two patients in our ccu/icu can be ok, but more often than not, it's not. we have no ancillary staff-none. it is total rn care, and with obese patients quite often, they are pushing us beyond our limits physically. two rns on, even with three patients total between them, with two average wt and one 600pounder--it's ridiculous. flash up two floors to the stepdown unit--they take 3-4 with a tech and a pca to assist! the difference in aquity between the floors is staggering, and we are the ones with no assistance provided. i can't imagine the anomosity locking them in at 3 will do to our unit. our patients, on occasion, actually require two rns running full throttle to keep them alive and we are the most horridly treated of all. all the doctors respect us, our knowledge, our care, and comment often how most of the patients would probably not made it somewhere else---and the hospital treats us like garbage. why is that?

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Specializes in ICU, ER, RESEARCH, REHAB, HOME HEALTH, QUALITY.

I have not seen this but what is the update, did it pass or what.. or were there revisions and add on;s

thanks

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