Would you support this federal staffing bill?

GHGoonette, BSN, RN · Jul 28, 2010

The International Council of Nurses stated that (as regards PACU, and I presume it should apply in any ICU or emergency setting) that unconscious patients must be cared for on a 1:1 basis. From my own experience, no child in an unconscious or critical condition, neonatal or paediatric ICU, should be cared for on less than a 1:1 staffing ratio.

I appreciate the need for minimum ratios, but I think that is one that needs to be very critically examined and amended.

Asystole RN · Jul 28, 2010

I am not sure if I support staffing ratios that specify actual numbers without going into detail on acuity.

You cannot say X amount of patients per RN on X unit. 3 high acuity Med Surg pts could equal 8 low acuity Tele pts. etc.

I like the effort but I would like to see actual Medicare dollars placed in the bill for actual staffing numbers, not a "as estimated by the Secretary."

Besides, what if the pts are not Medicare patients?

Long Term Care Columnist / Guide · Jul 28, 2010

(taking deeeep breath)

As usual, I have to say NO to more government. It's got enough on its plate without getting into the business of staffing healthcare facilities. The main failing is that government tends to try to make one size fit all, and as most of us know, healthcare is a bit more complex than that.

I also have a problem with government bureaucrats deciding for hospitals and other health facilities how many staff they MUST have, what mix of staff they must have, and so on. What does a facility do when staffing ratios mandate a maximum of 5 patients per nurse, and doesn't have that many nurses available because half the staff is out sick, or because they're a small-town hospital with limited numbers of nurses in the area? First thing you know, they will be mandated to hire 'adequate' numbers of staff or even worse, use agency nurses; otherwise, they will be forced to close units......which means fewer patients can be served.......which means less money for the hospital........which means fewer dollars available to pay nurses and ancillary staff.

I think the legislation, while well-intentioned, would end up shooting us in the foot and making matters even worse in the long run. And you know what they say about good intentions and the road to Hell....

allnurses Guide · Jul 28, 2010

The International Council of Nurses stated that (as regards PACU, and I presume it should apply in any ICU or emergency setting) that unconscious patients must be cared for on a 1:1 basis. From my own experience, no child in an unconscious or critical condition, neonatal or paediatric ICU, should be cared for on less than a 1:1 staffing ratio.
I appreciate the need for minimum ratios, but I think that is one that needs to be very critically examined and amended.

I encourage you to write your senators and congress person with your proposed amendments when the bill is coming up for a vote. And join with others to write as many legislators as possible.

For PACU it would be two or fewer patients per RN. And national organizations, associations, and societies such as ASPAN, AACN, ACOG and others have standards the HHS secretary would be hard pressed to ignore; especially with thousands of nurses writing letters and testifying on behalf of patients.

The law would apply to all acute care and LTAC hospitals that accepr Medicare or Medicaid payments whether. The improved staffing would apply to all patients.

oktravelnurse · Jul 28, 2010

Would you support this bill to provide staffing in acute care and long term acute care hospitals by patient acuity with the ratio the maximum number of patients that may be assignd to a nurse?

One of these links should work:
http://www.govtrack.us/congress/billtext.xpd?bill=s111-1031

http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=111_cong_bills&docid=f:s1031is.txt.pdf

I would definitely support it! :yeah: :up:

Wise Woman RN · Jul 28, 2010

If we have the government mandate staffing levels, the hospital will cut corners elsewhere.. picture your 5 patients, no CNA's, no secretary, and cuts on housekeeping, etc. 5 to one is good, if you don't have to do all of the orders, answer the phone, clean patient rooms, do all the baths, etc. etc. And if the government is involved, the oversight committees and extra govenment workers will be taking their share off the top of medicare/medicaid funding. The bottom line will still be the money, not the patients.

BackfromRetirement · Jul 28, 2010

It has been introduced in 2009, and has not gotten out of committee by mid 2010? Seems like it's already dead in committee.

mskate · Jul 28, 2010

Coming from a California nurse who has worked in other states that do not have mandated staffing ratios - there is no way I will work as a bedside nurse in an area that does not have mandated ratios.

I have done my fair share of running 2 patients on CVVHD, I have had to have a 2 patient assignment with one patient unstable on ECMO, I have had to work too many times where I don't get lunch breaks because my patients are too critical to walk away from the bedside and there is no one to watch them while I eat. --- Never. Ever. Again.

oktravelnurse · Jul 28, 2010

Coming from a California nurse who has worked in other states that do not have mandated staffing ratios - there is no way I will work as a bedside nurse in an area that does not have mandated ratios.
I have done my fair share of running 2 patients on CVVHD, I have had to have a 2 patient assignment with one patient unstable on ECMO, I have had to work too many times where I don't get lunch breaks because my patients are too critical to walk away from the bedside and there is no one to watch them while I eat. --- Never. Ever. Again.

I traveled to CA and the the 5:1 spoiled me. I left a neuro floor here that on my 1st day off orientation I had 14 patients! This is insane. Staffing did get better. It was down to 10-12. Very unsafe. Yes we had a tech but they were overloaded with patients as well. Give me CA anytime!:redbeathe

ADPIE10 · Jul 28, 2010

With the current excess New Grads, this would be a good time to mandate ratios. If there is an anticipated shortage as the data from previous years attempted to show, then maintaining a steady flow of nurses in the profession is necessary. Driven by a profit motive, Hospitals cannot be depended upon to improve ratios. The very few hospitals with the vision to maintain New Grad programs and improve ratios will suffer when the economy improves and demand for nurses in other hospitals woo the trained nurses away with higher salaries.

The economics of healthcare, if left to the Executives of hospitals will result in a greater shortage of qualified nurses and decrease of patient outcomes in the future. Mandated ratios need to occur quickly.

anonymurse · Aug 6, 2010

Interesting: RNs only. And presumably the hospitals, to keep costs as low as possible, would eliminate Nursing Assistants. Two job fields gone in one whack.