NY Safe Staffing Campaign

[-jt]

Spread the Word: Safe RN Staffing Saves Lives

by Nancy Webber

New York State Nurses Association Report

Across New York state, NYSNA members are gearing up to spread the message: "Safe RN staffing is a matter of life and death."

More than 50 research studies have connected inadequate staffing with adverse patient outcomes and mortality. Registered Nurses are telling the public - and their elected officials - that now is the time to enact staffing ratios to protect the public health.

NYSNA begins postcard campaign

To help nurses inform friends and family members about the need for safe staffing, NYSNA has developed a colorful flyer with some of the compelling statistics related to staffing:

- Each additional patient per RN increases that patient's chance of dying in the hospital by 7%.

- Nurse staffing levels have been a factor in one out of every four unanticipated events resulting in death, injury, or permanent loss of function reported to the Joint Commission on Accreditation of Healthcare Organizations (JCAHO).

- Patients who receive a higher number of hours of care per day from RNs have significantly lower rates of complications.

The flyer includes a tear-off postcard urging NY Gov. George Pataki to support NYSNA's proposal to establish RN-to-patient ratios in acute-care facilities. A bill written by NYSNA has been introduced in the State Legislature (see below).

Copies of the postcard flyer are available from NYSNA nursing representatives at facilities where NYSNA represents nurses for collective bargaining and from NYSNA's Practice and Governmental Affairs Program. Copies also have been distributed to local district nurses associations. Non-members may contact NYSNA to purchase copies.

New booklet describes current staffing information

In the absence of comprehensive staffing legislation, RNs need to know a patchwork of laws, regulations, guidelines, and standards related to staffing in various care settings.

NYSNA has compiled much of this information in an easy-to-use booklet, Staffing in Healthcare Settings.

Based on extensive research by NYSNA staff, the booklet provides a synopsis of staffing requirements or recommendations for each acute and non-acute care setting. Citations are provided for relevant state and federal laws and regulations to make it easier for nurses to "go to the source" for more detailed information.

The 36-page booklet was first distributed at NYSNA's annual Convention in October. NYSNA members may get one copy free of charge. The booklet is available to non-members at a cost of just $10.00, plus a shipping and handling fee.

To order the postcard flyer or staffing booklet, contact the NYSNA Practice and Governmental Affairs Program at 1-800-724-NYRN, ext. 282. When you call, state clearly which publication you would like, and give your name, complete address, and phone number.

NYSNA Safe Staffing State Legislation

NYSNA has introduced legislation in Albany that would establish minimum, upwardly adjustable RN-to-patient staffing ratios in hospitals. The following ratios are included in the bill, along with a process for involving staff nurses in increasing the number of RNs if needed. Further ratios would be developed by the state Department of Health with assistance from a nurse advisory committee.

Behavioral Health 1:4

Critical Care 1:1

Emergency trauma patients 1:1

Emergency non-critical care 1:3 (triage must be done by an RN, but that nurse and any supervising nurse would not be included in the ratio, even if they provide direct patient care)

Perioperative Care 1:1 in the operating room (not including RNs serving as circulating nurses or first assistants)

Post-anesthesia 1:2

Maternal/Child Care 1:1 in second or third stages of labor, 1:2 in first stage of labor

Med/surg telemetry patients 1:3

Med/surg step-down units 1:3

Med/surg general, 1:4

pediatrics 1:4

Newborns/intermediate care nursery 1:3

Non-critical antepartum patients 1:4

Postpartum mother/baby couplets 1:3

Postpartum well-baby care 1:6

Rehabilitation care 1:5

:: Publications | :: Departments and Services Home | :: NYSNA Home

[Ted]

JT -

Thanks for the info and for taking the time to share! You're great! :)

Will pick up some postcard flyers!

Ted

[nowplayingEDRN]

I just would like to toss out some thoughts here, stir the pot a bit....something that I don't usually do but another nurse and I were talking about this at work the other day and I am interested in hearing what others think.

I am all for safe staffing, especially having been in numerous situations in the past where my license has been on the lin ebecause the staffing was grossly inadequet. However, with the nursing shortage that is facing us, in order to meet these staffing recommendations there would be the high potential to end up doing away with LPNs and CNAs (which in my opinion are vital to patient care) and if we do away with LPNs to bring in more RNs to meet these new staffing requirements, won't we be contributing to the nursing shortage?

Thoughts??? Input??? Opinions???? (Please don't beat me, I am just looking to see what others think)

[Deaconess]

I am a big fan of safe staffing ratios, but I have some concerns about legislating these.

First, the ratios are listed as RN to patient ratios. It seems that if hospitals were forced to implement these ratios, it would force the removal of LPN's, phlebotomists, CNA's and other support staff out of the hospitals. This is just pure economics.

Second, in light of an already existing shortage of RN's, it seems that these ratios would force inpatient beds to close and plug up ER's. It seems that it would be impossible to enforce such ratios in the ER since ER nurses are responsible to triage every patient and then to provide, at minimum, follow-up vital signs as patients wait to be seen. This is a problem that ER nurses in California are reporting. (California has mandatory staffing ratios.)

Third, it seems that State legislated ratios would inevitably result in usage of mandatory overtime to maintain staffing. We already know that mandatory overtime is a contentious issue with RN's.

Fourth, it seems that the staffing ratios seem to lack account for acuity. For example, not all ICU patients require 1:1 care. A fresh open heart with complications or "hot trauma" might require 2:1 while a DNR, no meds on ventilator (which still has to go to the ICU in my facility) would do just fine with a 1:2 or 1:3 depending on the other patients. These types of judgements would seem to require at scene decisions rather than a one-size-fits-all set of legislation.

It seems to me that the best way to improve staffing ratios is to legislate disclosure of staffing ratios. Hospitals and other health care intitutions should be required to report ACTUAL staffing ratios by specialty area quarterly, delineating those providing direct care from charge nurses, Nurse Practitioners, and nurse managers. This way the consumer can decide which hospital has staffing to best provide their care. With increasingly saavy health consumers, hospitals will be more motivated to recruit and retain proper staffing, especially if they think it will affect their bottom line.

[-jt]

>

All good points. Thats why NYSNA has introduced this legislation to establish these minimum, upwardly adjustable RN-to-patient staffing ratios (see the first paragraph of the press release). Legislated ratios are a starting point, a bottom line that the employer cannot cross, bare minimums that are to be increased - by the nurses who are working in an individual unit - based on their evaluation of pt acuity. NYSNA made sure this legislation includes a process for evaluating acuity and involving staff nurses in increasing the number of RNs & upwardly adjusting the ratios. Also, youre quite right about disclosure of staffing and NYSNA introduced legislation for exactly that. That bill has already been passed in the Assembly & is now under consideration in the Senate Health Committee. It would help if nurses contacted their state Senator & asked for their support on it. NYSNA has introduced a whole stack of staffing-related legislation - not just ratios. For details, see:

Bills Pending In Legislation:

*Ensuring A Safe Workplace

*Establishing Safe Staffing

*Disclosing Staffing Ratios

*Prohibiting Mandatory Overtime

*Encouraging Continued Competency

*Increasing the Supply of Nurses

*Universal Healthcare

*Protecting Nursing Practice

http://www.nysna.org/programs/legislative/activity.htm