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Join Nurses from across America in contacting their legislators and making a difference.​​

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Medical errors are the third leading cause of death in the United States. Nurses, healthcare providers, and the scientific community understand that unsafe nurse-to-patient ratios contribute to increased morbidity and mortality for patients.

Unsafe staffing also creates unhealthy and unsafe environments for nurses to practice, and contributes to nurse burnout. As a result, our community is working to change the current care environment. NursesTakeDC is a nurse-driven movement to make safe nurse to patient ratios a reality for all nurses in the United States. This year nurses will gather in Washington, DC for a National Rally to raise public awareness regarding the importance of safe nurse-to-patient ratios and to support pending legislation. Visit https://www.nursestakedc.com/ for more info.

 

NursesTakeDC's Latest Activity

  1. Nurses comment every day on social media about staffing issues. I just wish they’d take it one step further. Words matter—but action is your true power. Action—as in organizing to educate yourselves. Action— as in showing up to a 2-day event, NursesTakeDC, a Conference with CEs and a Rally/Lobby Day on April 21-22, 2020. Action— as in then meeting with your legislators to convince them why they must pass federal legislation to support nurses staffing ratios—and acuity. Because the complaining on social media just becomes background noise. And I want you to —ROAR. Then you will be heard. Professor Linda Aiken's Study on Nurse Staffing Another way to take action is happening right now in Illinois and New York—nurses pay attention! Could you tell all your Illinois and New York APRN, RN and LPN colleagues to complete Professor Linda Aiken's study survey on the quality of nurse staffing in Illinois and New York? Did YOU complete it? Only 8,361/180+k nurses in IL and 14,226/334+k in NY responded to the email survey as of December 20th. Less than a 5% response rate. I’m quite shocked. And angry. And this is why. Why Should You Respond to a Survey? In Illinois, we’ve had the Nurse Staffing by Acuity Act since 2008 - A law that states hospitals must purchase an acuity tool and form staffing committees comprised of bedside nurses and management. A law without any penalty to somehow enforce hospitals to comply. As a result, few hospitals do in fact comply. In fact, the ANA-IL collected data from nurses to show just how unsafe staffing is in Illinois. And NursesTakeDC completed a survey concurrently with ANA-IL which duplicated similar results for Illinois. How Can Nurses Fight for Safe Staffing Laws? So what is the answer to move us forward? How can nurses fight for safe staffing laws? I believe it’s by mandating safe staffing ratios that include patient acuity and penalties if hospitals do not act in good faith. The ANA and the AHA state its laws are like Illinois’s. Illinois nurses say—No way! We are attempting to pass the Illinois Bill HB2604 Safe Patient Limits Act, similar to California nurse to patient ratio legislation from 2004. Illinois and New York nurses must tell their state legislators their unsafe staffing stories—like I did with the NPR affiliate interview with Philadelphia's WHYY and Chicago's WBEZ. However, how can nurses impact on safe nurse staffing if nurses in Illinois and New York choose NOT to be a part of Professor Aiken’s survey study? An evidenced-based nursing study— which we, as nurses, have a responsibility to participate in. We are expected to advocate, impact and improve patient safety, as well as our own profession of nursing— on healthcare policy in Illinois and New York. These 2 states have pending legislation, HB2604/S.1908 in Illinois and A2954/S1032 in New York. Illinois and New York Nurses Should Complete the Survey All Illinois and New York nurses should complete the email survey, not just hospital-based nurses. Even currently inactive and retired nurses who are holding an active license to practice. Please remember—it as an independent, objective research project— to inform the policy debate about patient to nurse ratios in Illinois and New York. Additionally, a large part of the study is to link your responses with actual patient outcomes. Please complete the study survey, your voice does count. Search Your Email The email survey is from the National Council on State Boards of Nursing and the respective state’s Board of Nursing—IDFPR in Illinois and NYSEOP in New York. Make sure you search your email— all folders including, the junk folder for NCSBN. It was sent to the email you used when you renewed your license. Please do this and be a part of history—evidenced-based research on the quality of nurse staffing in Illinois and New York. You Can Affect the Future of Nurse Staffing Finally, your participation may have implications for the future of nurse staffing in all states. Imagine that. You will be a part of evidenced-based research on healthcare policy and nurse staffing. Here’s your chance now. So—what’s stopping you? And get yourselves to NursesTakeDC. Now. Your inaction is deafening. It silences your voice. Make it heard. Doris Carroll BSN, RN-BC, CCRC Illinois Nurse https://www.congress.gov/bill/116th-congress/house-bill/2581/text https://www.congress.gov/bill/116th-congress/senate-bill/1357/text https://www.congress.gov/bill/116th-congress/senate-bill/1357/all-inf allnurses.com Illinois Nurse Staffing Survey https://www.yumpu.com/en/document/fullscreen/62266590/the-nursing-voice-december-2018/ Bill Status Illinois State House Bill HB2604 NPR - Why Mandated Nurse-to-Patient Ratios Have Become One of the Most Controversial Ideas in Health Care Illinois Nurses Push for Safe Patient Limits, Working Conditions New York State Senate Bill S1032
  2. NursesTakeDC

    How many more decades?!?

    How many more decades must we continue this fight for safe nurse to patient ratio staffing?!?! Remember the “mandated ratio” legislation INCLUDES patient acuity and nurse skill mix adjustment. #SafePatientLimits indeed saves lives. “Nightingale rigorously researched the impact of the introduction of trained nurses on mortality in military hospitals. Once having established an association between trained nurses and reductions in patient deaths, she spent much of her life advocating for these findings to be widely translated into practice to improve the quality and safety of hospital care. The International Year of the Nurse and Midwife in 2020 in recognition of the 200th anniversary of Florence Nightingale’s birth is a fitting time to take action based on the preponderance of evidence to date that good professional nurse staffing results in safer and higher quality hospital inpatient care. “ “All three papers confirm—at least with respect to mortality—that low RN staffing increases the risk for poor outcomes for patients. What is especially important about the confirmation provided by the Needleman et al 4 11 and Griffiths et al 13 papers is that they show longitudinal associations between RN staffing and patient outcomes at the patient level, within hospitals, which suggests that the cross-sectional associations found in studies that use hospital-level RN staffing data and compare outcomes across hospitals, such as the RN4CAST study, are more likely to be causal than artefactual and reflect differences in patient exposures to different staffing levels as well. We provide additional evidence of this in our own recent work” “The findings of the RN4CAST paper on the outcomes of nursing skill mix are closer to those of Griffiths et al than to Needleman et al, showing, for example, that substituting one nursing assistant for an RN for every 25 patients is associated with a 21% increase in the odds of dying”. Credit to authors: Linda H Aiken and Douglas M Sloane https://qualitysafety.bmj.com/content/29/1/1.full #NursesTakeDC www.nursestakedc.com
  3. NursesTakeDC

    Just Say “NO” to Nurse Staffing Laws

    This was originally written on the Yes article, we feel it warrants to be placed here especially. Not one analytical study of staffing committees shows that the method promoted by the ANA is effective at improving patient outcomes or nurse staffing. Which you do note in a paragraph above, thank you, but readers need to really understand the gravity of the inadequacy of that legislation. It looks great on paper and in theory, but the real effect of it greatly lacks. There is a notion that with mandated ratios that acuity of patients and a nurses skill set cannot be accounted for, but ironically enough, the national nurses study completed by the data we collected and published by the Illinois Economic & Policy Institute and the Illinois Labor & Employment Relations; shows that CA (with ratios) actually accounts for the acuity of patients more than Illinois, a state that has had the ANA legislation since 2007. That legislation is useless. "47% of nurses in California report that staffing levels are based on the needs of patients in their units compared to just 32% in Illinois" https://illinoisepi.files.wordpress.com/2019/09/pmcr-with-ilepi-do-nurse-staffing-standards-work.pdf There are mixed results from California, true enough. This can be attributed to methods of data collection and study design and have been acknowledged as so by Aiken. An aspect for people to know, having read several articles (including anti ratio) that explain how California did not have a significant need for an increase in nurse staffing numbers. It has especially been noted in the Kaiser facilities that most of them were already at the legislated level before the law went into place. Therefore, if you look at before and after, you may not see a significant difference depending on data collection and hospitals used in the studies. When common sense tells us that improvement should occur on such a fundamental topic such as staffing, and some (not all) research contradicts that, we must ask why did those results that don't make sense occur? Could it be that by statistically correlating items that did not always have a difference, such as falls and bedsores (again mixed results), in with items that have significant findings, such as failure to rescues, resulting in a decreased overall significant result has skewed significant results? Failure to rescues is statistically significant in almost all, if not every study that I have read, even ones that are anti-ratios. Death of a failure to rescue is significant and warrants not being calculated in with other nursing measurements just to decrease the overall significance. It is no secret that our professional organization does not support real safe staffing legislation. They only support the fantasy "staffing committee" and the acuity method. And don't get me wrong, having nurses participate in the process is a good thing (if it actually happens and acuity needs to be part of staffing; but there needs to be a cap on the amount of patients nurses can be forced to take at one time. Most hospitals have demonstrated that they will only do this after being forced. Staffing should be well enough that one call out does not result in unsafe staffing, contingency plans should be in place for unexpected events within reason. It should not be considered unreasonable to have break/resource nurses on units so that nurses are not watching two assignments when someone goes on break. Most hospitals in California have made it work successfully and hospitals there are making Millions-->Billions. So what if it is less than they would like. When CEOs are making Millions (and they are) along with other shareholders.... why do we care that they would make a little less in return for safe staffing? The fact is, even if CA hospitals are below the rest of the nation, they are still thriving. In the article against having mandated ratios, it is discussed how EDs in CA wait time increased. That was found in a hospital that refused to hire staff (because they did not want to spend money, documented in the study). Therefore, they went against the law because they did not want to invest in nursing staff. This is an obvious purposeful outcome from the hospital's manipulation. Yet, there are also studies where hospitals did increase their staffing for the law, and the results show wait times decreased. So basically, we are supposed to concede to what a hospital's responsibility is because they purposely did not staff as they should have? Instead of penalizing them for refusing to abide by the law, safely staff, and provide care in a timely manner we should say no to having a safe patient limit? NO.... plain and simple. That should not be the response. We absolutely should hold them accountable. If anyone would like to contact their legislators to support real safe staffing legislation, you can do so at https://www-nursestakedc-com.filesusr.com/html/6004d0_2ed35ee2fb8ab9833cd60448c91cb3af.html#/ It is time to implement evidence-based practice into holding hospitals accountable for their responsibility... safely staffing. To see world-renowned Linda Aiken Ph.D. discuss this as she has researched it for over two decades: To the author, thank you again for including our movement, getting nurses to discuss the issue, and allow for the education of what nurses need to be advocating for.
  4. NursesTakeDC

    Just Say “YES” to Nurse Staffing Laws

    Safe staffing legislation is not just because nurses feel their job is too hard. A copious amount of research indeed shows that patient outcomes are related to the nurse-to-patient ratio. Readmissions, mortality, failure to rescue, infections, falls, I can go on.... have all been demonstrated in research to have an association. And research this past year has been documented to have a "casual relationship" fully linking the two. Nurses getting a better work environment (also demonstrated in research to have a negative effect on poor patient outcomes if the environment is poor) is a side effect of safe staffing legislation. Nurses have been martyrs for decades. We need to say enough is enough, and actually advocate for our patients and the profession, as just accepting the status quo is not the best. And 29.00 for per-diem is horrible pay. Sincerely, thank you for serving, but your war experience is not comparable nor should be used as a measure to guilt people into accepting the status quo.
  5. NursesTakeDC

    Just Say “YES” to Nurse Staffing Laws

    AMEN... comparing the two is absolutely absurd and the acceptance of things that can and should be better as ok is what hurts patients. Studies show poor outcomes to patients from poor staffing. For anyone to defend the current unsafe staffing conditions because they have faced other Nobel but not relevant, to unsafe staffing situations, is more than misguided.
  6. NursesTakeDC

    Just Say “YES” to Nurse Staffing Laws

    Staffing laws are need because of people like you. I am sincerely happy that you have never had more than 2 patients in an ICU... many hospitals across the US are brainwashing their nurses that 3 patients are the new normal. And I mean 3 really sick, should have fewer ICU patients. I have seen step-downs where they are pushing 6 patients. Yes, very sick patients. For starters, not everyone can just pack up and move to a hospital that has safe staffing practices. But more importantly, patients do not always get the choice and patients in any hospital deserve the opportunity to receive safe patient care. Considering hospitals receive Millions of dollars from our taxpayer's money, in the form of reimbursements, they absolutely should have a real standard to be held accountable with safe staffing. Safe staffing should be a non-partisan approach. Unsafe staffing is a public health issue as failure to rescues are absolutely a real problem, and better nurse staffing can prevent it, as documented in evidence-based articles. Over 20 years of research show unsafe staffing as a problem and show a solution to help it. It is time for accountability and change.
  7. NursesTakeDC

    Just Say “YES” to Nurse Staffing Laws

    Not one analytical study of staffing committees shows that the method promoted by the ANA is effective at improving patient outcomes or nurse staffing. Which you do note in a paragraph above, thank you, but readers need to really understand the gravity of the inadequacy of that legislation. It looks great on paper and in theory, but the real effect of it greatly lacks. There is a notion that with mandated ratios that acuity of patients and a nurses skill set cannot be accounted for, but ironically enough, the national nurses study completed by the data we collected and published by the Illinois Economic & Policy Institute and the Illinois Labor & Employment Relations; shows that CA (with ratios) actually accounts for the acuity of patients more than Illinois, a state that has had the ANA legislation since 2007. That legislation is useless. "47% of nurses in California report that staffing levels are based on the needs of patients in their units compared to just 32% in Illinois" https://illinoisepi.files.wordpress.com/2019/09/pmcr-with-ilepi-do-nurse-staffing-standards-work.pdf There are mixed results from California, true enough. This can be attributed to methods of data collection and study design and have been acknowledged as so by Aiken. An aspect for people to know, having read several articles (including anti ratio) that explain how California did not have a significant need for an increase in nurse staffing numbers. It has especially been noted in the Kaiser facilities that most of them were already at the legislated level before the law went into place. Therefore, if you look at before and after, you may not see a significant difference depending on data collection and hospitals used in the studies. When common sense tells us that improvement should occur on such a fundamental topic such as staffing, and some (not all) research contradicts that, we must ask why did those results that don't make sense occur? Could it be that by statistically correlating items that did not always have a difference, such as falls and bedsores (again mixed results), in with items that have significant findings, such as failure to rescues, resulting in a decreased overall significant result has skewed significant results? Failure to rescues is statistically significant in almost all, if not every study that I have read, even ones that are anti-ratios. Death of a failure to rescue is significant and warrants not being calculated in with other nursing measurements just to decrease the overall significance. It is no secret that our professional organization does not support real safe staffing legislation. They only support the fantasy "staffing committee" and the acuity method. And don't get me wrong, having nurses participate in the process is a good thing (if it actually happens and acuity needs to be part of staffing; but there needs to be a cap on the amount of patients nurses can be forced to take at one time. Most hospitals have demonstrated that they will only do this after being forced. Staffing should be well enough that one call out does not result in unsafe staffing, contingency plans should be in place for unexpected events within reason. It should not be considered unreasonable to have break/resource nurses on units so that nurses are not watching two assignments when someone goes on break. Most hospitals in California have made it work successfully and hospitals there are making Millions-->Billions. So what if it is less than they would like. When CEOs are making Millions (and they are) along with other shareholders.... why do we care that they would make a little less in return for safe staffing? The fact is, even if CA hospitals are below the rest of the nation, they are still thriving. In the article against having mandated ratios, it is discussed how EDs in CA wait time increased. That was found in a hospital that refused to hire staff (because they did not want to spend money, documented in the study). Therefore, they went against the law because they did not want to invest in nursing staff. This is an obvious purposeful outcome from the hospital's manipulation. Yet, there are also studies where hospitals did increase their staffing for the law, and the results show wait times decreased. So basically, we are supposed to concede to what a hospital's responsibility is because they purposely did not staff as they should have? Instead of penalizing them for refusing to abide by the law, safely staff, and provide care in a timely manner we should say no to having a safe patient limit? NO.... plain and simple. That should not be the response. We absolutely should hold them accountable. If anyone would like to contact their legislators to support real safe staffing legislation, you can do so at https://www-nursestakedc-com.filesusr.com/html/6004d0_2ed35ee2fb8ab9833cd60448c91cb3af.html#/ It is time to implement evidence-based practice into holding hospitals accountable for their responsibility... safely staffing. To see world-renowned Linda Aiken Ph.D. discuss this as she has researched it for over two decades: To the author, thank you again for including our movement, getting nurses to discuss the issue, and allow for the education of what nurses need to be advocating for.
  8. NursesTakeDC

    Male Nurse Disgusted by Female Nurses

    He is correct. Even if you are lucky enough to work some place that has good staffing, there is no reason you should not be advocating for it in all hospitals. Seeing the apathy of our profession on this for the past 4 years has been discouraging a lot of times. But I keep advocating for the patients. ALL patients in ALL hospitals in ALL states deserve the opportunity to receive safe patient care. www.nursestakedc.com
  9. NursesTakeDC

    Safe Staffing Survey Results

    See results from the survey we did this past October 2018. Thank you to allnurses for your support, and for assisting us to reach the nurses who responded to the survey. Link to the complete article is below. "Results from an October 2018 national survey of over 9,000 registered nurses in hospitals across the United States provides important new evidence to inform this debate. Survey responses indicate that workplace outcomes for nurses and patient care are better in California, the only state that has enacted safe patient limits for nurses, than in Illinois and other states. 47 percent of nurses in California report that staffing levels are based on the needs of patients in their units compared to just 32 percent in Illinois; 66 percent of nurses in California care for between one and four patients at a time during a shift compared to just 35 percent in Illinois; The average nurse in California has 4.3 patients at one time while the average nurse in Illinois has 5.2 patients at one time; 40 percent of nurses in California report that the patient-to-nurse ratio in their units is safe compared to just 18 percent in Illinois; and 55 percent of nurses in California fear retaliation for providing input about staffing in their units compared to 61 percent in Illinois. As the only state with safe patient limits, California’s staffing standards and workplace safety have fostered an environment where more nurses feel that staffing is based on the needs of patients and more nurses feel that the patient-to-nurse ratio is safe. By reducing patient-to-nurse ratios, enacting a safe patient limits law in Illinois could improve occupational safety, increase nurse retention rates, and promote better health outcomes for patients and have little to no negative impact on the financial performance of Illinois’ hospitals. " https://illinoisepi.files.wordpress.com/2019/08/pmcr-ilepi-do-nurse-staffing-standards-work.pdf
  10. NursesTakeDC

    ICU Nurse Fired For Refusing 3rd Patient

    Honestly, it is not our position to question her decision making on that day. If she felt it was unsafe then it was. She is not a new nurse who lacks critical thinking. Us accepting these occurrences is what is allowing admins to make 1:3 in ICU a normal behavior. Often those patients are really still fragile but downgraded to make room for an impending admit. Patients being charged for ICU level of care, and interventions like continuous monitoring that are not getting that level of care is fraud... period. The best nurse ever can only do so much. We need to stop criticizing each other and hold hospitals accountable to their responsibility of staffing properly. This is why we need #SafePatientLimits www.nursestakedc.com
  11. NursesTakeDC

    Know who supports what.

    Please help us continue to grow and get nurses and patients educated on the importance of patient and nurse advocacy. www.nursestakedc and https://www.facebook.com/nursestakedc/ Anyone can follow and support this cause, as unsafe staffing is a public health issue... it is not just a nursing issue. Every person will one day be a patient and have loved ones as patients. Everyone has the likelihood of being negatively impacted by unsafe staffing. Support #SafePatientLimits Support S 1357 & HR 2581 #NursesUnite #PatientSafety #NursesTakeDC
  12. Your goal... contact your legislators once a month for one of two things. Develop a relationship with them. 1. If they are already sponsor/co-sponsors: Thank them for supporting S 1357 and HR 2581. We want to keep them reminded at the importance of the legislation and show appreciation for their support. 2. If your congressman is not yet a supporter, they need to hear from you(their constituent) the importance of co-sponsoring the legislation. Personal stories are best. An action site that can easily assist you to your legislators is at https://www-nursestakedc-com.filesusr.com/html/6004d0_2ed35ee2fb8ab9833cd60448c91cb3af.html#/ You can email, tweet, FB post and call. Just type in your address. Remember that there is no need to fear repercussions as your boss will never know that your contacting them.
  13. NursesTakeDC

    Report your current staffing

    Nurses RNs & LPNs... Acute care and LTC... This is for you. It's anonymous, simple to fill out, and we can periodically post what is going on countrywide. The guidelines for it include: 1. Only complete this if you are a direct care bedside working RN or LPN/LVN. 2. This is to be completed for the shift you are working. Keep responses to one per shift. ** It's about BOTH ratios and acuity** Thankfully every piece of legislation for safe patient limits INCLUDES acuity. #NursesUnite #NursesTakeDC #SafePatientLimits https://www.nursestakedc.com/real-report-your-current-staffing
  14. NursesTakeDC

    Should Hospitals Set Workloads for Nurses?

    No they most certainly should not!!!
  15. NursesTakeDC

    CEO Says More Nurses Won't Improve Care

    A national survey was completed in October 2018. This article presents the data that was collected from the State of Illinois. The purpose of this article is to show the experiences that bedside nurses are having in Illinois in their hospital staffing practices, as their state has legislation that has been enacted since 2008 called the Nurse Staffing by Patient Acuity Act. #NursesTakeDC #NursesUnite https://allnurses.com/illinois-nurse-staffing-survey-t699288/
  16. NursesTakeDC

    Should Hospitals Set Workloads for Nurses?

    A national survey was completed in October 2018. This article presents the data that was collected from the State of Illinois. The purpose of this article is to show the experiences that bedside nurses are having in Illinois in their hospital staffing practices, as their state has legislation that has been enacted since 2008 called the Nurse Staffing by Patient Acuity Act. #NursesTakeDC #NursesUnite https://allnurses.com/illinois-nurse-staffing-survey-t699288/
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