Safe Nurse Staffing for Patient Safety & Quality Care Act

[j0yegan]

Please send a letter to your Congressman about enacting the bill about having mandatory nurse-to-patient ratios by going here:

http://www.nationalnursesunited.org/page/speakout/national-ratios

You can look more into what the proposed RN ratios will be and more here:

http://www.nationalnursesunited.org/issues/entry/ratios

We need your help to make this bill a reality. Send this to everyone you know.

This will ~~ NEVER ~~ pass at the national level.

State by state, though, is attainable.

The middle ground has been snatched away LONG ago; the leeway has been in favor of the money camp for over 20 years.

And now that SCOTUS has decreed that (1) corporations are people, (2) that spending money is speech, and (3) that campaign donations are unrestricted, it's going to get much, Much, MUCH worse over the coming decades.

[Altra, BSN, RN]

It is all too black and white. It is all to us vs them. It is all to big bad corporation bean counters vs wonderful nurses. There is a huge middle ground.

In that "middle ground" you speak of are patients' lives. Are you honestly saying you can provide the same care to 8 patients that you can to 4, in the same shift? I beg to differ. Making it to 0700 without anything bad happening is far too low a bar to set.

Honestly I guess this 64 year old is still to naive. I think most bean counters, CEO's, want satisfied patients, (or a good product from their factory), happy workers, well run institutions.

Patient satisfaction is measured extensively (you can google HCAHPS and/or Press Ganey to learn more) on topics that have little to do with actual care provided or with health outcomes. Reimbursement for services is heavily tied to documented compliance with multiple layers of governmental regulatory mandates and adherence to insurers' protocols. Those are the "customers" served.

[Altra, BSN, RN]

I have shared this extensively with family, friends and contacts. I always stress that this is not about me as a nurse ... it's about you (the person to whom I'm speaking) as a patient!

[seadobe]

I am wondering what the ratios are where everyone works. Im doing a project for my MSN on ratios. https://www.surveymonkey.com/s/XXT87DH

[cjcalimer]

I've been a nurse on an Orthopaedic unit for almost 7 years on night shift. I can say how my night goes has aboslutely nothing to do with how many patients I have. I could have three patients at 7pm and be entirely overwhelmed or have 6 and be sitting pretty. There are so many factors that affect safe staffing beyond just a number. Acuity, availabilty of ancillary staff, admisions, discharges, how busy the person I picked my assignment up from was, etc.

I can also honestly say I have seen acuity on our unit drastically increase in just the last three years to the point that what might have been a good number then is not now. We almost always work without any ancillary staff and for falls prevention all bed alarms mut be on, all patient's must be accompanied to the bathroom, and staff must remain with them until they are safely back in bed. It's not unrealistic for me to do this 15+ times in a 12 hour shift. We also now must do our own transport, so if I get an admission I have to go get them. Our ER is two full city blocks from my unit. The process, from calling for report to settling the patient in their room, becomes almost an hour process. There's no way to capture or account for this sort of time suck. In addition, our unit has incredibly high turnover. While a day shift nurse might never technically have more than 4 patients, with admission and discharges she might care for more like 7 patients over her shift. Ratios can be used to create unsafe staffing in some circumstances too and you can bet that if a ratio is in place, you are always going to have that many patients no matter what.

That being said, ratios at least offer some protection from a completely insane assignment. I know I start to loose track of my patients with the 7th one. I start to forget who is who, when people have meds due, and I just feel stressed and on the defensive. Instead of trying to take good care of my patients, I'm just trying to get everything done and not leave a mess for the person following me. I can also say my manager cares way more about day shift staffing then she does about nights. Perhaps because she's actually there to complain to during the day whereas night shift never sees her.

Either way, I don't think there's an easy answer. Ratios are ok but problematic. Acuity would be better but there's no evidence based way to acurately assess acuity to my knowledge. Sure there are tools, but I'm not sure how valid they've been shown to be. It would be nice is administration could be trusted to be vested in safe staffing and listen to nurses when they say it's not. Unfortuneately it's just not the case.

There's no way to capture or account for this sort of time suck.

I presume that you mean there's no way to capture it in your present system. Generally, though, it can certainly be captured and accounted for as a burden rate. The powers-that-be, however, have no vested interest in doing so.

Ratios are ok but problematic.

I think ratios are much better than "ok" and aren't really problematic. They are, however, only the beginning and merely a piece of what should be a comprehensive approach to appropriate staffing.

[herring_RN, ASN, BSN]

I think it will pass someday. Not with this Congress. If we nurses continue to educate the public and elected legislators they will finally realize safe nurse staffing is good public policy.