Texas RN's ask for lower patients-ratio

NT · Mar 6, 2009

This concerns me because staffing is so multifactorial. Hmmmm, how do they account for all the different situations based on acuity, environment, etc.?

NurseTim

Purple_Scrubs, BSN, RN · Mar 6, 2009

I may be wrong, but my understanding is that the proposed law will not set staffing ratios per se, but will require that hospitals have a committee staffed of NURSES who will set the ratios. That way, it can vary from hospital to hospital and from unit to unit. If I am understanding that correctly (maybe someone can confirm that?), then I think it is a great idea as long as STAFF nurses are involved and not nurse managers who are in administration's pocket.

If it passes and it works, it might be enought to draw me back to the bedside.

nicurn001 · Mar 6, 2009

In CA the ratio law , is the floor ,not the ceiling to staffing levels . It sets a minimum staffing level , applicable in various areas eg. Telemetry , ICU,ER etc here is a link :- http://www.calnurses.org/nursing-practice/ratios/ratios_index.html

Whilst the minimum is met , if Acuity is higher ,then staffing should be increased to meet that requirement .

I have not read the proposed Texas law , but hopefully it would work in a similar to the CA law.

allnurses Guide · Mar 6, 2009

texas hospital patient protection act of 2009:

to mandate safe staffing, based on patient acuity, by setting the minimum direct-care registered nurse-to-patient staffing ratios necessary for safe nursing care and for retention and recruitment of qualified direct-care rns.
to establish direct-care rn nursing standards and practice protections to assure that care is provided in the exclusive interests of patients.
to recognize direct-care nurses' duty and right to be a patient advocate.
to provide effective protection against retaliation for reporting unsafe patient care and for refusing unsafe patient care assignments.

http://www.calnurses.org/nnoc/texas/

RN4MERCY · Mar 7, 2009

This concerns me because staffing is so multifactorial. Hmmmm, how do they account for all the different situations based on acuity, environment, etc.?
NurseTim

It's about time for more laws like this one, Tim. The law codifies minimum safe staffing standards to protect patients from the harmful consequences of profit-driven administrative restructuring schemes. The direct care RN's independent professional clinical judgement about what constitutes a "safe" assignment should not be over-ruled by employer controlled "staffing committees" that lack transparency and accountability. Hospital administrators are organized to protect their profits. These nurses in Texas are organizing to protect their patients, and their right and duty to advocate for them.

Direct care nurses are educated and make these "multifactorial" assessments everyday. It's called "critical thinking" and it underlies the nursing process. Because no two human beings respond alike to any illness, injury, or treatment regimen, the application of judgement is critical. The bottom line is that the RN who is directly accountable to the patient is responsible for making the determination of patient acuity and their ability to safely carry out the assignment.

For too long hospitals have failed to provide sufficient RN staff to meet patient needs based on valid patient classification determinants. California nurses were the first in the nation to successfully challenge the hospital industry at the bedside and in the legislature. Staffing based on the employer's bottom line and profit margin, with no staffing variability based on patient acuity, has been the defacto M.O. of the hospital industry. Texas RNs are stepping up to the plate, like the RNs did in California, and they're saying: "ENOUGH" by supporting the Texas Patient Protection Act.

Multiple studies demonstrate that patients have suffered preventable complications, even death as a result of profit-aligned staffing as opposed to patient needs-based staffing. Kudos to the Texas RNs who are fighting for minimum safe RN to patient ratios and staffing by patient acuity to correct those conditions which are against the interests of their patients and their profession. :bow:

loricatus · Mar 8, 2009

I would be shocked if they passed the bill as introduced. Texas legislation sides with the rich, who make substantial campaign contributions and are part of the old boy network. Hospitals/Health Networks would be financially impacted by having to properly staff: so, my bet is that this bill will be watered down with a feeble explanation on how ratios could somehow harm patients.

I am hoping I am wrong.

Not wanting to get my hopes up; but, maybe, just maybe, their egos might be large enough to actually enact something better than CA. Pride is big in Texas and maybe it might work in nurses' favor.

RN4MERCY · Mar 8, 2009

I would be shocked if they passed the bill as introduced. Texas legislation sides with the rich, who make substantial campaign contributions and are part of the old boy network. Hospitals/Health Networks would be financially impacted by having to properly staff: so, my bet is that this bill will be watered down with a feeble explanation on how ratios could somehow harm patients.
I am hoping I am wrong.
Not wanting to get my hopes up; but, maybe, just maybe, their egos might be large enough to actually enact something better than CA. Pride is big in Texas and maybe it might work in nurses' favor.

It's a sad day when we've become so numbed by corporate interest/dirty money politics that we would express shock at the possibility that legislators would do the right thing on behalf of the people.

You're right, Texas does have a reputation to uphold. As I see it, the California Legislature has thrown down the gauntlet. Now let's see if we can get "a little less talk and a lot more action" from the Texas State Legislature: A BIGGER AND BETTER RATIO LAW THAN CALIFORNIA!

The Texas nurses have taken up the challenge on behalf of their patients. I'm down with that! :up: