What does this mean for Michigan LPNs??

[KrisRNwannabe]

So what does this bill mean for the LPNs in the hospital setting?? Today one of the hospitals north of me anounced they were laying off LPNs. 22 in all. in my area of the 3 hospitals only 1 hires LPNs. and south of me don't hold your breath cuz I have never seen an ad for LPNs at a hospital since I started school. I am bummed because I graduate from LPN school in August and will be forced to work extended care until I get my RN. I graduate in august and am going back for my RN in september. I am interested in hearing your comments on this new bill.

SENATE BILL No. 169

February 3, 2005, Introduced by Senators PATTERSON, PRUSI, BASHAM, JACOBS, OLSHOVE, SCHAUER, BRATER, CHERRY and BARCIA and referred to the Committee on Health Policy.

A bill to amend 1978 PA 368, entitled "Public health code," (MCL 333.1101 to 333.25211) by adding section 21525.

THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

Sec. 21525. (1) Within 1 year after the effective date of the

amendatory act that added this section and annually thereafter, a

hospital shall submit to the department a staffing plan as provided

under this section. Each hospital is responsible for the

development and implementation of a written staffing plan that

provides sufficient, appropriately qualified nursing staff in each

unit within the hospital in order to meet the individualized needs

of its patients. Each hospital shall develop an assessment tool

that evaluates the actual patient acuity levels and nursing care

requirements for each unit during each shift. The hospital shall

use the assessment tool to make adjustments to the staffing plan as

needed to ensure safe patient care.

(2) To assist in the development of a staffing plan, the

hospital shall establish a staffing committee for each unit and at

least 1/2 of the members shall be registered professional nurses

who are direct care providers in that unit. If the nurses in the

hospital are under a collective bargaining agreement, the

collective bargaining representative shall designate the nurses

from within each unit to serve on the staffing committee for that

unit. Participation on the staffing committee shall be considered a

part of the nurse's regularly scheduled workweek. A hospital shall

not retaliate against a nurse who participates on the staffing

committee. The staffing committee shall establish a staffing

strategy for that unit if the patients' needs within that unit for

a shift exceeds the required minimum direct care registered

professional nurse-to-patient ratios set forth under subsection (4).

(3) Within 2 years after the effective date of the amendatory

act that added this section, each hospital shall have established

and implemented an acuity system for addressing fluctuations in

actual patient acuity levels and nursing care requirements

requiring increased staffing levels above the minimums set forth

under subsection (4). The assessment tool shall be used annually to

review the accuracy of the acuity system established under this

subsection.

(4) Within 3 years after the effective date of the amendatory

act that added this section, a hospital's staffing plan shall

incorporate, at a minimum, the following direct care registered

professional nurse-to-patient ratios for each of the corresponding

units:

(a) Critical care - adult or pediatric: 1 to 1.

(b) Operating room: 1 to 1.

© Labor and delivery:

(i) During second and third stages of labor: 1 to 1.

(ii) During first stage of labor: 1 to 2.

(iii) Intermediate care newborn nursery: 1 to 3.

(iv) Noncritical antepartum patients: 1 to 4.

(v) Postpartum mother baby couplet: 1 to 3.

(vi) Postpartum or well-baby care: 1 to 6.

(d) Postanesthesia care unit: 1 to 2.

(e) Emergency department:

(i) Nontrauma or noncritical care: 1 to 3.

(ii) Trauma or critical care patient: 1 to 1.

(iii) One r.n. for triage.

(f) Stepdown: 1 to 3.

(g) Telemetry: 1 to 3.

(h) Medical/surgical: 1 to 4.

(i) Pediatrics: 1 to 4.

(j) Behavioral health: 1 to 4.

(k) Rehabilitation care: 1 to 5.

(5) Except as otherwise provided under this subsection, in

computing the registered professional nurse-to-patient ratio

required under subsection (4), the hospital shall not include a

registered professional nurse who is not assigned to provide direct

patient care in that unit or who is not oriented, qualified, and

competent to provide safe patient care in that unit. In the event

of an unforeseen emergent situation, a hospital may include a staff

member who is a registered professional nurse who is not normally

used in computing the ratio requirement because the staff member

performs primarily administrative functions if the staff member

provides direct patient care during the emergency, but shall be

included in the computation only for as long as the emergency

exists. In computing the registered professional nurse-to-patient

ratio for the operating room, the hospital shall not include a

circulating r.n. or a first assistant r.n.

(6) The registered professional nurse-to-patient ratio

established for each unit under subsection (4) does not limit,

reduce, or otherwise affect the need for other licensed or

unlicensed health care professionals, assistants, or support

personnel necessary to provide safe patient care within the unit.

(7) The hospital shall post the hospital's staffing plan for

each unit in a conspicuous place within that unit for public

review. Upon request, the hospital shall provide copies of the

staffing plan that are filed with the department to the public. The

hospital shall make available for each member of the nursing staff

a copy of the staffing plan for his or her unit, including the

number of direct care registered professional nurses required for

each shift and the names of those registered professional nurses

assigned and present during each shift. A staffing plan developed

under this section and the minimum staffing ratios established

under this section are minimums and shall be increased as needed to

provide safe patient care as determined by the hospital's acuity

system or assessment tool. A hospital shall not use mandatory

overtime as a staffing strategy in the delivery of safe patient

care except in the event of an unforeseen emergent situation.

(8) If a hospital fails to submit an annual staffing plan as

required under this section or does not meet the required staffing

plan established for each unit during each shift, as adjusted in

accordance with the hospital's acuity system or assessment tool to

maintain safe patient care, the hospital is in violation of this

section. Each violation shall be reported to the department by the

hospital's designated representative, and the department shall

assess an administrative fine of up to $10,000.00 for each

violation. Each day that the staffing plan is not filed and each

shift that does not satisfy the minimum staffing requirements for

that unit is a separate violation. The department shall take into

account each violation of this section when making licensure

decisions.

(9) The fines assessed under this section shall be deposited

into the nurse professional fund established under section 16315

and expended only for the operation and administration of the

Michigan nursing scholarship program established under the Michigan

nursing scholarship act, 2002 PA 591, MCL 390.1181 to 390.1189.

(10) As used in this section:

(a) "Acuity system" means a system established to measure

patient needs and nursing care requirements for each unit to ensure

safe patient care based upon the severity of each patient's illness

and need for specialized equipment and technology, the intensity of

nursing interventions required for each patient, and the complexity

of the clinical nursing judgment needed to design, implement, and

evaluate each patient's care plan.

(b) "Department" means the department of community health.

© "Mandatory overtime" means a mandated assignment for a

registered professional nurse to work more than his or her

regularly scheduled hours according to his or her predetermined

work schedule.

(d) "Registered professional nurse" or "r.n." means that term

as defined in section 17201.

(e) "Staffing plan" means a written plan that establishes the

minimum specific number of registered professional nurses required

to be present in each unit for each shift to ensure safe patient

care.

(f) "Unforeseen emergent situation" means an unusual or

unpredictable circumstance that increases the need for patient care

including, but not limited to, an act of terrorism, a disease

outbreak, adverse weather conditions, or a natural disaster.

[rjflyn, ASN, RN]

Not much more than things are already. Having lived and worked in MI for a total of about 5 years most hospitals dont have alot of LPN's working in them anyway. This is basicly a nurse patient ratio legislation. Having worked in a union facility its pretty much what has been being talked about for the last 2-3 years. If this comes to a surprise to some then all I can say is one needs to get themselves up to date quickly.

Rj:rolleyes:

[suzanne4, RN]

This has been talked about for some time in Michigan. Glad to see that they are finally talking of ratios.

Many hospitals have not been hiring LPNs for some time, this is also not anything new. Not sure what your school has been telling you..........

Good luck with your schooling........... :)

[lapappey]

Ratios are nice, but some of these particular ones seem like oh so much pie in the sky. 1:2 in my PACU? I'd love it. But do we have it? No sir.

But wouldn't it be nice?

And what does:

In computing the registered professional nurse-to-patient

ratio for the operating room, the hospital shall not include a

circulating r.n. or a first assistant r.n.

mean for Surgical Techs in Michigan???

[starcandy]

Glad to see a bill finally with patient ratios, Med Surg 1:4 that is good. In my hospital there are not many LPN's at all.