By Debra Wood, RN, contributor
Recognizing a need to improve patient care while helping to curb the nursing shortage by creating better work environments, U.S. Rep. Jan Schakowsky (D-Ill.) recently introduced in Congress the Nurse Staffing Standards for Patient Safety and Quality Care Act of 2007.
“Nurses are leaving the profession at an alarming rate, because they are overworked and hospitals are understaffed,” Schakowsky said in a written statement. “In our hospitals today, there are too few nurses caring for too many patients, a dangerous prescription with disastrous side effects.”
The Nurse Staffing Standards act (H.R. 2123) would establish minimum nurse-to-patient staffing ratios in all hospitals within two years of passage, four years for rural facilities.
A hospital would be required during each shift, except during a declared emergency, to assign a direct-care registered nurse to no more than the following number of patients in designated units:
• One patient in an operating room and trauma emergency operating room and trauma emergency unit. • Two patients in all critical care units, intensive care, labor and delivery, and postanesthesia units. • Three patients in antepartum, emergency, pediatrics, step-down and telemetry units. • Four patients in intermediate care nursery, medical/surgical and acute care psychiatric care units. • Five patients in rehabilitation units. • Six patients in postpartum, three couplets, and well-baby nursery units.Hospitals must post in a visible place the ratio for that unit, so patients and staff will know what is required.
Failure to comply with the staffing requirements could result in a range of corrective actions, including monetary penalties and loss of funds. The Department of Health and Human Services will oversea compliance. Hospitals could receive additional Medicare reimbursement related to costs associated with staffing appropriately.
The bill requires hospitals to develop, with assistance from direct-care nurses, staffing plans within one year of its passage. Facilities also would be required to maintain documentation of actual staffing.
The legislation would offer whistleblower protection to nurses reporting a violation or refusing assignments that threaten the safety and health of patients due to staffing below the minimum ratios.
Nine House members have signed on as cosponsors of the staffing bill. Several unions, including the Service Employees International Union-Nurse Alliance (SEIU), endorse the bill.
Schakowsky encourages nurses to support the federal legislation and state bills, which help build momentum for national initiatives. She indicated the best way to convince lawmakers is to share personal stories about how short staffing has affected care and their satisfaction with the profession.
In a related matter, U.S. Rep. Pete Stark (D-Calif.) and Rep. Steven LaTourette (R-OH) introduced the Safe Nursing and Patient Care Act (H.R. 2122), limiting the amount of mandatory overtime hospital nurses are required to work, except during a declared state of emergency. The American Nurses Association and SEIU support the mandatory overtime bill.
“Mandatory overtime exhausts nurses mentally and physically, placing patients’ lives at risk and driving nurses out of the profession,” said Stark. “We limit the time that truck drivers and pilots can work to protect public safety. Safe nursing is in the public interest as well.”
The bill would protect nurses from discrimination by employers trying to force them to work additional hours, beyond what the nurse feels is safe.
“No patient wants to be cared for by a nurse at the end of a 16-hour shift. That's when errors are most likely to occur,” said Cathy Glasson, a registered nurse with 20 years of experience and the president of the Nurse Alliance of SEIU. “Short staffing and forced overtime are also huge factors in the growing number of nurses leaving the profession. To keep patients and nurses safe, Congress should end this dangerous practice.”
© 2007. AMN Healthcare, Inc. All Rights Reserved.