Nurses from around the state of New York are pushing lawmakers to finally pass legislation that would set minimum staffing levels for hospitals and nursing homes to improve patient outcomes by addressing chronic staffing problem.
When the emergency room fills up — whether it’s a big accident, flu season or bad luck — nurses say they can easily wind up with 16 or 17 patients, too many be able to provide appropriate care.
Nurses push for Safe Staffing for Quality Care Act
The Safe Staffing for Quality Care Act will set nurse-to-patient ratios in New York healthcare facilities and is supported by the New York State Nurses Association. California already has such a law, and the proposal has been debated in New York for years. This year it has bipartisan support in the Legislature.
The legislation would set out different staffing ratios for specific units. Operating rooms and trauma emergency units would have one nurse for each patient. Emergency rooms and newborn units would have one nurse for three patients. Rehabilitation units would have one nurse for every five patients. Hospitals that violate the law would face civil penalties.
Nurses point out that the ratios set a floor, not a ceiling there is flexibility for hospitals to make a staffing plan that addresses changes in patient acuity by staffing as patient needs dictate. According to the proposed law, assistive personnel would not count toward the licensed nurse-to-patient ratios and the ratios are the maximum number of patients assigned to any RN at all times during a shift – not an average.
In nursing homes the bill sets minimum care hours per resident, per day for RNs, LPNs and CNAs. The minimum hours of care per resident, per day are as follows: RNs: 0.75 hours divided among all shifts to provide an appropriate level of RN care 24 hours per day, seven days a week; LPNs: 1.3 hours; and CNAs: 2.8 hours.
Hospitals say Bill will only increase spiraling costs
Hospital executives say such a mandate would raise health care costs for patients, and would add $3 billion a year in costs statewide. They feel state lawmakers shouldn’t constrain hospitals by dictating unnecessary and inflexible rules. They say a “one-size-fits-all” approach doesn’t make sense when hospitals around the state vary so much when it comes to size and scope of practice.
Kenneth Raske, president of the Greater New York Hospital Association, said the mandate doesn’t take into account new technologies, medications and procedures are transforming hospitals and the demands on staff.
California implemented its staffing mandate in 2004. A 2010 study led by researchers at the University of Pennsylvania compared data from hospitals in California, Pennsylvania and New Jersey and found that lower staffing ratios are associated with fewer patient deaths.
Nurses say in addition to the number of patients, the types of patients they see has changed. Many people now take a variety of medications to manage complex illnesses. Also because relatively healthy patients are increasingly discharged to recover at home, those patients who stay in the hospital often present more difficult cases.
They point to thousands of formal protests filed by nurses last year about shifts in which there were not enough nurses scheduled to handle patient loads.
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