Nursing Notes

October 3, 2009

Nursing Staffing Laws |

Yet another article about staffing ratios and the effects they have on both nursing and patient care.  As you can see from reading below, this is a very controversial issue with very complex problems; I’m not sure if there is a “one size fits all” solution.  However, the fact that there is a multitude of articles and research that points out the problem should catch our attention.

Nurses are leaving our profession in large numbers.  Yes, some are retiring after long years of service; yes, some are leaving to take on the responsibility for the new, young families they have created; however, some are simply leaving because the profession asks for more than a person has to offer.

Nurses don’t become nurses to just “have a job”; nurses become nurses because they have a desire to help others, they have a calling, so to speak.
But when you leave at the end of your shift feeling that nothing you have done was enough, that you are sure you forgot to do something important, that you have been drained of both physical and psychic energy–what are your options?

Please read this article and then visit the site to read some of the related articles there.  You will find it very thought-provoking.

By Paul Oranika

Nurse staffing laws differ from state to state, an issue that is rife with controversy. Many states have different laws governing their staffing, while others are just beginning to explore the matter. The problem is compounded by the shortage of nurses that resulted from the exponential increase in health care demands across the nation. There are some important nursing staffing laws either on the books or being considered that may address these concerns.

Nursing Staffing Plans

1. Some states have adopted a new law requiring all hospitals to form committees that will create what the law calls nurse staffing plans, which seek to address the needs of patients as well as the appropriate ratios of nurses to patients. The plans seek a holistic approach to establish standards and to address the nurse/patient relations within the hospital setting, and they aim to increase nursing staff in line with the acceptable ratios. This law also requires that at least 50 percent of the members chosen as committee members be drawn from the the nursing profession. This means that half of the members of this new commission must be direct care nurses. The state of Illinois is spearheading this effort, although it is not alone. Texas, Oregon, Washington state and Ohio either have similar laws or are seeking to enact them.

Nursing Staffing Ratios

2. Many states are also implementing new laws to address the issue of nursing staffing ratios. This effort was originated by a nursing advocate group, according to Zenei Cortez, an RN and a leading member of the group. Cortez belongs to the President’s council of the Oakland-based California Nurses Association, a group that is working in conjunction with the National Nurse Organizing Committee. Advocates of the nursing staffing ratio want hospitals to take into account what they described as a patient acuity model to adjust the staffing ratio of hospitals. The patient acuity model seek to address the issue of nursing staffing from the perspective of each patient’s need for hospital services, which is in turn influenced by the patient’s medical condition.

California’s Safe Staffing Law

3. The California Safe Hospital staffing law went into effect on January 1, 2008, establishing a minimum ratio of nurses to patients. The new law has revolutionized health care in the state. It requires a minimum of one RN for every five patients in all the hospitals in the state for general medical care units and a ratio of one RN to four patients in the pediatrics department and in medical emergency rooms. Hospitals can choose to increase the number of nurses in any situation depending on need and the patient’s illness or acuity.

Controversy Over the Nursing Staffing Laws

4. Even though many states have adopted the law and more plan to do so, there is some controversy and objection from select nursing groups. The Oregon nursing union–11,000 members strong–opposes the new standards. Susan King, the executive director for the group, argues that it is difficult to adopt a single staffing standard for all hospitals because of the variables that exist in those medical institutions.

Should Ratios Be Imposed or Not?

5. While many hail the new ratio laws, some have also opposed the legislation. The National Nurse Organizing Committee sent out a mass mailing to the nursing establishments around the country supporting the initiative, arguing that the measure has increased the number of nurses in California. Other groups believe that such ratios should not be imposed on every medical institution. Some argue that while such a law has some benefits, each hospital should be allowed to decide its own nurse-to-patient ratio based on the hospital’s unique circumstances.

Nursing Staffing Laws |

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