Federal Nurse Staffing Bill Backed by ANA

Nursing Staff Management

The American Nurses Association has provided input for and is backing newly proposed legislation that would require each unit to create and publicly report staffing plans.

Last month, on May 15, the Registered Nurse Safe Staffing Act of 2014 was introduced as Senate Bill 2353. It’s a continuation/companion bill to the slow-moving H.R. 1821 — the RN Safe Staffing Act of 2013. Democratic Senator Jeff Merkley of Oregon sponsored the 2014 legislation.

Unlike California’s specifically mandated nurse-to-patient ratios, and the similar scope of nurse staffing legislation efforts underway in Massachusetts, the Registered Nurse Safe Staffing Act of 2014, doesn’t intend to specify staffing levels or nurse-to-patient ratios, but rather would simply require staffing levels to be formally decided on within each unit, with the results of such decisions available publicly.

Under the bill, hospitals would be required to form committees to establish nurse staffing plans. Committees would be required to be comprised of, at minimum, 55% direct care nurses, with the remainder committee members being selected at the hospital’s discretion. Some examples of other potential committee members have been hospital or nurse administrators, doctors, and stakeholders, for example.

The decided upon staffing plans would be determined for each unit and shift, and would be established based upon a variety of factors, including, but not limited to:

  • The experience/certifications/skills of nurses working a unit
  • Number of support staff available in a unit (as well as their background/skill)
  • Physical and technological resources within a unit
  • Quantity of patients in a unit, as well as patients’ conditions

Those in favor of the legislation believe that it threads the needle of doing something about improving nurse staffing ratios, while also avoiding a “one-size-fits all” attitude that might ignore each facility, unit, and shift’s unique staffing needs.

“What works in a rural hospital in my hometown [in North Dakota] may not be the same thing in an urban trauma center. It allows flexibility and it also allows buy-in,” Jerome Mayer, associate director, Department of Government Affairs at the ANA, told Health Leaders Media.

Mayer also commented on the part of the bill that would require the public reporting of the established staffing plans.

“We as consumers of healthcare are getting smarter about the delivery of care,” Mayer told Health Leaders Media. “If you’re able to compare the staffing levels … you’re probably going to go to the one that has a better ratio of nurses to patients.”

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