Nurses, federal lawmakers push for staffing ratio legislation

U.S. Rep. Jan Schakowsky, co-chair of the House Democratic Caucus Task Force on Aging and Families, and U.S. Sen. Sherrod Brown recently joined leaders from three unions to call for minimum nurse-to-patient staffing requirements in hospitals.

On March 30, the lawmakers reintroduced federal legislation that would set limits on the numbers of patients each registered nurse can care for in hospitals. They were joined by National Nurses United, the American Federation of Teachers, and the American Federation of State, County and Municipal Employees, which have endorsed the bill, dubbed the Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act.

"Numerous studies have shown that safe nurse-to-patient staffing ratios result in higher quality care for patients, lower healthcare costs and an overall better workplace for nurses," Ms. Schakowsky said in a news release. "For years, I've talked to exhausted nurses who have said they go home at night wondering if they forgot to turn a patient because they were stretched far too thin. The need for federal safe staffing standards is about nurses, patients and everyone's lives." 

In addition to establishing nurse-to-patient staffing ratio requirements in hospitals, the bill would also study best practices for nurse staffing and provide whistleblower protections to protect nurses' right to advocate for patient safety, according to the release. Currently, California has mandated nurse-to-patient ratios while other states are mulling similar legislation. The legislation introduced March 30 is the latest effort at the federal level.

"Nurses work long hours doing vital work in our healthcare system, but too often they're stretched too thin, caring for too many patients with too little support," Mr. Brown said in the release. "We can empower nurses to protect … patients by ensuring nurses are adequately staffed and can advocate for their patients without fearing potential retaliation."

Unions have supported staffing ratios, saying such measures are necessary to improve patient care and retain workers. Hospitals, however, have advocated for other solutions to workforce challenges.

Robyn Begley, DNP, RN, senior vice president of workforce for the American Hospital Association and CEO of the American Organization for Nursing Leadership, emphasized hospitals' commitment to safe staffing to ensure quality patient care and optimal patient experience. 

But "mandated nurse staffing ratios are a static and ineffective tool that does not guarantee a safe healthcare environment or quality level to achieve optimum patient outcomes," Dr. Begley said in a statement shared with Becker's. "Staffing ratios are usually informed by older care models and do not consider advanced capabilities in technology or interprofessional team-care models. These newer models incorporate not only nurses at various levels of licensure, but also respiratory therapists, occupational therapists, speech-language pathologists, physical therapists and case managers."

She added that U.S. hospitals and health systems "are working to foster healthy practice environments, advance patient safety [and] affordability, and enhance value by transforming healthcare delivery. Mandated approaches to nurse staffing limit innovation, reduce the flexibility needed to respond to patients' changing care needs and increase stress on a healthcare system already facing an escalating shortage of educated nurses."

To read the full bill, click here

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