Inside nurses' decades-long battle for better staffing ratios and why the healthcare industry has remained resistant. There's a palpable air of excitement among nurses in Pennsylvania. For the first time in the state's history, a governor has voiced support for nurse-to-patient staffing rules that would set a maximum number of
Mandating nurses and pa an individual nurse can care for at once.
On top of Democratic Gov. Tom Wolf's support, 49 state legislators in Pennsylvania have co-sponsored bills in the House and Senate that seek to establish mandated nurse-to-patient staffing ratios in hospitals.
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The fight for staffing ratio legislation in Pennsylvania is just one of many across the country, largely led by labor unions and nearly always met with steadfast resistance from the hospital industry. Currently, 14 states have laws that address safe staffing, though California is the only state to implement a ratio mandate, at five patients to one nurse.
Seven states pass the buck on to hospital committees responsible for setting ratios within their own facilities.
Five states enforce a reporting mechanism for publicly disclosing staffing ratios. Short-staffed and overworked nurses pose real risks to patient safety, health outcomes and workforce retention in hospitals. Recent research shows patient-heavy nurse staffing ratios are also costing patients their lives, especially in intensive care units.
both mandatory and voluntary overtime...
The hospital industry has pushed back, arguing that there simply isn't enough research to support a front-loaded investment in nursing staff. They also contend there are not enough nurses to
Mandating nurses and pa in the first place and say staffing mandates would force facilities to close.
Advocates, many of whom believe the nurse shortage to be an industry myth, argue that California's ratio mandate, which adjusts for acuity and hospital setting, has proven to be cost-effective, produce better health outcomes and open the floodgates for job-seeking nurses.
The advocates tout California as a model for curbing the threat of a shortage.
We're the ones doing the work day-to-day. AONE has maintained the same position on mandatory staffing ratios sincebefore California's mandate was enacted. Welton also dismissed two studies on staffing ratios from the s in the New England Journal of Medicine and the Journal of the American Medical
Mandating nurses and pa, both cited among safe staffing advocates.
Aiken told Healthcare Dive that her team has been tracking the rate of change in nurse staffing over the past decade. So far, they've found that hospitals have reduced their staffing ratio by about a half-patient per nurse. Most of that improvement, she said, has been made by a small group of hospitals that have pursued more balanced ratios.
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They have much better hospital outcomes
Mandating nurses and pa well. But he said it's more complicated than that. In most states where staffing legislation exists, policymakers have forged compromise between nurses and hospitals. The result has been a market-friendly approach to legislation that mandates hospitals and health systems address staffing ratios themselves via internal committees. The hospital industry and leadership have overwhelmingly supported this as a solution when faced with the possibility of ratio mandate legislation.
Duty to the Patients
Aiken said this approach has worked in some hospitals, but executives need to be aware of research that shows hospitals get better patient health outcomes at a "significant savings" when safe staffing ratios are implemented. Nurses argue that many state-mandated committees are largely comprised of finance executives and management staff who don't necessarily know or have experience in the clinical side of the business.
Gerard Brogan, lead nursing practice representative with National Nurses United, does not believe the committee solution is good enough. Brogan pointed to Illinois, where the "Mandating nurses and pa" approach to staffing was enacted in as an alternative to a ratio mandate. Five years after passing the law, only Much to the former's chagrin, a proposed ballot question in that state could have voters deciding on a staffing ratio mandate in all hospitals this fall.
Ratio mandate advocates like Brogan say the assertion that hospitals will close is "bulk standard" rhetoric commonly adopted by hospital associations when faced with staffing ratio regulations, as are claims that mandated ratios are too rigid and the nurse talent pool too shallow. Boyle said the hospital industry made similar claims when the state banned mandatory overtime for nurses in The world is going to end,'" Boyle said.
It's the same thing with safe staffing.
Mandating nurses and pa Billa similar piece of legislation that seeks to set staffing ratio mandates, has garnered a handful of Republican cosponsors. Getting bipartisan support for ratio mandate legislation has been tough for other states. NNU has, unsuccessfully, helped mount such campaigns in Illinois, Ohio and Texas, among other states.
In addition to burnout rates, high turnover and an alarmingly high risk of experiencing workplace violence
Mandating nurses and pa, many nurses believe there's Mandating nurses and pa disconnect between business administrators driven by financial gain and clinicians driven by the ability to heal.
Aiken, for her part, will keep focusing on how nurse-to-patient ratios impact hospitals' bottom lines to get executives' attention. While consolidating health systems have in many cases relied on staff cuts for financial preservation, she pointed to her own research finding that growing organizations such as Kaiser Permanente that invest in nursing staff while placing patient-centered care at the core of their mission can simultaneously achieve a healthy bottom line and produce healthy outcomes.
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There's a palpable air of excitement among nurses in Pennsylvania.
For most workers, mandatory overtime...
seek to establish mandated nurse-to-patient staffing ratios in hospitals. In May, Pennsylvania Governor Tom Wolf voiced support for mandated nurse-to- patient staffing rules, making state history.
In mid-June, the. Pennsylvania Act covers health care providers (broadly defined) in Pennsylvania.
It prohibits covered employers from mandating that.
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