Contacting Political Figures

As a group, we have contacted various key figures in politics who support the RN Safe Staffing Act. We provided them a link to our blog and asked for their feedback.

Daniel K. Inouye of Hawaii is the most senior member of the U.S. Senate. He has many accomplishments in Hawaii regarding health including building community health centers that target services to medically under served people, emergency medical services for children, administration on aging grants, pharmacy and pre-pharmacy programs, and much more. Senator Inouye reintroduced this act in Congress for the 2011-2012 session.

Congresswoman Lois Capps represents California’s 23^rd district. She is a former nurse and she supports the Safe Staffing Act as well as the Affordable Care Act. Unfortunately, we were not able to contact her because due to the large volume of email she receives, she only accepts emails from those within her district.

Karen Daley is the president of ANA. She is also a former nurse, as well as a strong supporter of the Safe Staffing Act. She was elected in 2010 and is known for mandating the use of safer needles in health care settings.

Congressman Steven Latourette from Ohio’s 14^th district is very active in nursing issues and is co-chair of the House Nursing Caucus. Along with his support of the RN Safe Staffing Act he is focused on nursing shortage, mandatory overtime, and increased funding for Nursing Workforce Development. Unfortunately, he only accepts emails from constituents within his district.

Delegate Vivian Watts is a delegate in northern Virginia. She is a member of the Virginia House of Delegates. She is also a former Secretary for Transportation and Public Safety and has worked hard to improve the quality of life in Fairfax County and in the Commonwealth of Virginia

There have been no recent updates to our Bill.

Support of the RN Safe Staffing Act

We support the RN Safe Staffing Act (S. 58/ H.R. 876) because we believe that is important for patient safety, adequate care and work satisfaction. This bill, instead of establishing a set nurse-patient ratio, allows for RNs to make the decision on safe ratio based on patient acuity, patient number, resources available and ancillary support services. As future RNs, we understand that while mandatory ratios are helpful, they are rarely sufficient. We have experienced first hand that only nurses who are actually on the floor of a unit understand the need for more staff and how to accommodate. Also, research has shown that poor staffing causes nurse burn out, job dissatisfaction and turnover, and poor patient outcome. Obviously as future RNs, job satisfaction and providing safe care are important components of a future career. Another huge component of this bill is addressing the concern with patient safety. Studies have shown that the consequences of not having adequate staffing are unsafe with multiple detrimental outcomes and that adding RNs to unit staff eliminates almost 1/5 of hospital deaths. The number one goal of the nurse is to provide safe, therapeutic, adequate care to patients, and current ratios are making this difficult. These are the main reasons that this bill has our full support.

The first step in our political action plan is to get in touch with legislators who support this bill to express our support and receive feedback on the current status of the bill. These legislators including Senator Daniel Inouye, Representative Lois Capps, Representative Steven LaTourette, Karen Daley, president of ANA, and Delegate Vivian Watts. We’re also going to e-mail all of the students in the nursing department with the link to our blog to promote awareness and gain support.

QUESTIONS AND RESPONSE

- Does the Bill take in to consideration the budget cuts most hospitals are experiencing?

- Was there any talk of adding an amendment on to the bill to cover some of the additional costs in order to maintain adequate staffing?

- How is the bill, if it becomes a law, going to be effectively enforced if some hospitals are incapable of paying the nurses required to meet the staffing ratios?

- How will patient acuity level and RN acuity level be measured to determine staffing?

Initially, if this bill becomes a law, hospital costs will be increased because of increased nursing staff. However, costs in the long run will be sufficiently decreased. According to a recent research study, “increasing the number of RN can yield a cost savings of almost $3 billion – the result of more than 4 million avoided extra stay days for adverse patient events such as infection and bleeding occurring in the hospital.” This bill is not establishing a mandated nurse-patient ratio, but instead suggesting that the number itself is set at the unit level with the RN input. Therefore, patient and RN acuity level would be evaluated by the RNs on the floor. This system is even more efficient and effective than a computer system, since the RNs have first hand knowledge and input on the situation.

Potential Impact of Safe Staffing Act on Health Care

As we talked about last week, the Safe Staffing Act will have a huge impact on nurses as well as clients and the health care system. The ANA sees this as a very important issue in health care. The president of ANA, Karen Daley, said "We know that nurses across the country are deeply concerned about unsafe staffing because it puts patients at risk as well as puts nurse’s careers on the line. Nurses observe all the time how insufficient nurse staffing diminishes the quality of care for patients. We wont stop advocating on this issue until federal legislation is enacted to increase protections for patients and ensure fair working conditions for nurses.” Safe staffing is a major concern because it impacts both patient safety as well as job satisfaction for the nurses. Stress related to higher patient ratios is directly related to nurses being unable to provide proficient and quality bedside care. This is one of the major reasons nurses leave the bedside perpetuating a shortage of nurses. In order to keep nurses at the bedside we need to create an optimal working environment. Also understaffing of registered nurses is leading to an increase in unlicensed personnel performing duties for which they are not licensed to do.

Patient safety and outcome is another concern because when nurses have an increased patient load it makes it more difficult to provide safe and therapeutic care. A study conducted in 2002 by Linda Aiken PhD, RN, showed that “each additional patient added to the average workload of staff registered nurses (RNs) increased the risk of death following common medical procedures by 7%, and the risk of death was more than 30% higher in hospitals where nurses' mean workloads were 8 patients or more each shift than in hospitals where nurses cared for 4 or fewer patients.” The Safe Staffing Act not only affects nurses workloads but more importantly it affects patient safety and overall well-being.

The governmental objectives include that the safe staffing bill would require hospitals that participate in Medicare to make nurse staffing plans for each unit accessible to the public. It would limit the practice of floating nurses by making sure that RNs do not work in areas where they lack the education and experience in that specialty. ANA is one of the major groups that has had political influence on this policy. They are promoting this bill and other legislation that holds hospital accountable for developing and implementing unit nurse staffing plans. Based on their principles there are no mandated ratios for nurse staffing plans because they want them to be based on specific needs for each individual unit and the RN’s are directly involved in coordinating the staffing plans. Some of the political figures that support this bill include Representative Lois Capps (D-CA), Representative Steven LaTourette (R-OH), Senator Daniel Inouye (D-HI), and Delegate Vivian Watts (D-VA).