The Safe Nurse Staffing Act

Safe nurse staffing refers to keeping patient needs in balance with adequate staffing. In addition to the obvious, saving lives, safe staffing has a positive impact on retaining nurses. This is important as the nation is faced with an increased shortage of nurses. A bill first introduced to Congress during the 2003-2004 session, The Registered Nurse Safe Staffing Act, creates some hospital mandates. The core of the bill involves hospital staffing plans and compliance provisions to improve our health care delivery system through safe staffing.

History

• The original bill was not passed into law. Representatives Lois Capp, a Democrat from California, and Ginny Brown-Waite, a Republican from Florida introduced a second, bi-partisan attempt in November 2007. Capp announced, “This legislation encourages nurses and hospitals to work together to make sure the right number of nurses are there to provide the excellent care that each and every patient deserves.” Congress did not pass the bill as written.

  The legislation was revised and resubmitted to the 2010-2011 session of Congress, where it is still circulating through committees. The American Nurses Association continues its support of the bill as it empowers nurses to create a viable staffing plan.

Significance

• A study performed by Linda Aiken at the University of Pennsylvania School of Nursing reported that an estimated 20,000 patients die each year based on being admitted to hospitals that suffer from inadequate staffing. The retiring of baby boomers in the nursing field continues to impact the nursing shortage. The Bureau of Labor Statistics (BLS) reports that a shortfall of approximately one million nurses will occur by 2020.

Features

• Under the proposed act, staffing would be based on patient numbers. It would prohibit placing registered nurses in situations where they lack competency. The legislation is crafted to make hospitals accountable for designing a process to receive and investigate complaints. Additionally it would provide whistleblower protection and require that staffing information be made public. Monetary fines could be levied on hospitals by the Secretary of Health and Human Services should any violation occur.

State Efforts

• State legislatures are also working to handle nurse staffing issues. California implemented a staffing law in 2004 citing a minimum ratio of one nurse to every five patients. This was a significant improvement over past scenarios where nurses had to care for more than 10 patients on a shift. In a study conducted by the University of Pennsylvania, more than 22,000 registered nurses were polled in Pennsylvania, New Jersey and California. Results showed that in Pennsylvania and New Jersey, 11 to 14 percent fewer deaths would occur if those states implemented California’s staffing ratio.

Considerations

• Quality care is an important issue for both health care workers and their patients. State legislatures continue to work on implementing staffing laws that will upgrade the medical system. Recently, about 1,000 nurses rallied on Capitol Hill to support the need for staffing ratios at the federal level.