Nurse Alliance

Save the date for the Patient Safety Summit – June 7

Every day, a lack of action by our hospitals on key patient safety issues leaves patients susceptible to injury, infection, falls, readmission into the hospital, or even death.

Hospitals continue to make unsafe decisions regarding nurse staffing, all while multiple studies show that safer working conditions are linked to safer patient care and reduced healthcare costs.

We have to act now to improve the current staffing law to save lives, ensure safer care, stronger staff retention and reduced healthcare costs.

Join with nurses from across the state as we discuss how to advance our campaign for patient safety and staffing minimums.

Saturday, June 7
10:00am – 5:00pm
DoubleTree by Hilton Hotel (Near SeaTac Airport)

RSVP here.

Certificates of attendance will be issued that meet the continued competency requirement for Washington State RN licensure renewal.

What nurses say about the Affordable Care Act

The 2.1 million members of SEIU have been fighting for decades to ensure that everyone has access to quality affordable healthcare. We fought hard to get the Affordable Care Act passed, and we are still fighting hard to protect and fix the law.

Just before leaving for August Recess, the extremist Republicans in the House of Representatives held the 40th repeal vote on the healthcare law. It is unconscionable that they are more interested in scoring political points than ensuring that their constituents understand the benefits and protections of the law.

These extremist Republicans have no plan and their actions would take away health insurance for 3.1 million young people, force 6.3 million seniors to pay more for lifesaving prescription drugs and make 71 million hard working Americans start paying for what is now fully covered preventive care, such as cancer screenings, well child visits and contraception. Additionally, insurance companies could go back to denying people healthcare coverage, dropping people when they are sick and charging women more than men for the same care.

Enough is enough!

SEIU Nurses are leading outreach efforts in their communities this summer to ensure that everyone in America knows the facts about the benefits and protections of the new healthcare law. The law is working for families, communities and patients.

Here’s what SEIU nurses are saying about the Affordable Care Act:

Angie Bartels, RN and Certified Diabetes Educator
SEIU Healthcare 1199NW
Harborview Medical Center
Seattle, Washington

I am certified diabetes educator and a specialist in HIV care at Harborview Medical Center in Seattle, Washington. Because of the Affordable Care Act, I see people better able to manage their chronic conditions. I also know it was such a relief for my colleagues and family members to be able to keep their children under 26 on their insurance policies, for patients to access free preventive care and screenings and for seniors to see the prescription drug “donut hole” close.

Sharon Ingram, RN
SEIU Local 521
Kern Medical Center
Bakersfield, California

Anyone who’s been in my shoes has seen the look of despair on a patient’s face when they can’t afford medications or treatment. I can think of hundreds of patients who have been helped by the healthcare law, but the one that sticks in my head is a 23 year old woman who was having a gallbladder attack and did not have insurance. She was there with her mom and I noticed that her mom was wearing a U.S. Postal Service uniform. I told the patient that she could be on her mom’s plan because under the healthcare law those under 26 can stay on their parent’s insurance. This made such a difference to them in their ability to afford the follow up care.

Amy Fusselman, RN
SEIU Healthcare Pennsylvania
Allegheny General
Pittsburgh, Pennsylvania

Because of President Obama’s Affordable Care Act, 80 million Americans have access to preventive care. I have seen the grief and pain suffered by patients and their families who delayed care because they could not afford the co-pays that come with visits for preventive screenings. In my experience outcomes are much better when patients have access to proper preventive care and appropriate medical treatment. Early screenings — now covered by the healthcare law — for heart disease (the leading cause of death in the U.S), cancer (the second leading cause of death in the U.S), and even screenings during pregnancy have changed outcomes for my patients. We’ve caught diseases early and have been able to pro-actively treat patients rather than reacting to a condition that could have been prevented.

Dian Palmer. RN
Chair, Nurse Alliance of SEIU Healthcare and President, SEIU Healthcare WI
Milwaukee, Wisconsin

As a nurse for 25 years, I have seen the challenges and health risks for women and their families when they do not have access to the full range of health services – from contraception and maternity care to preventive check-ups and cancer screenings. President Obama’s healthcare law stopped the worst of insurance company abuses which included the outrageous practice of charging women more than men for the same insurance coverage, using Caesarean sections or domestic violence as pre-existing conditions to deny women healthcare, and dropping women’s coverage if they got sick.

Carmen Morales-Board, NP and Certified Diabetes Educator
SEIU Local 521
Kern Medical Center
Bakersfield, California

As a perioperative nurse practitioner and certified diabetes educator, I daily witness the devastating effects of unmanaged chronic disease on the patients in my care. Limb amputation, stroke and kidney failure due to uncontrolled diabetes and hypertension is a sad reality for those unable to access essential primary/preventive care services and lifesaving medications. The Affordable Care Act removes financial barriers to front-line care by eliminating co-payments for basic health care services. This has made all the difference to my patients.

Linda Bock, RN
SEIU 1199
Community Health Center
Bowie, Maryland

I tell my patients that donuts are not good for them and neither are the holes. This law dramatically improves their lives by allowing them to stay on their prescribed medications and get preventive check-ups to stop serious problems before they start.

Bonnie Chappell, RN
SEIU Healthcare 1199NW
Spokane Valley Hospital
Spokane Valley, Washington

I have been been a registered nurse for 38 years and I work in labor and delivery at Spokane Valley Hospital in Spokane Valley, WA. In 38 years I’ve delivered a lot of babies, and with the Affordable Care Act mothers and babies are getting the care they need to start off life with the best possible odds.

Norlissa Cooper, RN
SEIU 1021
San Francisco General
San Francisco, California

The Affordable Care Act focuses on preventative care, eliminating co-pays for essential healthcare such as check-ups, cancer screenings and contraception. More patients will be covered in 2014, and we will see fewer people using the emergency department at San Francisco General as their sole source of primary care. When patients have the opportunity to see a practitioner when they are ill, without fear of cost, many of the costly health care crisis’ that I see now, will be avoided.

Raushanah Abdullah, RN
SEIU Nevada
Valley Hospital
Las Vegas, Nevada

As a nurse I worked with many transplant patients and saw the dramatic difference that they experienced-life before and after a transplant is a world apart. Unfortunately, I also saw the negative impacts of a system where insurance companies – and not healthcare providers – made the decisions on how much and what kind of care patients were able to receive. Some transplant patients would reach their lifetime limit on care and the insurance companies would stop paying for their daily anti-rejection medication. Some of these patients would try to buy it on their own, but it is very expensive. They would try to ration the pills, taking them every other day or weekly which is ineffective; some patients just stopped taking the pills altogether. Without the medication, their transplanted organs died. What a waste in so many ways. These insurance companies took away the healthy lives that these transplant patients were living and put them back on dialysis or worse. The Affordable Care Act eliminates lifetime limits on care. The law puts the decision about what kind and how much care patients receive into the hands of healthcare providers.

Kim Klinger, RN
SEIU Healthcare Pennsylvania

One of the last things a person with cancer needs is more stress. But I’ve seen that happen again and again when my patients learn that they have reached their health insurance cap while getting the cancer treatment they need to survive. Families have been bankrupted just by trying to get well…[The law means], no cancer patient–or anyone with a serious illness–will be faced with this kind of death sentence again.

Becky Leaven, RN
SEIU Local 199
University of Iowa Hospitals and Clinics
Iowa City, Iowa

Repealing the healthcare law would end free preventive care-including maternity care, allow insurance companies to once again charge women more than men for the same care, and would allow insurance companies to count things like Caesarean sections as pre-existing conditions–which would allow them to deny coverage.

Pauline Taylor, RN
SEIU Local 199
University of Iowa Hospitals and Clinics
Iowa City, Iowa

At a time when our kids are struggling to land that first good job with benefits, this law is giving me, and parents like me, tremendous peace of mind.

Dee Ives, RN
SEIU Healthcare WI
Veterans Care Facility
Madison, Wisconsin

These benefits [of the healthcare law] already have changed the lives of patients I have treated, such as Tom, who had a mild heart attack and was diagnosed with diabetes. Doctors prescribed medication to control his high blood pressure and blood sugar. Tom initially skipped scheduled doctor appointments and rationed his medication because he simply couldn’t afford it…thanks to the health care law, he had a free wellness visit and his prescriptions cost less. Today, Tom makes it to all of his appointments and takes his medication as prescribed. Medicare recipients such as Tom may not know that these improvements are due to the law, but nurses do know and it matters.

Margie Forrest, RN
SEIU 1199
Palm West Hospital
Loxahatchee, Florida

As a nurse, I strongly support the instrumental changes President Obama made to Medicare and Medicaid through the Affordable Care Act…. those who struggled to cover their prescription drug costs are now seeing their costs go down as the “donut hole” is closed. About 48,000 Floridians have saved roughly $665 each since the law was passed. Seniors also are getting regular preventive care like cancer screenings and annual wellness check-ups with no-copays. In the first six months of 2012 alone, more than 1,250,000 Florida seniors received free preventive services.

Denise Glass, RN
SEIU 1991
Jackson Memorial
Miami, Florida

I am a nurse at Jackson Memorial in Miami, Florida. Working in a public hospital where 21% of our patients are uninsured. Florida has over four million uninsured residents, many of whom would be eligible for coverage under the expansion of Medicaid services in the Affordable Care Act. Healthcare is not a commodity that only the rich should be able to afford.


New partnership for more affordable, flexible RN education

Healthcare Career Advancement Program (H-CAP) and SEIU to work with online university to provide BSN and MSN opportunities to members

Western Governors University (WGU),, Healthcare Career Advancement Program (H-CAP), and the Service Employees International Union (SEIU),  have partnered to provide the union’s 85,000 nurses a new, more affordable means to earn advanced degrees. Under the terms of an agreement with the Healthcare Career Advancement Program (H-CAP), SEIU members will receive information regarding WGU’s accredited BSN and MSN degree programs as well as eligibility for a 5% discount for up to two years.

WGU offers online, CCNE-accredited bachelor’s and master’s degree programs for working nurses. These programs are ideal for RNs who wish to complete their bachelor’s degrees as well as those who wish to prepare to become advanced practice nurses or educators by earning a master’s degree. All online, WGU’s programs use an innovative, competency-based learning model. Designed for working adults with prior education and experience, competency-based learning allows students to move quickly through what they already know so they can focus on what they still need to learn.

“This partnership will support the career aspirations of nurses and ultimately equip nurses with deeper skills and expertise, whether at the bedside, in a clinic or health center, or within the home,” said Diane Sosne, RN, MN and President of SEIU Healthcare 1199NW.  “This opportunity is more important than ever as nurses strive to deliver the right care at the right time in the right setting for patients.”

In addition to their flexibility, WGU’s advanced nursing degree programs are very great value. With the H-CAP discount, tuition is approximately $6,200 per 12-month year. In addition, scholarships and federal financial aid are available to qualified students.  Furthermore, nurses working for employers who participate in the SEIU Healthcare 1199NW Multi-Employer Training Fund may be eligible for additional tuition assistance and other assistance programs.  Nurses at Harborview, Swedish, Valley Medical Center, Northwest, Group Health, or Highline should contact the Training Fund for more information.  Nurses who work elsewhere should contact WGU directly.

What would Florence do?

As we celebrate National Nurses’ and Hospital Workers’ Week this month and the critical roles we play, we also recognize the 193rd birthday of Florence Nightingale.

Florence, the mother of modern nursing, was called the ‘lady with the lamp’ for her late night rounds among patients. While today’s rounds might not warrant a lamp, they do require an endless checklist of patient needs, often dictated by business priorities instead of the actual needs of our patients.

As our fight to keep patients safe moves from the legislature this year, we refocus our efforts to hold hospitals accountable. We must strengthen our staffing committees and use community education to improve patient safety. And we wonder, what would Florence do if she were here?

Florence Nightingale believed that advocacy for patients was at the core of our mission as nurses and healthcare workers. In fact, during the Crimean war Florence advocated for better care for patients who were often treated by overworked medical staff, while also facing unhygienic conditions and a lack of medical supplies.

I believe if Florence were here to celebrate her 193rd birthday, she would have been pleased that hundreds of us have continued that message of patient advocacy with our work in Olympia to advocate for patients and to lobby legislators to pass our patient safety reform bills. Thousands signed the petition to pass our bills and we flooded legislators with phone calls and emails. We had lots of necessary conversations and got two-thirds of the way there, but in the end we were blocked by legislators who mistakenly aligned with hospital employers instead of patient needs.

She would have also been disappointed, just as we were, that not enough legislators supported our bills to pass them into law. But she would tell us that we can’t stop here. I  think she would agree that we should work to unseat candidates who choose CEO interests before patients’ needs and elect more lawmakers who put patients before profits – especially in the state Senate.

As we ask what Florence would do if she was here, the answer is clear: she’d be side-by-side with us fighting for our patients.

This month as we recognize the important work we all do, let’s look ahead and continue our campaign for patient safety. Whether we make gains during bargaining, strengthen our hospitals’ staffing committees or bring our message to the public, we continue the work of Florence Nightingale through our vigorous advocacy.

Taking Action for Safe Staffing

Nurses, healthcare workers, and patients across Washington state are taking action for patient safety in the 2013 legislative session. We brought three bills to the legislature for Patient Safety Reform to ensure safe staffing, reasonable breaks, and alert, focused care providers. We’ve been meeting with our legislators in Olympia  to ask them to support our legislation.

Now we’re taking our action into our hospitals to tell our story, sign petitions, and work to improve staffing both on our units and statewide.

Across the union, nurses are uniting to win on one strong plan for safe staffing:

1. To organize in our units to demand safe, quality care
2. To share our stories with the public and elected officials and urge them to support safe staffing.

We recognize that while we fight for safe staffing in Olympia, we must continue to keep up the fight in our units and on our staffing committees to ensure safe patient care.

Step up for patient safety!  Ask your delegate how you can get more involved in your workplace or by going to Olympia.

“We are in a crisis due to chronic under staffing. I often work so hard that I am exhausted when I go home and I try hard not to think about work because it is not a nice place to be right now. Morale is terrible on my unit. I am dedicated to my profession and yet I am unable to give the proper care my patients need because I have too many things to do during my shift.

During a recent shift I missed my first break, had to cut my meal short, and missed my next break. I still did not have enough time to bathe one of my patients. This makes me feel terrible even though I know it is not my fault.
We continually raise the issue in our unit-based staffing committee, but management is not hearing us. In our last meeting we had four staffing variances to discuss and we were told that staffing had been according to the matrix and it was unusually high acuity. But it happens all the time! High acuity is NOT unusual. I know that there is missed patient care.

Our staffing committee needs to gather data and make an argument for the changes that we need to see in our staffing matrix. We need to organize ourselves to put pressure on management. We also need the state to keep patients safe by passing staffing legislation and put safe staffing before profits.”
Shelley Burnett, RN Ortho

It’s time for patient safety reform!

Right now, 250 men, women, and children die each day from preventable medical errors—as many as a plane crash every day. We have the power to solve this problem by mandating safe staffing.

Nurses are experts on patient care. Our state acknowledges this by granting nurse licenses that make RNs responsible both for patient lives and for advocating for safe care. Every time we practice in a hospital with short staffing, we’re putting our licenses and patient lives on the line. Now nurses are raising our voices together to call for a safe minimum staffing standard to protect our patients.

Our experiences and scientific studies show that increasing nurse staffing will reduce medical errors and save lives—and money. It’s time for us to create an industry-wide standard to make hospitals safe for all patients.

Read the bills – HB 1095 Patient Safety Reform; HB 1152 Meal and Rest Breaks; HB 1153 Close the Mandatory Overtime Loophole

Nurses and healthcare workers – click here to share your story about why safe staffing matters to your patients.

“I became a nurse to help people and make a difference. And you can’t do that when you don’t have enough staff. With low staffing, we are putting our patients at risk.”
Shelli Spears, RN, Spokane

Safe staffing saves lives.
A mounting body of scientific evidence shows that improving staffing saves lives.

  • Increased nurse staffing results in shorter length of stay and lower rates of urinary tract infections, upper gastrointestinal bleeding, pneumonia, shock, cardiac arrest, and deaths from preventable causes.1
  • Raising RN staffing levels at all hospitals to a safe level would save 5,000 lives a year.2
  • Nurse-to-patient ratios save lives. 11-14% fewer patients die post-surgery in California since they implemented nurse staffing ratios there.3
“Our staffing committee worked hard to implement a plan that would keep our patients safe. Then, six months later, management decided to reduce it by one nurse per shift. Under current law, this is perfectly legal, though it put our patients at risk. We need to create a safe staffing minimum standard so that hospitals can’t understaff like this.”
Kathy Fletcher, RN, Seattle

Safe staffing saves money.
Medical errors and hospital-acquired conditions are costly but avoidable if we increase nurse staffing.

  • In total, increasing nurse staffing to a safe level would save $6.1 billion in medical costs nationwide.4
  • Under the Patient Protection and Affordable Care Act (ACA), hospitals will no longer be reimbursed for the treatment of hospital-acquired conditions including urinary tract infections, surgical site infections, and pneumonia.
  • If hospitals all staffed to a safe level, it would result in 60,000 fewer hospital-acquired conditions, avoiding 1.5 million hospital stay days.5
  • Those 1.5 million hospital stay days will no longer be reimbursed once the ACA takes effect. Now is the time to improve staffing so that our hospitals don’t have to give unreimbursed care.
“Our ratio numbers keep going up. There are days when we cannot keep up at half the patient load we have to care for. We have had an increase in missed nursing duties and unfinished work. It’s just too much. We have raised it at our staffing committee but our concerns never go past the meetings.”
Barbara Esperas, Nursing Assistant, Spokane

It’s time for an industry standard.
Keeping patients safe is in everyone’s interest—we are all potentially hospital patients.

  • The current law isn’t working. Nurses try to use the current staffing committees to make improvements, but committee recommendations are unenforceable and mean nothing when rejected by a CEO staffing to a budget instead of patient needs.
  • Patients need to know that any hospital in the state will provide safe care. Hospital-by-hospital committee-driven improvements don’t guarantee safety to every patient.
  • Legislators have enacted safe staffing standards for the airline industry and for the day care industry. It only makes sense to have similar life-saving standards for the hospital industry.
“I am a labor and delivery nurse. We do not have enough nurses to cover when admissions go up or patients become unstable. Some days we are lucky to have no emergencies. Our patients should not have to rely on luck to get safe care.”
Nancy Gladsjo, RN, Redmond

To stop the daily plane crash of 250 men, women, and children dying from medical errors, we need a combination of safe baseline staffing, guaranteed nurse breaks, and stopping misuse of on-call.
Support Patient Safety Reform for a guaranteed safe hospital staffing standard – because safe staffing saves lives.

Read the bill – HB 1095

1 Cimiotti JP, Aiken LH, Sloane DM, et al. Nurse Staffing, Burnout, and Health Care-Associated Infection. American Journal of Infection Control. 2012;40(6):486-490. Also, Needleman J, Buerhaus P, Mattke S, et al. Nurse-Staffing Levels and the Quality of Care in Hospitals. New England Journal of Medicine. 2002; 346:1715-1722.
2 Safe level defined as at the 75th percentile of hospitals nationwide. Needleman J, Buerhaus P, Steward M, et al. Nurse-Staffing in Hospitals: Is There a Business Case for Quality? Health Affairs. 2006;25(1):204-211.
3 Aiken LH, Sloane DM, Cimiotti JP, et al. Implications of the California nurse staffing mandate for other states. Health Serv Res. 2010; 45(4):904-21.
4 Dall TJ, Chen YJ, Siefert RF, et al. The Economic Value of Professional Nursing. Medical Care 2009; 47(1):97-104.
5 Needleman J, Buerhaus P, Steward M, et al. Nurse-Staffing in Hospitals: Is There a Business Case for Quality? Health Affairs. 2006;25(1):204-211.

January 29 hearings scheduled for Patient Safety Reform bills

Nurses and patients across Washington State are uniting to stand up for patient safety in the 2013 legislative session.  Three key bills will ensure a safe level of care from an alert, experienced nurse workforce, and they’re all slated for hearings on Tuesday, January 29th.  Let your delegate know or email us if you can be there to stand up for our patients.

Patient Safety Reform:  HB 1095
Right now, 250 men, women, and children die each day from preventable medical errors—as many as a plane crash every day.  We have the power to solve this problem by mandating safe staffing.

Nurses are experts on patient care.  Every time we practice in a hospital with short staffing, we’re putting our licenses and patient lives on the line.  Now nurses are raising our voices together to call for a safe minimum staffing standard to protect our patients.

Our experiences and scientific studies show that increasing nurse staffing can reduce medical errors and save lives—and money.  It’s time for us to create an industry-wide standard to make hospitals safe for all patients.

What the bill does: 

Requires the Department of Health to:

  1. With stakeholder input, adopt patient assignment limits (ratios) and recommend quality indicators;
  2. Upon receipt of a staffing complaint, conduct an audit of a hospital’s compliance with the Act and investigate complaints of violations of the Act; and
  3. Maintain, for public inspection, records of any civil penalties, administrative actions, or license suspensions or revocations imposed on hospitals for safety violations.

Rest and Meal Breaks: HB 1152

Nurses who work in hospitals often spend 12 hour shifts on their feet and due to short staffing are unable to take their rest or meal breaks.  In fact, some nurses report not finding time to use the restroom for their entire 12-hour shift.

This endangers patients who may be receiving care from nurses who are fatigued and it leads experienced nurses to leave the profession from burnout and exhaustion.

To protect patients and nurses, we must mandate that hospitals provide break times for hardworking nurses.

What the bill does:

Requires hospitals to:

  1. Provide all employees with meal and rest periods as required by law; and
  2. Record when an employee takes or misses a meal or rest period and maintain these records as required by the Department of Labor and Industries.

Safe Scheduling: HB 1153

In 2002, we recognized how mandatory overtime puts patients at risk and passed landmark legislation prohibiting mandatory overtime.  Since then, hospitals have found a loophole in the legislation where they rely on on-call nurses to fill chronic staffing shortages.

Nurses sign up for call in order to respond to unanticipated patient care emergencies, yet hospitals routinely use on-call nurses to fill in for staff on vacation, to fill long-standing staff vacancies, and to schedule surgeries at the end of nurse shifts in a way that requires they work overtime.  It increases nurse fatigue and burn-out and puts nurses at patients’ bedside who may not be alert and refreshed.

We must close this loophole to the mandatory overtime law to ensure safe scheduling.

What the bill does:

  1. Revises the definition of “employee” for purposes of mandatory overtime at health care facilities.
  2. Expands the mandatory overtime protections to include certain technical employees.
  3. Prohibits an employer, acting directly or indirectly in the interest of a health care facility, from using prescheduled on-call time to fill chronic or foreseeable staff shortages or scheduling non-emergency procedures in a way that would require overtime.

Upcoming CE Clinic: Delegation, Supervision, and Critical Thinking

The Washington Center for Nursing presents
Delegation, Supervision and Critical Thinking
Caring for patients and families, working in teams, and directing and supervising the work of others are leadership competencies that are all part of being an RN. Increase your knowledge and build your skills to feel more confident in your role!
Thursday, February 7, 2013
8:30 a.m. to 4:00 p.m.
University of Phoenix, 7100 Fort Dent Way, Tukwila, WA

Read more about it on this leaflet.

Getting the word out for Patient Safety Reform

As part of our efforts to pass Patient Safety Reform this year, the SEIU Healthcare 1199NW Nurse Alliance is up on the airwaves in Spokane and Yakima.

Starting January 2, nurses’ voices are hitting the radio to educate the public and our legislators about the importance of safe staffing.

Listen to our radio ad!

Make your voice heard for better nurse staffing– sign up for the Delegate Assembly and Lobby day.  Registration and more information is here.

If you can’t be there in person, share your story to let legislators know how important staffing is to our patients.

Nurse staffing ratios: why now?

As nurses, our fight to improve patient safety and staffing levels is ongoing.   But now is a pivotal moment in hospital reimbursements and it’s up to us to make sure that pivot benefits patients the way it’s meant to.

Under the Patient Protection and Affordable Care Act, Medicare reimbursements are shifting from pay-for-care to pay-for-quality.  Hospitals will be scored on quality measures and compared to other hospitals.   There are thousands of new scorecard measures, including:

  • How quickly heart attack patients receive surgery on arteries
  • How often surgery patients receive the right treatment at the right time to prevent blood clots
  • How often patients with heart failure get discharge instructions they need to care for themselves
  • How satisfied are patients with their care at the hospital

In 2013 hospital payments will be reduced if they have excess 30-day readmissions for patients with heart attacks, heart failure and pneumonia; in 2015 hospitals with high rates of certain hospital acquired conditions will receive further payment reductions.

What that means is hospitals now have a financial imperative to improve quality, and it’s critical that we use our voices as nurses to make sure the quality improvements they make result in real, better outcomes for patients.

We know and studies show that the best way to improve quality outcomes is to increase staffing.

By moving forward to create guaranteed, enforceable staffing standards now, we’re ensuring that staffing improvements are part of the quality improvements.   We can’t miss this opportunity to make sure that changes benefit our patients.

Our patients need safe staffing

Nurses and healthcare workers know that having more nurses at the bedside means better patient outcomes and quality of care, more job satisfaction and less burnout.
But hospital executives consistently understaff units and put budgets ahead of patient care, often disregarding our staffing committee plans.

The responsibility to improve patient care is ours, and that’s why nurses and healthcare workers from across the state launched our campaign on Saturday, November 17 to mobilize and win real staffing standards to protect our patients.

Keynote speaker Beatrice Kalisch, PhD, RN noted that inadequate staffing and unexpected rises in patient acuity are some of the top factors in missed nursing care. Ambulation, mouth care, timely medication administration, and turning are the most frequently missed nursing care components.

Nurses and healthcare workers in California have already passed a law guaranteeing minimum staffing standards, and California nurses joined our conference to speak about the difference guaranteed staffing standards have had on their ability to provide patient care.

A major comparison study from nurse researcher Linda Aiken recently showed that nurse staffing ratios in California are associated with significantly lower patient mortality. The key to saving more lives in hospitals is associated with the ability to not only have better staffing ratios, but also that the ratios are guaranteed and enforceable.*

Guaranteed staffing standards not only help improve patient outcomes, but they will save our hospitals money as well.

The financial impact of healthcare-acquired conditions and preventable hospital re-admissions runs into the billions. The human impact can be measured in significantly reduced quality of life, lost productivity in the workplace, and the emotional strain of prolonged pain and needed care.

At any given time, approximately one in every 20 patients has an infection related to the hospital care. Nearly one in five Medicare patients (2.6 million seniors) are discharged from the hospital and re-admitted with 30 days.

Preventing these adverse events can save billions of dollars and redirect current healthcare resources spent on re-admissions and healthcare acquired condition into further innovations in creating and delivering quality, patient-centered care, Chris Barton, RN told conference attendees.

The Affordable Care Act includes a number of policies to help nurses and healthcare workers improve the safety and quality of patient care. In October 2012, Medicare started to reward hospitals that provide high quality care for their patients through the new Hospital Value-Based Purchasing Program.

“This program marks the beginning of a historic change in how Medicare pays health care providers and facilities,” said Chris Barton, RN. “For the first time, hospitals across the country will be paid for inpatient acute care services based on care quality, not just the quantity of the services they provide.”

Changing how Medicare pays for hospital inpatient acute care services is expected to foster higher quality care for all hospital patients. The Value-Based Purchasing Program will distribute payments to hospitals based on their overall performance on a set of quality measures that have been linked to improved clinical outcomes and patient satisfaction.

Our next step is to take our message to our legislators in Olympia. Mark your calendar for our  Delegate Assembly and Lobby Day on January 31, 2013.

“We’re ready to go to our lawmakers and advocate to end unsafe and ineffective care. Safe staffing saves lives,” said Stephanie Curry, RN, at Swedish Medical Center





*Aiken“Implications of the California Nurse Staffing Mandate for Other States”…/Aiken.2010.CaliforniaStaffingRatios.pdf

Do staffing ratios improve care for patients?

Joanne Metroplos, RN, MPH
Lead Organizer, Nurse Alliance

Whenever the word “ratio” comes up in relationship to staffing, strong opinions dominate the discussion. So we were excited to have Ingela Dahlgen and Kathy Hughes, nurses from our SEIU Nurse Alliance of California, come to our March Delegate Assembly and share the facts about the California staffing ratios. Minimum staffing standards (or the mandated ratios that limit the number of patients an RN cares for) have been in place in California for nearly a decade. And yet, we see strong opposition to a similar staffing guarantee in our workplaces. Both the testimony of these nurses and several major research studies support the efficacy of ratios as a way to improve the quality of care and save lives.

Myth: California nursing ratios are rigid and ignore differences in patient acuity.

Fact: The ratios are not fixed. Rather they specify the maximum number of patients a nurse may be assigned. Patient classification systems are required, and additional staffing must be assigned based on patient acuity.

Myth: California hospitals cut support staff, increasing the workload of RNs.

Fact: Staffing for patient care that does not require a license is determined using the patient classification system. To ignore this system would be a violation of the law.

Myth: Implementing ratios would cost the hospitals too much.

Fact: Using evidence-based RN-to-patient ratios not only saves lives, but also is cost effective, as it reduces hospital-acquired infections, lengths of stay, adverse events and staff turnover. Several studies have illustrated a business case for quality and increasing the number of nurse hours at the patient’s bedside*.

Myth: There is no evidence that the California ratios improve care.

Fact: At least one major comparison study recently showed that nurse staffing ratios mandated in California are associated with significantly lower mortality. However, the key to saving more lives in hospitals is associated with the ability to not only have better staffing ratios, but also that the ratios are guaranteed and enforceable**.

Many hospitals are ignoring our 2008 Washington State Staffing law, and implementing unilateral decreases in staffing. While we support efforts to cut costs, quality patient care remains the top priority. Staffing ratios may not be the perfect solution to all staffing and patient care challenges, but they provide a necessary legal standard and a counter to market forces that do not put the patients first.

*Needleman “Nurse Staffing in Hospitals: Is There a Business Case for Quality?” Health Affairs 25, no. 1 (2006): 204-2211.

**Aiken“Implications of the California Nurse Staffing Mandate for Other States”…/Aiken.2010.CaliforniaStaffingRatios.pdf