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.

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.

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” www.nursing.upenn.edu/…/Aiken.2010.CaliforniaStaffingRatios.pdf