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Are there National Standards for Safe Nursing Levels at Hospitals?

Career News May 3, 2013

National standards for safe nursing – it seems like a given. Should all of us have some sort of legal responsibility when offering life-saving care? You would think so, but you would be wrong because there is not any national standard for safe staffing levels in nursing. What you may have heard about, however, is state regulated standards. Still, that does not thoroughly address the lack of planning because only a few states have actually implemented any rules.

Which States Are Leading the Way?

Fifteen out of 50 states, as well as the nation’s capital, have passed laws pertaining to safe nurse staffing levels. This progress has been made within the last 14 years. California was one of the first states to create legislation, and specifically address the all pertinent issue of the patient to nurse ratio. When there is more individual attention, obviously, greater care can be provided, and many states picked up on this.

National Standards – Are They Needed?

In theory, national standards protect patients, guaranteeing a minimal amount of quality care. State levels can always surpass the national level. However, passing minimum national standards has proven problematic. Two bills were created within the last three years, and both concerned hospitals, and how they employ nurses. These bills have been sent to committees and now facing votes. However, they have yet to make it to the floor. Obviously, nursing groups are supporting these bills, but their support is not enough.

What is Stated in the Bills?

You might be nervous at the idea of standardizing everything, so let’s discuss what the bills actually say and if there are any foreseeable problems. The Registered Nurse Safe Staffing Act is fairly upfront. It states, all facilities that handle Medicare would have to incorporate unit-by-unit staffing rules. There needs to be a minimum number of registered nurses on duty at all hours of operation, and this number would be based on the number of patients. The plan, however, would still be created by the facility’s own staff committee. What is required, hypothetically speaking, is to have more than half of the committee with direct care nurses.

The National Nursing Shortage Reform and Patient Advocacy Act

This is another part of the legislation, and it states that facilities would be required to create a staffing plan that meet a minimum ratio number for registered nurses to patients. Similar rules would be required for Licensed Practical Nurses.

Which is the Better Choice?

Nurses’ unions, staffed by working nurses who deal with daily nursing issues, would like the ratio-based bill over the committee-based bill. The reason being is it will be easier to ensure, enforce and maintain without interference. Those in favor of the committee-based model said ratio plans are not practical, considering there are multiple issues that cannot be addressed through standardized rules.

The Latest in National Legislation News

Ultimately, the question boils down to who knows best – the nurses who work with patients or the administrators who know the ins and outs of the hospital? Regardless, the legislation will eventually be discussed and debated. In general, average legislative bills can take anywhere from five to ten years to be approved. In fact, California, the trailblazer of states took well over ten years to pass their state-regulated standard for nursing level quality.

This will remain a fascinating subject to watch as it will affect the future of your profession and perhaps even your future working environment.

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