S. 73 would amend title XVIII of the Social Security Act to provide for patient protection by establishing minimum nurse staffing ratios at certain Medicare providers.
Detailed Summary
Registered Nurse Safe Staffing Act of 2007 - Amends part D (Miscellaneous) of title XVIII (Medicare) of the Social Security Act (SSA) to: (1) require each participating hospital to adopt and implement a staffing system that ensures a number of registered nurses on each shift and in each unit of the hospital to ensure appropriate staffing levels for patient care; (2) provide for the public reporting of certain staffing information, including a daily posting for each shift in the hospital of the current number of licensed and unlicensed nursing staff directly responsible for patient care; (3) prescribe recordkeeping, data collection, and evaluation requirements for participating hospitals; (4) specify civil monetary penalties for violations of such requirements; and (5) provide whistleblower protections.
Status of the Legislation
Latest Major Action: 1/4/2007: Referred to Senate committee. Status: Read twice and referred to the Committee on Finance.
Points in Favor
States in Sec. 1890 (a)(2)(a) [a staffing system adopted... shall] be based upon input from the direct care-giving registered nurse staff...
This is important, as the nurses are the ones directly affected by staffing shortages, and often have the best idea of how ill the patients on the floor really are.
Points Against
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Visitor Comments
melody polanec
April 5, 2007, 7:00am (report abuse)I AM A LABOR AND DELIVERY NURSE, WE ARE CONSIDERED A SPECIALTY AREA. THE REASON WE ARE A SPECIALTY AREA IS BECAUSE NOT JUST ANY NURSE CAN BE PUT ON OUR FLOOR AND CAN FUNCTION AS STAFF. THE OTHER SIDE OF THIS IS THAT WE HAVE A LIMITED KNOWLEDGE BASE,THEREFORE WHEN WE ARE FLOATED OUTSIDE OUR AREA WE ARE THE SAME. WE ARE NOT SAFE, WE CAN ONLY BE UTILIZED IN A TECH POSITION. NURSING IS BECOMING VERY SPECIALIZED. WE CAN NOT FLOAT FROM FLOOR TO FLOOR AND FUNCTION SAFELY. MOST FACILITIES HEAD SHEDS DO NOT UNDERSTAND THAT. THE HOSPITAL ADMINISTRATORS SEEM TO MISGUIDED IN HTERE THINKING THAT A NURSE IS A NURSE. TO MAKE SURE PATIENTS ARE RECEIVING ADEQUATE AND TRAINED CARE THERE NEED TO BE STANDARDS INPLACE FOR ADEQUATE STAFFING FOR EACH UNIT, NOT THRU OUT THE ENTIRE FACILITY.
Ed Tucker
May 15, 2007, 11:35pm (report abuse)The L&D nurse is correct - nursing in the various different hospital service areas can be very specialized, so that "a nurse is not a nurse." The solution lies in management more strictly enforcing the specialty requirements.
So for example, when the L&D unit patient demand is down, those nurses should be sent home without pay (or drawing paid time off pay) instead of being allowed to earn their specialty based salaries by doing work for which they are overqualified - such as tech work.
The hospital could then divert the wasted salary dollars to recruiting and training the specialty nurses needed for the different specialty.
Continuing the "nurse is a nurse" practice by not sending home the overqualified specialty nurse simply perpetuates the problem. If a specialty nurse wanted to cross-train in another specialty to avoid losing paid hours, that would be an option.
Sharon Solomon
July 15, 2007, 4:42pm (report abuse)Nursing has indeed become more specialized and the transition into another specialty or even ward requires training. When seeking a job faculty who find the nurse ratio difficult should engage in some upfront assessment of the nurses that they hire. Nurses are usually trained in more than one specialty and would gladly train in another if given the chance. While this may not be for every nurse, some would take a job knowing up front that they will train in more than one area and float to more than one area. Train personnel to the highestlevel possible.
Beth Phillips
July 22, 2007, 7:57am (report abuse)The bill states the facts very clearly and supports the facts by studies and adverse effects on patient outcomes.
Hospitals have inadequate staffing of RN's which protect the well-being and health of the patients, Studies show that the health of patients is directly proportionate to the number of RN's working in the hospital, A critical shortage of registered nurses in the United States, The shortage is revealed in unsafe staffing levels, Patient safety is adversely affected by unsafe staffing levels, creating a public health crisis, RN's are being required to perform professional services under conditions that do not support quality health care or a healthful work environment.
The government has a compelling interest in promoting the safety of individuals by requiring any hospital participating in such program to establish minimum safe staffing levels for registered nurses.
Bronwyn Sewell, RN
October 26, 2007, 10:29am (report abuse)This bill suggests that each hospital, and only those that receive medicaid/medicare money, determine what are "safe" staffing numbers for nurses on each floor/unit/area. This seems to make more sense than the corresponding house bill (HR 2123), as it takes into consideration that hospitals have different levels of acuity.
Diana Holte RN
March 19, 2008, 8:59pm (report abuse)I would really like to see a set number of patients per nurse, like for every 1 nurse they shall have only 4 patients on a med surge floor. I don't like that it is left up to the hospital b/c they will still try and get by saying that it is safe for 1 nurse to 7 patients. I think if it is set prior then there are no ways to get around it. This bill leaves too many "loop holes"
Mariah Proffitt, RN
April 3, 2008, 10:35pm (report abuse)I appreciate the difficulty in writing such a bill and I can see why specific ratios where not included. I think the heart of the matter was addressed by stating that direct-care persons would provide input based on the unit specialty and acuity of the patients. Nursing staff are frequently "burned out" and leaving the profession, causing only more stress on remaining staff. Some have made tragic errors in their care and others have left to salvage their own health and well-being. When this bill talks about safe nursing care, it encompasses both patients and staff.
I would like to see all health care facilities included in this legislation. All areas of nursing are facing the same challenges.
snug
September 17, 2008, 8:54am (report abuse)I don't understand, to this day, why well-trained LPNs are not used in hospitals to supplement quality nursing care. Patient care attendants are often mistaken for nurses and tend to take on a larger roll when RNs are not available. This seems like a mistake as their training is primarily technical such as performing EKGs, phlebotomy etc., and they receive much less valuable theory. Go figure.
Amy Cowperthwait RN
September 20, 2008, 1:49pm (report abuse)While I think this bill has great merit and is at least attempting to force hospital administrations to address the issue of safe staffing, I have to say as an ED nurse I am concerned.
We have a nursing shortage. When we set ratios, and there are patients in the ED waiting for a bed because the ratio has been meet, what happens then? Are there going to be staffing ratios for the ED also? Are they going to find med-surg or tele nurses to come into the ED to care for the admitted patients so the ED nurses can care for the unadmitted ED patients?
There is going to be a problem somewhere along the line. At some point there are not going to be enough nurses.