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Monday, November 29, 2021  

Staffing legislation worth watchingPublished 11/4/2003


In recent months, many nurses have testified about the underlying truth of the so-called nursing shortage: that it’s not so much a true shortage, but a shortage of nurses willing to tolerate unsafe working conditions for their patients or themselves. According to a 1999 Bureau of Labor statistics, the rare of occupation related illnesses and injury is increasing for nurses employed by hospitals. The occupations group, "RNs, nursing aides, and orderlies" reported 101,400 incidents of work related illness or injury. This number was second only to truck drivers, who reported 141,000. RNs themselves reported 25,700 incidents of illness or injury, which was an increase of 700 from the prior year.

Given the seriousness of the current situation, it is important that legislation is being introduced at the federal level in the form of the Safe Nursing and Patient Care Act of 2003 ("Overtime a Point of Contention for Nurses," Denver’s Nursing Star, vol. 2 issue 18). What was not well known locally was that similar legislation was introduced into the Colorado legislature the past week.

The subcommittee hearing for House Bill 1934 "Concerning Minimum Staffing Levels for Health Care Facilities that Employ Nurses," took place this past Monday (April 28th). I was advised about the hearing via the local 105 Service Employees International Union (SEIU) Nurse Alliance. Testifying against the measure were Chief Nursing Officers from several area hospitals, as well as the president of the Colorado Nurses Association. Testifying for the bill were several nurses from the SEIU Nurse Alliance. Unfortunately I was not able to stay for the remainder of the testimonies in favor of the bill. While I can see both sides of the argument (government regulation tends to involve a lot of bureaucracy) desperate times often do call for desperate measures.

Safe staffing should not have to be mandated by law. However, these days it’s frequently only lip service that is paid when it comes to employee in-put into company matters (including staffing issues). It’s time for healthcare administrators to "walk the talk" and if that has to be accomplished via legal venues (through collective bargaining or state/federal mandates) then so be it. I contend that many nursing jobs would be tolerable if enforceable limits on caseloads and a prohibition against mandatory overtime were in place. In light of this the SEIU and the American Nurses’ Association have some interesting reports from across the nation regarding what nurses are doing to take control of workplace issues, gain the right to have real input into decisions that affect their patients and their practice and advocate for patients.

Many of us know too well what it’s like to be on the receiving end of "bean counting" that leads to bare-bones staffing, which may produce satisfactory numbers for a company but at what expense? Frequently what’s missing from proposed solutions is a critical appraisal of the underlying values that have fed the nursing shortage in the first place. Why are companies offering incentives (i.e. sign on bonuses, tuition reimbursement) that are different from what nurses say they want (improved staffing, safer conditions for their patients, increased respect). One can’t help but think of the extraordinary compensation that many corporate executives receive. Yet this practice is frequently defended under the premise that CEOs need to be compensated as much, so that companies can recruit and retain their talent. This begs the question, though, does talent only matter at the senior management level? What about all the talented nurse and ancillary staff? Do they matter as much?

When the question arises (as it already has and will again) as to how to finance improved staffing patterns, in my opinion it comes down to this: While it may be a question of available resources and funds, it is no doubt also a question of values and priorities.

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