National Nurses United

Minnesota The 2012 Staffing for Patient Safety Act would set a maximum patient assignment for registered nurses abased on factors including nursing intensity and patient acuity, and would require hospital administrators to work directly with nurses to ensure that adequate resources are provided to keep patients safe. It would also increase the transparency surrounding the staffing process. Pennsylvania assigned to a nurse at one time, based on an evaluation of evidencebased research. In addition, the bill calls for staffing to be adjusted based on acuity and the patient���s needs and includes language to improve reporting of nurse-sensitive measure so that meaningful quality of care comparisons can be made. Michigan Michigan RNs have been working on passing minimum staffing ratios since 2004. In February and March 2012, two pieces of ���Safe Patient Care��� legislation, SB 1019 and HB 5426, were introduced at the state level that would require hospitals to develop and implement a written staffing plan that provides enough nurses to meet the individual needs of patients, and also establish numerical RN-topatient staffing ratios. Just 11 months later, Gov. Arnold Schwarzenegger issues an emergency regulation which suspends portions of the ratio law in emergency departments and delays improved ratios for medical surgical units that were to take effect in 2005. CNA files suit against Schwarzenegger���s administration and mounts a public campaign to protest his actions. 2005 More than 1,500 RNs packed the California Department of Health Services hearing on the plan to make Schwarzenegger���s emergency regulations a permanent rule change. CNA also delivers 11,000 letters from RNs opposing the new rules. A California Superior Court judge in June finds that the governor broke the law and NOVEMBER 2012 In 2011, Pennsylvania RNs worked to get SB 438 and HB 1874 introduced in the state Senate and House, respectively. The bills would establish minimum RN-topatient ratios, based on the California law, along with whistle-blower protections. Only direct-care nurses can be counted in the ratios, and the ratios would cover all shifts. Nothing would preclude any facility from implementing higher nurse staffing levels. Texas As far back as 2007, Texas RNs have been organizing and lobbying legislators to pass the Texas Hospital Patient Protection Act, a bill that would set minimum RN-to-patient staffing ratios, explicitly state the right of RNs to act as patient advocates, and provide real whistle-blower protections. Texas nurses have marched on the Capitol multiple times for ratios, and continue to strategize for passage of this important law. The Texas Legislature only convenes in January of odd-numbered years, so nurses are preparing and mobilizing for a 2013 effort to pass ratios. failed to present any evidence of the pretexts he used for the emergency regulation. In November, after losing every single measure he proposed on a special election ballot, Schwarzenegger drops his fight against the ratios. All told, tens of thousands of nurses joined together and led 107 protests in 371 days throughout California and other states. 2008 Final step of implementation sees ratios drop to 1:3 in step-down and 1:4 in telemetry and specialty units. 2010 University of Pennsylvania research study documents that California ratios save thousands of patient lives compared to similar states. 2012 The California Hospital Association, working with a local union, proposes to introduce legislation to suspend ratio requirements when RNs are on meal and rest breaks. RNs protest strongly and quickly. No legislator agrees to carry the bill, and the state labor federation opposes the proposal. 2009 Safe staffing ratios result in an increase of 100,000 new, active, licensed RNs in California. W W W. N AT I O N A L N U R S E S U N I T E D . O R G N AT I O N A L N U R S E 15

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