National Nurses United

NNOC 101

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All ratios are minimums. Hospitals must increase stang based upon individual patient needs. 1 1 to Operating Room Trauma Patients in the ER Intensive/Critical Care Neo-natal Intensive Care Post-anesthesia Recovery Labor and Delivery ICU Patients in the ER Step Down Antepartum Postpartum Couplets Pediatrics Emergency Room Telemetry Other Specialty Care Medical/Surgical 1 3 to 1 2 to 1 4 to 1 5 to Postpartum Women Only Psychiatric 1 6 to 11 RN SAFE STAFFING RATIOS SAVE LIVES NNOC's state-specific, and NNU's national safe staffing bills are all modeled on the standards set by legislation in California. Thanks to CNA/NNOC-organized RNs, staffing ratios are in effect today in California, bringing RNs back to the bedside by the thousands and dramatically improving staffing. It took many years, and nurses had to challenge a very popular governor along the way to defend the ratios, but CNA/NNOC prevailed and is now actively working to pass a comprehensive national bill with NNU, the Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act, sponsored by U.S. Sen. Sherrod Brown (D-OH) and a similar bill in the U.S. House of Representatives, sponsored by Rep. Jan Schakowsky (D-IL). We are also working with RNs in states all across the nation to adopt state-specific, mandatory nurse-to-patient ratios legislation. None of the dire warnings from the hospital industry have come to pass: There has been no rise of hospital closures as a result of ratios, California hospitals are financially sound, and in the many years since the law was signed, as we predicted, nurses came back to the bedside because they were able to give patients the care they deserve. Now the scientific evidence is in, too. A study led by the nation's most prestigious nurse researcher, Linda Aiken, RN, Ph.D., at the University of Pennsylvania School of Nursing provides unassailable evidence: The law reduces patient deaths and assures nurses more time to spend with patients. Examining patient outcomes and surveying 22,000 RNs in California, Pennsylvania, and New Jersey, the research found: X New Jersey hospitals would have 14 percent fewer patient deaths X Pennsylvania would have 11 percent fewer deaths if they matched California's ratios in post-surgical units X Fewer California RNs miss changes in patient conditions because of their workload X California RNs are far less likely to report burnout and leave than New Jersey or Pennsylvania nurses CALIFORNIA RATIOS SAFE STAFFING RATIO LAWS — MORE THAN JUST THE NUMBERS Both California's A.B. 394 and the federal bills have multiple provisions designed to remedy unsafe staffing in acute-care facilities. X Mandates minimum, specific, numerical ratios for each unit to apply at all times, including break coverage X Allows for additional RNs and ancillary staffing based on patient needs X Ensures RNs the legal guarantee to serve as patient advocates X Prohibits use of mandatory overtime X Regulates use of unlicensed staff X Restricts unsafe floating of nursing staff X Whistle-blowing protection for caregivers who report unsafe practices X LVNs/LPNs are not in the ratio count and are assistive to the RN

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