Democratic U.S. Senator, Barbara Boxer, from California originally introduced the National Nursing Shortage Reform and Patient Advocacy Act. The objective of this bill is to address the nationwide shortage of hospital RN’s and to protect patient safety in acute and long-term facilities. In addition, another goal of this act will be to allow nurses to report unsafe patient conditions and maintain their role as an advocate for the patient. According to Boxer, “We cannot guarantee high-quality health care to every American without a high-quality workforce of nurses to provide it. By investing in nurses and in their training, we can help improve the quality of care in our nation’s hospitals and save the lives of countless patients.” She also believes that by establishing specific nurse-to-patient ratios it will not only save lives and improve the quality of care but also encourage more nurses to enter and stay in the workforce. More details about Barbara Boxer’s objectives can be found at the following links:
http://www.calnurses.org/legislative_advocacy/national-nursing-shortage.html
http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=389x5727470
The potential impacts of this bill will hopefully create a positive change for those affected by our healthcare system, both nurses and clients. The nursing shortage can contribute to numerous adverse outcomes for patients. In an article written by the Agency of Healthcare Research and Quality (AHRQ) they found that in hospitals with high RN staffing, medical patients had lower rates of adverse patient outcomes such as UTIs, pneumonia, shock, upper gastrointestinal bleeding, and longer hospital stays than patients in hospitals with low RN staffing. By setting a limit on the number of patients a nurse can have, determined by patient acuity, nurses will have the capability to provide the quality care that all patients deserve. The current nursing shortage puts a huge strain on nurses due to their increased workload. Statistics show that there has been increased job dissatisfaction and nurse burnout since this nursing shortage began. Boxer hopes that by enacting this bill nurses will have the ability to report unsafe conditions and refuse additional assignments over the safe limit without any discrimination or concerns of being penalized by their employers. With this bill, nurses will hopefully be encouraged to stay in the field and for prospective nurses to commit to the profession, knowing that their voices will be heard.
When taking a look at our healthcare system, you can find that due to the shortage of nurses, adverse patient outcomes have contributed to unnecessary and preventable hospital costs. Another AHRQ-funded study found that all adverse events studied (pneumonia, pressure ulcer, UTI, wound infection, patient fall/injury, sepsis, and adverse drug event) were associated with increased costs. For example, “the cost of care for patients who developed pneumonia while in the hospital rose by 84 percent.” By cutting down and eliminating some of these preventable events, hospitals would be able to afford to hire more nurses therefore creating proper nurse to patient ratios. The information and statistics collected by the AHRQ can be accessed using the following article: Agency for Healthcare Research and Quality (AHRQ). (2004). Hospital nurse staffing and quality of care. Research in Action, (14), 1-12.
Our group supports the National Nursing Shortage Reform and Patient Advocacy Act on many points. Overall the bill addresses the nursing shortage facing the healthcare system in our country from a retroactive and proactive standpoint. The aim of the bill is to fight the shortage and to protect patient safety in acute and long term facilities. The fact that the bill will hopefully lead to more Americans seeking to become an RN will help solve the problem of understaffed and under qualified hospitals and not just react to it. The bill proposes specifically for certain nurse to patient ratios in different units, a set level of qualifications for the amount of licensed personnel in areas, investments in training for nurses, and other measures coping with the shortage of nurses and the adverse outcomes associated with this problem.
ReplyDeleteThe bill will do more than just set standards for nurse to patient ratios and make the job of a nurse more focused on a limited number of patients. It will attract more citizens to become nurses if they feel more support from the government and this support leads to better working conditions. This bill however, will not make the job of a nurse any easier. The fact that a nurse can focus their attention on fewer people does not mean that the nurse will be doing less work or easier work. In fact nurses who feel less burnt out might be able to devote more energy and care to patients than before. The patients will receive better care from a nurse who can get to know their patient more in depth. From a cost efficiency standpoint one could argue that adding more qualified nurses to hospital staffs will be costly to the hospitals and that this could have adverse effects. However if this bill is passed the cost of hiring more nurses will hopefully be mitigated by fewer adverse and costly preventable events such as patients developing pneumonia while at the hospitals, UTI, wound infection, or adverse drug effects.
The nursing shortage is not something that can be solved overnight but this bill is definitely a step in the right direction. Having better nurse to patient ratios and investing in nurses and their training will not only lead to better care for patients but it will improve the lives of the nurses providing the care.
It appears as though the National Nursing Shortage Reform and Patient Advocacy Act will positively impact the nursing field if passed. The bill addresses the nursing shortage in a factual and realistic manner. It is very important for nurses to feel comfortable reporting unsafe patient conditions. When nurses are fearful of reporting errors, this increase adverse patient outcomes and lowers overall quality of nursing care. The fact that high costs related to adverse patient outcomes cause hospitals to higher even less nurses is a very important point. This is a cyclical problem that needs to be addressed. As future nurses, we need to be aware of these issues that will relate directly to our nursing care. The bill will have a significant influence on our careers, our patients, and our overall health care system.
ReplyDeleteI am more than happy that there is a bill such as this one being brought to our attention. The nursing shortage and the issue of patient safety are clearly very important to every single one of us future nurses and our future patients along with today’s nurses and patients. We need to know what we are potentially getting ourselves into and if there is anything that anyone of us could potentially do to help this issue and to push this bill forward.
ReplyDeleteIf this nursing shortage continues to decline then what happens to all of the sick people out there and to the nurses that are still left? The nurses that are left will have to take on more patients for which the impending effect on patients is again, receiving insufficient care. Also this will cause even more burnout for nurses and again carry on this downward cascade of the shortage of nurses. I agree 100% with the statement by Senator Barbara Boxer when she talks about how we aren’t able to guarantee high-quality healthcare to every American without a high-quality workforce of nurses to provide it. This is entirely true, because if these nurses have to take on more patients because of the shortage in their hospital then unfortunately they are unable to give the right level of care that patients need.
“The National Nursing Shortage Reform and Patient Advocacy Act - Amends the Public Health Service Act to require hospitals to implement nurse-to-patient staffing plans that provide adequate, appropriate, and quality delivery of health care services and protect patient safety. Sets forth minimum direct care registered nurse-to-patient ratios for emergency units, operating rooms, critical care units, and nursery units. Prohibits hospitals from imposing mandatory overtime and layoffs to meet required ratios. Requires hospitals to post a uniform notice that sets forth nurse-to-patient staffing ratios and requirements and to maintain records of actual direct care registered nurse-to-patient ratios in each hospital unit.” (http://www.opencongress.org/bill/111-s1031/show) This act not only should be passed but needs to be passed. If we can implement this bill and have all of the things stated above actually happen then we will all see a change for the better. There will be optimal patient care and less nurse burnout. We will see an increase in the number of people who want to become nurses and the issue of nursing shortage will gradually begin to get better.
I know that when I become a nurse in the very near future I want to be able to be an advocate for my patients and provide them with the best possible care that they will ever need. I don’t want to have to worry about running around to a numerous amount of patients and rushing their care. It is just as important to address the issues nurses are facing (i.e. too many patients, burnout, etc.) as well as patients (i.e. insufficient care). There will be a lot more happy people in the world if the National Nursing Shortage and Patient Advocacy Act is passed.
Taylor did bring up many valid concerns about the passing of this bill. For example, the concern of nurses still will experience burnout because their work will not become easier. While this is true, the benefit of the patients will greatly increase with the passage of this bill. Nurses will be able to pay more attention to their patients and better address their needs through detailed assessments and frequent interactions with the patient. While I do agree that the nursing profession is quite demanding both physically and mentally, we all have to common goal to advocate for the best interests in our patients and to help in our patient's recovery. For this reason, our group is in support of the passage of "The National Nursing Shortage Reform and Patient Advocacy Act."
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