Empowering Nurses at the Bedside and in Business

Safe Staffing?


Can you believe that mandatory minimum staffing in nursing homes is now a law in New York?  Interestingly, last year Governor Cuomo was exposed for requiring nursing homes to accept COVID-19 positive patients when New York hospitals were overflowing and then not being truthful about the number of deaths of nursing home residents.
 

However, New York recently passed laws and Governor Cuomo signed legislation requiring safe staffing in nursing homes and hospitals.  It requires that nursing homes be properly staffed with a minimum of 3.5 hours of nursing care per resident.  I hope this does not mean CNAs and that it is hours of licensed nursing staff.   

With regard to the hospitals, they are required to seek input from nurses and other staff in creating staffing plans to include specific guidelines on how many patients each nurse is assigned.  Requiring a committee to develop specific guidelines on how many patients each nurse is assigned causes me concern.  When there is not an absolute minimum number of nurses to take care of patients, doesn’t that give you cause for concern when hospitals are allowed to create staffing guidelines? 

If hospitals were going to provide adequate staffing, they would have done so already.  A law requiring them to have a committee to create their own standards and levels of staffing, it seems like the fox guarding the hen house. 

  That is why I like California’s laws requiring mandatory minimum staffing.  And remember, minimum staffing levels are for a minimum and hospitals can flex up with higher acuity.  For if you don’t have the minimum number of staff it can be dangerous for patients.  When hospitals are not properly staffed, it causes increased incidences of  medical malpractice, decreases retention of nurses, and decreases nurse satisfaction. 

While I applaud New York for taking steps to ensure that its residents receive proper care, I am not sure this is the best resolution.  I am glad nurses have a seat at the table but is this in name only?  Is it someone in administration or someone working the floors? 

I would not be surprised if hospitals intimidate or strong-arm nurses to agree to lower staffing levels than is safe or necessary.  This has been happening for years where nurses are put in dangerous positions for their license and wellbeing. 

While I appreciate the attempts, I’m not sure that the means will be worth it.  We shall see. 

I would love to hear your thoughts on this approach to mandatory minimum staffing.  I believe this was tried after a strike in Illinois, but it has not been successful. 

1 Comment

  1. Theresa Ellingsen

    Safe staffing won’t happen until we can measure nursing care needed against available nursing care minutes/hours. We need research to measure nursing tasks in minutes, and an agreement on prioritization of nursing care when available nursing care minutes do not equal needed nursing care minutes. We also need research to quantify competency of available staff, specifically to ensure that adequate expertise is available for our new grads that generally start on night shift. When we can quantify the value of nursing, we’ll have a better framework to justify our return on investment.

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