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| Statement by Senator Moore - Redraft of House Bill No. 2663, Nurse Staffing Legislation |
| Delivered at Health Care Financing Executive Session |
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May 18, 2006 -
The redraft of House Bill No. 2663 referred to this committee by the Committee on Public Health recognizes the fact that there is a growing shortage of nurses that cannot be adequately addressed without making it possible for more people to obtain a nursing education and that part of the solution to the nursing shortage is to encourage more nurses to become nursing educators as well as to make it more affordable – especially for those with limited financial resources – to obtain advanced degrees and to make the faculty positions as attractive in salaries and benefits as clinical nurse positions. Unfortunately, the bill is more propaganda than promise, it does not provide the resources for this work and leaves that matter to some later time, some future budget. Yet, the resources are needed now if we are to begin to close the gap that exists in the number of nurses that are needed to care for patients in the future. The redraft establishes a mechanism for determining how many patients nurses should serve; however, it is a seriously flawed mechanism. The mechanism focuses only on the role of the Register Nurse, but ignores the patient care team that is critical to safe patient care. The practical result of the proposed mechanism will be to force cutbacks in non-R.N. members of the patient care team creating a more stressful work environment for most nurses than they find when they have too many patients. We should not embrace any system that increases stress for nurses and reduces the supports necessary for safe patient care. The competition for the limited number of RN’s willing to work at the bedside that the staffing mechanism established in the proposed redraft will ignite will be especially problematic for those health care facilities and services that struggle routinely for funding, especially to care for our most vulnerable citizens. It will, in my opinion, reduce access to care for many of our residents, especially those in more rural areas, because beds, hospital units, or even hospitals will have to close in order to meet the staffing requirements proposed in the bill. The redraft does not provide sufficient flexibility for managing the patient care team in caring for patients whose needs may change in a heartbeat within a shift and the staffing requirements assume that every nurse has the same experience, education and ability as every other nurse and that isn’t at all realistic. Especially problematic is the method by which the Department of Public Health is expected in this redraft to establish nurse staffing requirements. Let me cite the provisions contained in Section 221 (d) which states: “If the commissioner (of public health) finds that, for any unit, it is not possible for the department to arrive at a rationally based limit utilizing available scientific data, he shall establish a temporary alternative quantifiable limit.” In other words, if he cannot find any scientific evidence on which to base the staffing requirement – and so far, there is no peer-evaluated, evidence based research to validate any nurse staffing ratios – he is authorized by law to just make it up! Sadly, the bill before us that has been billed as a “compromise” is a sham, containing glaring inaccuracies, misrepresentations and lacks substantive data collection. It reads as though it was written by the MNA, as, in effect, it was. The Oxford Pocket dictionary defines “compromise” as an agreement attained by mutual concession. Now if we look at the definition we note that: 2. For a compromise, those parties involved, must wish to arrive at an agreement. In this case, MNA only wanted everyone else to agree with them. 3. For a compromise, all parties must be able to accept the results. It is clearly not acceptable to all parties if only the MNA position prevails and if legislators who are seeking a way out of a difficult choice between politics and evidence choose only the easy political answer. 4. A compromise requires all, or some of the parties to concede some ground. Only the MHA-MONE has conceded any substantive ground. The MNA only agreed to let DPH rather than the Legislature set the rules but without any requirement that the rules be based on clear and convincing, objective evidence. I cannot support this sham. I firmly believe that it will not improve the workplace for nurses. It will not improve safe patient outcomes. It will increase health care costs and reduce access to care. I vote no on the redraft, and I ask to be listed as dissenting from the committee report! |
