Derail
unsafe staffing, put legislation on the fast track
By KATRINA HOWARD, RN
Patients and nurses are the ones most severely hurt by
the increasing emphasis on holding down health care
costs.
All health care workers have valuable roles to play in
patient care, but the RN has the specific patient
assignment and coordinates the care for that patient
provided by the other workers. The other workers are
needed to do their own jobs, not the nurse’s.
Nevertheless, that’s what’s happening more and
more often.
“Bottom-line” driven health care has eliminated
thousands of direct-care RNs in recent years and shifted
many of their duties to cheaper, unlicensed, less skilled
workers.
The remaining nurses are made responsible for the
performance of those duties by the less skilled workers,
a situation that can jeopardize the nurse’s license
as well as patient care.
That focus on cost also allows only the sickest patients
to be admitted to hospitals. And as soon as they begin to
improve they are sent home.
So, the number of acutely ill patients with complex
medical problems that require the expertise, skill and
surveillance of professional nurses has been steadily
mounting, just when the number of nurses has been
dropping.
Nurses made the
scapegoats
The effectiveness of nurse surveillance — the early
detection and prompt intervention when a patient’s
condition deteriorates — depends largely on the
number of RNs available to assess patients on a continual
basis. That effectiveness drops when nurses are over
loaded or their duties are handed off to unskilled staff.
Many nurses feel they can’t provide adequate care,
much less quality care under these circumstances. Nurses
feel frustrated and overwhelmed physically,
psychologically, and emotionally.
The focus on cost has decimated staffing standards. The
result has been unsafe staffing and impossible
assignments. This, in turn, has given dramatic rise to
errors, injuries, “failure to rescue,” and
death.
Health care facilities have been quick to blame, and
Boards of Nursing have been quick to discipline and/or
revoke the licenses of hard working, conscientious,
dedicated nurses.
People are dying needlessly
Countless studies have proven a patient’s health,
safety, and satisfaction are directly related to the
availability of the RN, and patients fare far better when
patient-to-nurse ratios are lower.
According to a 1999 report by the Institute of Medicine,
one of the foremost authorities on safe medical
practices, 98,000 people die in this country each year as
a result of preventable medical errors. That’s
nearly 2,000 people needlessly dying each week.
The report emphasized most errors were not the fault of
nurses, but of a dysfunctional system. These are system
errors that kill.
Staffing ‘flexibility’ abused Evidence is
mounting that those who govern health care have been
given far too much flexibility in setting staffing
standards.
The Patient Classification System (PCS) was instituted to
assure the number of nursing staff is appropriate for the
health care needs of the patients, while allowing the
provider maximum flexibility for efficient use of staff.
But PCS is not working.
The emphasis on staffing “flexibility” allows
facilities to manipulate the PCS based on budgetary
targets by focusing on the overall patient population,
rather than individual patient- care needs. 
Time for PEF to
‘Show and Tell’
If nurses and the public could trust health care
facilities to staff safely and appropriately, PEF would
not have to picket them and lobby lawmakers to pass safe
staffing legislation to ensure safe, quality care.
Unfortunately, the system desperately needs an overhaul.
But that won’t happen unless nurses stand up and
demand it — not just once a year on lobby day, but
over, and over, and over again until the changes become
law.
You can help PEF push the state Legislature to pass
S2857/A7937 which would direct the state health
commissioner to develop safe-staffing standards for
nurses in health care facilities such as hospitals,
nursing homes, correctional facilities and other
institutions.
This bill would set minimum staffing ratios for certain
types of hospital units. It also would require each
facility to develop policies for staff training and
orientation.
It is unlikely the Legislature will take up this bill
this year, even if it briefly returns to session. But the
bill will still be there, with the same identifying
numbers, next January when the 2004 session opens in
Albany.
The summer and fall recess give you an ideal opportunity
to meet with your legislators in their district offices
to talk about this issue that affects virtually every
hospital and health care facility.
Make them see how it could become a matter of life or
death for them or their loved ones at any time.
Persuade them to visit your worksite this summer to see
for themselves how understaffing hurts their constituents
— your patients and you. (Katrina
Howard is
PEF’s nurse organizer.)
Compassion, knowledge strengthen
oncology care:
Roswell Park honors nurses
Nurses conference addresses timely
topics
GO TO RN DEPARTMENT
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Inside This Issue:
Features
Lawmakers override all 119
budget vetoes
Set state safety, security
standard
Thank your legislators
Departments
President's Message:Our work
continues
You Said It: Member's
letters this month
PS&T Contract Update:
Pay hikes hot topic
Member Highlights;Keeping up
the good fight
Retirees In Action: New
officers take the reins
PEF Membership Benefits
Program & Travel Corp
Nurses' Station:
- Derail unsafe staffing, put
laws on the fast track
- Roswell Park honors nurses
- Nurses conference addresses
timely topics
Legislative Action:
- Union presses lawmakers on
contracting out
- Legislature passes 11 bills
PEF supports
- Don’t let feds
shortchange NY
Health Benefits:
- Feds aim to guard your
privacy
- College students need shot
in arm
- HMO applied wrong rule for
disabled kids
Union Matters
PEF, OASAS train workers for
emergencies
EAP Coordinator earns
Quality Service Award
Making state park system a
summer delight
Pre-Tax Transit pilot put on
hold
Balloting brings 13
newcomers to E-Board
Convention 2003: Delegate
preview
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