News | January 06, 2008

Arizona Patient Protection Act Sets Safe Nurse-to-Patient Staffing Ratios

January 7, 2008 - Arizona registered nurse leaders announced last week the introduction of legislation to make Arizona hospitals safer for patients and strengthen the ability of RNs to expose unsafe conditions and advocate for patient protections.

“Hospitals have a responsibility to staff properly in order for nurses to provide quality care for patients. Hospitals aren’t doing that,” said Diane Baker, an RN at Flagstaff Medical Center. “The Arizona Patient Protection Act requires staffing levels, at all times, based on the acuity of the patient. This will save lives and allow us to provide the care that our fellow Arizonians deserve.”

HB 2041, the Arizona Patient Protection Act is being sponsored by Rep. Tom Prezelski at the request of the National Nurses Organizing Committee/California Nurses Association. The association said the bill is needed to address the erosion of care conditions in Arizona hospitals that it says puts patients at risk and contributes to the nursing shortage, as many RNs will no longer work in unsafe hospitals.

“A legal mandate is the safest way to establish staffing ratios and real whistleblower protection for nurses,” said Phoenix metro RN Lindy Abts. “I know many nurses have left hospitals because of the staffing ratios; those same nurses have said they would return if ratios were safe for patients and for themselves.”

The bill’s major provisions include mandating minimum, specific RN-to-patient staffing ratios, whistleblower protection for RNs who report unsafe hospital conditions or for refusing unsafe patient care assignments, and legal recognition of the right of RNs to act as advocates for their patients rather than for the economic interests of their hospital employer.

“I have been a nurse since 1993 and have worked in different hospitals in Arizona,” said Kirk Herbert, RN at Yavapai Regional Medical Center. “I know that when I worked in a skilled nursing unit inside of a hospital, I was assigned up to 25 patients on the night shift. On many occasions I had a patient developed a life threatening complication. While I cared for this patient, the other 24 patients would end up with delayed care. With better staffing ratios, patients would receive better care and the life that is saved might be yours.”

The APPA’s ratios are modeled on a 1999 law in California that was strengthened again on Jan. 1. Ratios differ by hospital area, such as a minimum of no less than one RN for every five patients in general medical or post-surgical care units, 1:4 in pediatrics, and 1:4 in emergency rooms. The ratios are a floor, not a ceiling, with hospitals also required to increase registered nurse staffing as needed based on individual patient illness or acuity. Since the law was signed, 80,000 more licensed RNs have come into California’s workforce.

In addition to Arizona, NNOC/CNA members are promoting similar bills in Illinois, Maine, Ohio, and Texas, and working with the Massachusetts Nurses Association on a proposed ratio law in their state.

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