The Role Of A Nurse During The Legislative Process

Dr. Linda Aiken is the leading researcher in nursing staffing rates within the United States (Kerfoot & Douglas, 2013). She suggests that each state follows California’s example of conducting research to determine a minimum staffing ratio and making it a law (Kerfoot & Douglas, 2013). The California legislation enhanced nurse staffing in hospitals across the state and improved the patient care results of millions of patients (Kerfoot & Douglas, 2013). After the bill went into effect, job satisfaction increased, and the nursing shortage ended (Kerfoot & Douglas, 2013).

Health policies, whether allocative or regulatory, are presented, debated, and decided on through the legislative process. It is the responsibility of all nurses to understand the many steps to this process, recognize problems that require attention, and know how they are able to influence the decision making process (Burkhardt & Nathaniel, 2014). The required steps for a bill to become a law include: introduction, committee consideration, floor scheduling, House and Senate consideration, difference resolution, and Presidential action. Only after successful passage through all steps can a bill be delivered for submission into public law.

In an article published by Applied Nursing Research the authors point out that nurse staffing is related to patient outcomes, “lower levels of RN staffing are associated with higher rates of OPSN (Outcomes Potentially Sensitive to Nursing) in both medical and surgical patients treated in hospitals, U.S. Medicare, and other publically available administrative data” (Duffield et al., 2011, p. 245). The writer of this paper researched 5 relevant articles regarding the relationship between nurse to patient ratio, morbidity, and mortality, every article related similar information. “A systematic review of 102 studies concluded that increased RN staffing levels are associated with lower rates of morbidity and mortality” (Ball, Murrells, Rafferty, Morrow, & Griffiths, 2013, p. 2).

Mandatory staffing ratios may improve the working conditions of nurses, provide safety to patients and achieve desirable outcomes for everyone involved in health improvements. One might assume quality health with lower nurse to patient ratios could reduce complications, shorten patients’ stays at the hospitals and lower nurse turnover rates. Lower turnover rates may be much more cost effective then adding additional staff for each shift. Safe training ratios identify the fact that shortage in nurses endangers the lives of patients while at the same time driving nurses from their professions (Silvestre, Bowers & Gaard, 2015). With increasing populations and

One can wonder if there is any correlation between patient-nurse ratio and it’s effect on patient safety. In the research conducted by Jack Needleman and his associates (2002), they examined the relationship between amount of care provided by the nurse and compared it to patient outcome. The result showed that the increase amount of time a nurse is able to spend with the patient better the quality of care is. The data for this research was collected from seven hundred and ninety-nine hospitals across eleven states. This covered both medical and surgical patients that were discharged and the data was evaluated the relationship between the time provide to the patients by the nurses and patients’ outcome. As research showed,

This assignment requires that I develop and thoroughly analyze a public policy in order to advocate for one that improves the health of the public and/or the nursing profession globally (local, state, national or international). To do this, I must reflect on several aspects of being a policy maker within the nursing profession. I was instructed to consider the following:

The organization which I have chosen to exemplify my policy change will be the Florida state board of nursing. Every aspect that pertains to the nursing, and overall healthcare is embedded into the board of nursing and that is why for these and other reasons which I will later discuss, I have chosen this organization. The Florida board of nursing plays an essential role in health care regulation as the board members and staff interact regularly with other nursing associations affiliated with state legislators, as well as the National Council of State Board of Nursing. The board of nursing works with law politicians to change or invoke new healthcare policies, which play an integrate role in patient care.

Mandatory nurse-patient ratios have been a controversial topic facing nurses for decades. Nurses, patients, physicians, nursing organizations, researchers, hospitals, federal government, and state governments have opposing views in regard to mandatory nurse-patient ratios. Those that support the idea of mandatory nurse-patient ratios believe that there would be an improvement in quality of patient care, decreased nursing shortages, increased job satisfaction, decreased client hospitalization, and increased nurse recruitment (Pamela Tevington, 2012). Groups that oppose mandatory nurse-patient ratios believe that mandatory staffing laws ignore factors such as the level of care a patient requires from a nurse, treatments, length of hospitalization, improvements and differences in technology, the expense of an increased nursing staff, and nurse experience and education (Tevington, 2012).

Ensuring an appropriate nurse-patient ratio can increase patient satisfaction in one of the most vulnerable times of their life, reduce incidents of staff burnout, and decrease incidents of nosocomial infections. Listed below are some added facts on the subject.

The final bill mandates minimum, specific and numerical nurse-patient ratios in hospitals. For example, a mandated nurse patient ratio of 1:5 was set for medical surgical units and smaller ratios were assigned to specialty units (Tevington 2011). Today, California is the only state with mandated nurse-patient ratios. 14 other states have set laws and regulations addressing nurse staffing in hospitals but they all address the issue differently and have set different requirements (ANA,

This is a sobering statistic: “the odds of a patient dying in hospitals with an average workload of 8 patients per nurse are 1.26 times greater than in hospitals where the mean workloads of 4 patients per nurse” (Aiken, Clarke, Sloane, Lake & Cheney, 2008). A rubber band can only stretch so far before it breaks. It would follow that attempts to improve patient care must address adequate patient-to-nurse ratios and workload.

This highly studied issue is one of great importance. A majority of the studies conducted on this topic, including the ones mentioned above, have concluded with the same grim results: understaffed hospitals result in needless patient deaths. Chapter twenty-five in the Patient Safety and Quality: An Evidence-Based Handbook for Nurses provides a substantial overview of the studies that have been carried out on this topic; it reiterates the concepts of the studies, and strengthens their findings: high patient to nurse ratios result in heavier workloads, decreased job satisfaction and patient danger. Conversely, this chapter also maintains

The health care, policy-making process is composed of three major stages; the formulation stage, legislative stage, and the implementation stage. The policy process refers to the specific decisions and events that are required for a policy to be proposed, considered, and finally either implemented and/or set aside. It is an interactive process with multiple points of access providing opportunities to influence the multiple decision makers involved at each stage (Abood, 2007). Each stage presents a unique set of events for a policy to be proposed, considered, and either implemented or rejected. In the formulation stage there is

According to Martin (2015), California is the only state that stipulates that in law and regulations have a required minimum nurse to patient ratios to be maintained at all times by unit. Nurses across the United States are talking to their Senators to help them lobby bills that would help establish a minimum nurse to patient staffing ratios for all hospitals in the country, among other improvements of nursing rights. Nurses from around the country also visited Congressional Representatives on Capitol Hill and urged them to support

According to L.H. Aiken et al., there is strong evidence that supports a connection between better nurse staffing and better patient outcomes. Scientists argue that a higher amount of nurses on staff allows for a lower rate of overall patient mortality. The reasoning behind this point is the fact that higher nurse rates correlate with “better nurse care environments.” Patient to nurse ratio, highly educated nurses, and increased nurses on staff during a single period of time effects the environment that allows for proper patient care. If there are too many patients assigned to a single nurse it will lead to increased patient complications (medical care/ medication errors, mortality rates, etc.) increased nurse fatigue, and decreased nurse retention/job satisfaction. Scientists argue that these issues must be looked at immediately because there are “numbers of lives that would be saved through improved care environments.” Scientists also argue that the way to improve care environment is by having hospitals become “magnet