Proposed Legislation Addresses Public Health Crisis and Would Save Lives

National Nurses United applauds the reintroduction of the Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act sponsored by Sen. Sherrod Brown in the Senate and Rep. Jan Schakowsky in the House. This important legislation addresses an epidemic of deliberate understaffing in our nation’s hospitals that puts patients and the public at risk, said National Nurses United. 

“Registered nurses are on the front lines of caring for our patients at the bedside, and yet we are often unable to deliver the care that patients need because hospital administrators dangerously understaff our facilities to increase profits,” said Bonnie Castillo, RN, executive director of National Nurses United (NNU). “We know from numerous scientific studies, and from the results of the landmark nurse-to-patient ratios law in California, that mandatory, minimum nurse-to-patient ratios save patients’ lives and improve quality of care, while also reducing nurse burnout and keeping experienced nurses at the bedside. NNU commends Senator Brown and Congresswoman Schakowsky on their leadership on this issue, and urges all members of Congress to cosponsor this vital legislation.” 

Nurses know there is a patient safety crisis in hospitals and medical facilities across the United States. According to the most conservative estimates, approximately 250,000 American patients die annually from preventable errors. That translates into nearly 685 patients a day. Studies show that when RNs are forced to care for too many patients at a time, the risk of preventable medical errors and avoidable complications increases. 

“Nurses work long hours doing vital work in our health care system – their jobs are critical to keeping patients safe and providing the highest quality care,” said Sen. Brown. “But too often, nurses are stretched too thin, caring for too many patients with not enough support. We can prevent that by ensuring nurses are adequately staffed, and protecting their ability to go to hospital management without fearing potential retaliation.”

“This National Nurses Week, I am proud to once again reintroduce the Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act with my friend Senator Brown,” said Rep. Schakowsky. “Safe staffing levels save lives. Numerous studies have shown that safe nurse-to-patient staffing ratios result in higher quality care for patients, lower health care costs, and a better workplace for nurses. This bill will improve the health of patients by improving nursing care—establishing minimum registered nurse-to-patient ratios in hospitals, protecting the rights of nurses to advocate on behalf of their patients, and investing in training and retaining nurses to address the nationwide nursing shortage. It is past time that we act on the evidence and give nurses the support they deserve, and put patients over profits. I will continue to partner with nurses across the country in promoting this bill and fighting to end dangerous staffing.”

California is the only state in the nation with mandated nurse-to-patient ratios across all units and for all shifts. The research from California provides irrefutable proof that adequate minimum nurse-to-patient ratios saves lives.

• A landmark 2010 study found that New Jersey hospitals would have nearly 14 percent fewer patient deaths and Pennsylvania would have nearly 11 percent fewer deaths if they matched California’s ratios in medical-surgical units. 
• Studies show that when RNs are forced to care for too many patients at one time, patients are at higher risk of preventable medical errors, falls and injuries, certain medical complications, increased length of hospital stays, and readmissions.
• A 2007 meta-study found that adding one more full-time RN to a patient day was linked to a 9 percent decrease of deaths in ICU patients, a 16 percent decrease in deaths in surgical patients, and a 6 percent decrease in death in medical patients.  

Key Components of the Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act 

• Mandates unit-specific RN-to-patient ratios for acute-care hospitals 
• Incorporates an acuity system to allow for bedside nurses to utilize their professional judgement to decide the acuity and level of care of patients 
• RN-to-patient ratios must be followed on all shifts, without averaging
• Provides strong whistle blower protections for nurses who speak out against assignments that are unsafe for patients or nurses
• Prohibits the substitution of direct patient care and RN professional judgement with video monitors or technology
• Includes monetary fines for violations Sen. Brown’s bill is cosponsored by Sens. Tammy Baldwin (Wisconsin), Kamala Harris (California), Bernie Sanders (Vermont), and Elizabeth Warren (Massachusetts).

Sen. Brown’s bill is cosponsored by Sens. Tammy Baldwin (Wisconsin), Kamala Harris (California), Bernie Sanders (Vermont), and Elizabeth Warren (Massachusetts).

Rep. Schakowsky’s bill is cosponsored by Reps. Earl Blumenauer (OR-03), Susan Bonamici (OR-01), Julia Brownley (CA-26), Yvette Clarke (NY-09), Steve Cohen (TN-09), Danny K. Davis (IL-07), Peter A. DeFazio (OR-04), Rosa L. DeLauro (CT-03), Debbie Dingell (MI-12), Tulsi Gabbard (HI-02), Pramila Jayapal (WA-07), Robin L. Kelly (IL-02),  Ro Khanna (CA-17), Barbara Lee (CA-13), Zoe Lofgren (CA-19), Betty McCollum (MN-04), Gwen Moore (WI-04), Jerry Nadler (NY-10), Eleanor Holmes Norton (DC), Mark Pocan (WI-02), Jamie Raskin (MD-08), Bobby Rush (IL-01), Brad Sherman (CA-30), Mark Takano (CA-41), Nydia M. Velázquez (NY-07), Frederica S. Wilson (FL-24).