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Bill would require nurse-to-patient ratios in Michigan hospitals

LSJ.com, 3/5/13

Written by: Staff and wire reports

The Michigan Nurses Association joined Democratic lawmakers Monday in their push to make Michigan the second state to mandate hospital staffing levels, but hospital officials expressed concern the requirement could backfire due to higher costs.

Democratic Sen. Rebekah Warren of Ann Arbor and Rep. Jon Switalski of Warren recently introduced legislation that would require Michigan hospitals to develop and implement staffing plans and meet statewide minimum nurse-to-patient ratio requirements, depending on the type of patient.

The bills would, for example, require hospitals to have one nurse for every patient in critical care units and one nurse for every four patients in pediatric units. It also would ban mandatory overtime for nurses except in emergencies.

Dr. Laurence Rosen, a health care researcher at Public Policy Associates in Lansing, said research shows low nurse staffing levels are associated with higher death rates and can also cause patient complications such as blood stream infection and hospital induced pneumonia.

The Michigan Nurses Association agreed. It represents about 2,200 nurses and other health care professionals at Sparrow Hospital in Lansing, where nurse-to-patient ratios were inked in a 2010 employee contract and continued under an extension ratified last month.

“Staffing is an issue everywhere, every hospital, for every nurse,” nurses spokeswoman Dawn Kettinger said. “Sparrow is an example of how ratios work, but it’s a very rare example.”

Sparrow administrators said in a statement that “both organizations believe that the needs of our patients must come first. We believe that the agreement we have in place with (the nurses’ union) serves the needs of our patients and allows Sparrow to provide quality compassionate care to every patient every time.”

McLaren Greater Lansing hospital could not be reached for comment.

Similar legislation has been introduced every year since 2004 but has failed to gain traction, Switalski said.

“Without a doubt, the hospital industry has a firm grip on the Legislature,” he said.

California is the only state that has statewide nurse-to-patient ratio requirements. Lawmakers in other states, including Minnesota, have introduced similar measures this year.

Chris Mitchell, senior director of advocacy at the Michigan Health and Hospital Association, which opposes the legislation, said the law in California has shown only “mixed results.”

“Hospital leaders reported difficulties in absorbing the costs of the ratios, and many had to cut budgets, reduce services, or employ other cost-saving measures,” he said in a statement.

Warren said Michigan has requirements for the number of day care providers that must be present as well as laws that limit the number of hours a truck driver can be on the road.

“When it comes to a life and death situation like we have in our hospital care setting, we are letting our citizens down if we don’t talk about the same kind of common sense plan,” she said.

But Mitchell said the legislation does not address the bigger issue of state and nationwide nurse shortages.

“Hospitals simply cannot maintain a supply of nurses that do not exist,” he said.

Lansing State Journal reporter Lindsay VanHulle and The Associated Press contributed to this report.

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