Beware! Not All “Staffing” Bills Are Real Ratios

In an effort to derail mandated, RN-to-patient, ratios laws, the hospital industry along with its allies has pushed for passage of inferior “staffing” bills. When analyzing the merits of a particular bill, be suspicious when a bill has any of the following markers.

Is It a Real Ratios Law or a Fake, Weakened “Staffing” Plan?

• Voluntary and/or “permissive” ratios.
• These laws may provide specific, numeric ratios, however they also include loopholes
• giving employers the right to staff as they please. One of the loopholes allows employers to interchange RNs for “other health care personnel.”
• No public disclosure.
• No enforcement.
• No rights for the RN as patient advocate, no whistle-blower protection.
• Staffing based solely on patient classification systems without ratios as a minimum safety standard.

These approaches make vague and undefined references to “appropriate” staffing levels without providing specific ratios numbers. Acuity-based staffing — using tools developed by hospital industry consultants — is presented as an alternative to mandated minimum ratios. All of these “plans” are designed to prevent the implementation of real, enforceable, RN-to-patient ratios that are improved upon per patient need as determined by the independent judgment of the direct-care RN.

In states where “staffing plan” style legislation has passed, there has been little to no change in the nurse-to-patient ratios. In many cases, the hospitals do not even create a nurse staffing plan because there is no penalty for noncompliance.

Nurses must unite and demand nothing short of minimum, mandated, nurse-to-patient ratios. The industry will continue to push policymakers to adopt toothless reforms. However, nurses have the power to use our voice as the most trusted profession to push for meaningful, lifesaving alterations.

NNU RNs are able to advocate for the strongest protections because we have built a powerful union run by and for direct-care RNs, not giant corporations like some other groups who claim to represent direct-care nurses.