Nurse staffing bill withdrawn

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A bill designed to improve working conditions at hospitals — a key cause of Maryland’s nursing shortage — by setting staffing minimums has been withdrawn. Del. Veronica Turner, D-Prince George’s, withdrew a proposal which, if passed, would have limited the number of patients nurses can care for. “We never thought it would happen in the first year and we thought we would let it percolate in people’s minds for the rest of the year,” said Jamie Kendrick, state director of the Service Employees International Union Maryland/DC Council, which represents some 1,500 registered nurses in Maryland. The bill, called the Safe Nursing Staffing for Quality Care Act, would have created nurse-to-patient ratios which, in many hospital units, would have limited every nurse to four to six patients. In operating rooms, hospitals would have been required to have one nurse for each patient. The bill was aimed at increasing patient care and safety while improving the working conditions — such as uncompensated overtime and heavy patient loads — that contribute to the state’s nursing shortage, the Statewide Commission on the Crisis in Nursing found. It is a shortage that could swell to more than 17,000 nurses by 2012, according to the commission. As representatives from the union and the Maryland Nurses Association testified last month in support of the bill, critics argued the ratios are unreasonable, impossible to meet given the state’s chronic shortage, and could ultimately undermine patient care by limiting a hospital’s ability to be flexible in managing care. It would be difficult and wildly expensive to produce the number of nurses called for in the bill, said Sen. Paula Hollinger, D-Baltimore County, who is also a nurse. Critics also point to problems in California, the first and only state to establish nurse-to-patient ratios, as evidence that the limits are not feasible. Gov. Arnold Schwarzenegger suspended ratios that guarantee one nurse per five patients after hospitals complained they could not meet the requirements. But earlier this month, a county court ruled he overstepped his authority.The shortage that exists is not a shortage of registered nurses. It is a shortage of nurses willing to work in hospitals, said Linda Moses, a nurse on a medical surgical unit at the VA Medical Center in Baltimore.Moses said the average ratio for her unit tends to hover at one nurse to five or six patients but it has gone — once in her time at the facility — as high as nine patients to one nurse, she said. “Working in hospitals is stressful,” said Valerie Tate, a representative of the nursing alliance of the union. “Collective bargaining [for nurses] is never about money or days off, it is because they are afraid a patient is going to be harmed, and every effort they have made to voice their position has not had the clout to make a difference.”Improving working conditions would coax more nurses back into hospital care, she said. Kaiser Permanente in California, for example, was able to decrease its vacancy rate of registered nurses from 14 percent to 2 percent after it implemented a 1-to-4-nurse-to-patient ratio in 2003, according to Moses’ testimony before the House Health and Government Operations Committee.