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Response to NJSNA position on nurse-to-patient ratios EDITORIAL

To the editor:

New Jersey Senate Bill 989 is a critical piece of legislation that protects and impacts the lives and safety of patients and the professional licenses of every nurse in New Jersey.  This bill is important because it will set minimum nurse-to-patient ratios in conjunction with a staffing system.

In the article “State nurses rail against bill requiring minimum nurse-to-patient ratios,” (NJBIZ.com, Feb. 7) the New Jersey State Nurses Association’s narrow view of this legislation has been debunked by the American Nurses Association, the largest professional and credentialing organization in the country.

While NJSNA’s may be correct in one aspect — nurse-to-patient ratios may not be effective as a standalone answer to safe staffing — they completely fail to acknowledge the importance of the regulatory component of the bill.

Senate Bill 989 features regulatory requirements for hospitals to employ an acuity system (which by licensing regulations are to be in place, but are lacking in numerous hospitals in New Jersey) to increase staffing levels above the minimum nurse-to-patient ratios.

The wording of the bill states the acuity system is to be based on “patient acuity; professional nurse-staffing standards adopted by nurse specialty organizations; skill mix; and the staffing levels of other health care personnel and the use of agency or temporary staff.  The system shall be established in the facility by the Department of Nursing with a majority of the unit staff nurses approval …”

Who knows better than the nurse at the bedside how much staff is required to provide a safe environment for patient care?

NJSNA’s contention that the bill does not address some key issues such as constantly changing patient needs is just not true.

The ANA’s “Optimal Nurse Staffing to Improve Quality of Care and Patient Outcomes” utilized clinical cases to derive at its conclusions:

  • “Existing nurse staffing systems are often antiquated and inflexible”; and
  • “Greater benefit can be derived from staffing models that consider the number of nurses and/or the nurse-to-patient ratios and can be adjusted to account for unit and shift level factors.”

Only seven states currently require hospitals to have staffing committees: Connecticut, Illinois, Nevada, Ohio, Oregon, Texas and Washington.  Only one state, California, requires minimum nurse-to-patient ratios, and they have already seen significant improvements in care outcomes.

Studies by the ANA revealed that establishment of minimum staffing requirements in California resulted in lower patient mortality, improved nurse retention, and economic benefits – not unsafe care.

Don’t New Jersey patients deserve the safest care environment we can provide?

Instead of relying on fear tactics by telling half-truths about the components of Senate Bill 989, NJSNA should be supporting what staff nurses have been calling for as advocates of their patients for years: a system that gives nurses a voice in safe staffing.

JNESO represents more than 5,000 health care professionals in 19 facilities in New Jersey and Pennsylvania. The JNESO union represents nurses, medical technicians, medical support personnel, caregivers and others in the health care field.

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