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INVOLVED
If you are someone who works in healthcare (or know someone who
does) and you want to get involved or find out more information,
join our Rapid Response Network now or contact
the Vermont Workers’ Center at 802-229-0009 or
workerscenter@pjcvt.org |
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JUSTICE
FOR HEALTHCARE WORKERS CAMPAIGN
NURSING LEGISLATION INTRODUCED IN THE VERMONT LEGISLATURE
Since the historic RN union election victory in
October 2002 at Fletcher Allen Health Care (FAHC), a number of RNs and other
healthcare
workers involved in the Justice For Healthcare Workers Campaign have been working
with Vermont legislators to develop legislative proposals to ease the crisis
in
their profession.
Click here to read
about how you can help pass this legislation.
Click here to read House
Bill 335 or click
here to read Senate Bill 158
- Under this Act, hospitals in Vermont would have to meet
minimum nurse-to-patient ratios (see below).
- Hospitals would submit an annual staffing plan, developed
in consultation with direct-care nurses, to meet the minimum
ratios and provide adequate and appropriate healthcare services.
- The Act would protect employees when they report unsafe
staffing and would require appropriate orientation prior
to assuming a clinical area assignment.
Operating Room
Trauma Emergency Unit
Labor & Delivery (active labor) |
1 RN: 1 Patient |
| Postpartum (immediate) |
1 RN: 1 Couplet (2 Patients) |
All critical-care areas, including:
• Emergency Critical Care
• Intensive Care
• Post-anesthesia |
1 RN: 2 Patients |
Antepartum
Emergency Room
Pediatrics
Step-down
Telemetry |
1 RN: 3 Patients |
Immediate Care Nursery
Medical/Surgical
Acute Care Psychiatric |
1 RN: 4 Patients |
| Rehabilitation |
1 RN: 5 Patients |
| Postpartum |
1 RN: 3 Couplets (6 Patients) |
| Well-Baby Nursery |
1 RN: 6 Patients |
Research Supporting the Need For Nurse to Patient Ratios
The
Institute of Medicine of the National Academies of
Sciences reported
that avoidable medical errors kill up to 98,000 people
in U.S. hospitals every year. The IOM published a book
on their findings, "To Err Is Human" (http://books.nap.edu/catalog/9728.html).
JCAHO, the Joint Commission on Accreditation of Hospital
Organizations, announced that inadequate staffing precipitated
one-fourth of all sentinel events - unexpected occurrences
that led to patient deaths, injuries, or permanent loss of
function - reported to JCAHO the past five years.
A
New England Journal of Medicine study documented that
improved RN-to-patient ratios reduces rates of pneumonia,
urinary infections,
shock, cardiac arrest, gastrointestinal bleeding, and
other adverse outcomes. A major study published in the
May 30, 2002
New England Journal of Medicine shows a clear relationship
between inadequate registered nurse staffing in America’s
hospitals and the risk of deadly complications. In hospitals
with higher nurse staffing, there were 9 percent fewer
patient complications compared to hospitals with lower
staffing.
Research
in the Journal of the American Medical Association
found that up to 20,000 patient deaths each year can
be linked
to preventable patient deaths. For each additional patient
assigned to an RN the likelihood of death within 30 days
increased by 7 percent. Four additional patients increased
the risk of
death by 31%. The findings are contained in the article "Hospital
Nurse Staffing and Patient Mortality, Nurse Burnout, and Job
Dissatisfaction," ( http://jama.ama-assn.org/issues/v288n16/abs/joc20547.html )and
appear in the October 23-30, 2002 issue of JAMA. The research
was funded by the National Institute of Nursing Research (NINR),
NIH, part of the U.S. Department of Health and Human Services.
Why RN Ratios? Some
answers to common questions about RN to patient ratios.
II. THE
BAN ON MANDATORY OVERTIME ACT (click
here to read bill)
Click here to read
House Bill 337 or click
here to read Senate Bill 157
- Legislation prohibiting mandatory overtime for employees
of healthcare facilities.
- Bans
mandatory overtime for healthcare workers except in emergency
situations. Over the past decade of managed care,
hospitals have started using mandatory overtime as a regular
way to staff their facilities. Instead of hiring enough nurses
to meet patients’ needs, understaffed hospitals often
order nurses to work back-to-back eight-hour shifts or four
extra hours on top of a 12-hour shift.
The legislation recognizes the growing danger to patient
safety posed by forced overtime practices increasingly
used by hospitals.
At least 1,720 hospital patients have been accidentally
killed and 9,584 other injured since 1995 because of
the actions or inaction of registered nurses across the
country, according to an investigative report by the
Chicago Tribune, which attributed the problem to cuts
in staff and other belt-tightening in U.S. hospitals.
Mandatory overtime actually has contributed to the
national nursing shortage, because nurses are refusing
to work in hospitals with unsafe conditions, including
when they are forced to work unplanned overtime hours.
III. THE WHISTLEBLOWER
PROTECTION ACT (click
here to read bill)
Click here to read House
Bill 128 or click
here to read Senate Bill 154
- Legislation that will protect workers against any retaliatory
action by an employer for reporting unlawful employer practices
or practices which constitute improper care of patients.
Patient advocacy is at heart of nurse's professional
commitment. In turn, patients depend on nurses to ensure
that they receive proper care. Patients must be assured
that nurses and other health care professionals, acting
within the scope of their expertise, will be able to
speak for them without fear of reprisal.
Whistleblowing by nurses usually
results from concern about issues that jeopardize
the health or safety
of patients, or occupational safety and health violations
that place the employee at risk. Yet, even though
we
are responsible for patient care and well-being,
nurses are often powerless when another health care
provider
performs unethical or life-threatening practices.
Retribution and dismissal for whistleblowing are not
uncommon.
In fact, there have been a number of legal cases
involving nurses who have been retaliated against for "blowing
the whistle" on their employers.
Current whistleblowing laws remain a patchwork of incomplete coverage.
For example, the False Claims Act contains a whistleblower provision that
applies only in cases of fraud or misuse of Federal funds. The Emergency
Treatment and Labor Act (EMTALA) includes protections for patient advocacy,
but only for personnel working in the emergency department of a hospital.
The Whistleblower Protection Act of 1989 only applies to federal employees
(e.g., VA nurses). This confusing, incomplete coverage leaves many nurses
fearing reprisals such as dismissal, harassment, and blacklisting. This
lack of a blame-free reporting system prevents many nurses from taking
the risk of trying to protect their patient's health and safety. In order
to allow nurses to function as successful patient advocates, effective
whistleblower protections for nurses who report unsafe patient care must
be enacted.
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