Bill Kaderly Case - Legislative Assignment

Legislative Assignment

Currently referred to as H. R. 876/S. 58 The Registered Nurse Safe Staffing Act, this bill had its origin in the 2003/2004 108th Congress. Representative Daniel Inouye of Hawaii and Representative Lois Capps of California assisted in the development and introduction the bill. (H.R. 876/S. 58, 2011) Although the billed died in committee at the end of the session, this was only the beginning for lawmakers and nursing organizations to seek greater regulation in hospital staffing. The passing of this bill would make healthcare organizations accountable for Registered Nurse staffing, contribute to patient safety and improve working conditions for all nurses and hospital personnel.

The Registered Nurse Safe Staffing Act calls for regulation of Medicare participating hospitals to establish a plan for staffing guidelines customized for each care unit. To ensure a fair and equal input for design of the plan, a committee consisting of at least 55% direct care nurses would take into consideration the demands and culture of each nursing unit . This would be predicated on patient acuity, the education, preparation and experience of each nurse, with other supporting factors such as unlicensed assistive personnel, unit design and the technology available to each individual unit. (American Nurses Association [ANA], 2011) Among other provisions, H.R. 876/S. 58 would require whistle-blower protection for individuals reporting inconsistency in compliance with the regulation, public reporting of all staffing information and establish a data base to track the correlation of nurse staffing, patient acuity with patient outcomes. (Safe Staffing, 2011)

The Registered Nurse Safe Staffing Act was reintroduced in the 110th and again in the 111th Congress, once again the bill died in committee at the end of each session. On January 25th 2011, The Registered Nurse Safe Staffing Act was re-introduced by Senator Daniel Inouye (D-HI) to the United States Senate. Senate Bill 58 was read twice and referred to the Senate Committee on Finance where it still rests today. March 2nd 2011, Rep. Lois Capps (D-CA) along with Rep. Steven LaTourette (R-OH) reintroduced what is now referred to as H.R. 876 into the 112th Congress. Along with Capps and LaTourette, 21 additional Representatives from various states and political parties united together to co-sponsor the bill. In a press release from Congresswoman Capps she states, "This legislation builds on the critical investments made in health care reform to educate and train more nurses by encouraging nurses and hospitals to work together to provide the highest quality of care that each and every patient deserves". (Capps. house 2011) H.R. 876 was referred to the House Energy and Commerce committee along with the Committee on House Ways and Means. On March 8 and 14, 2011 the committees referred the bill to the Subcommittee on Health where it resides today. (H.R. 876/S.58, 2011)

While most nursing organizations support H. R. 876/S. 58, this in no way encourages a mandated patient to nurse ratio. (ANA, 2011) Mandated nursing to patient ratios seems to be the quick fix answer, but in reality would assist in the perception of nurses as utter work place numbers and would not contribute to the perception of the professional nursing role. Placing this type of legislation into daily work rules would not take into account any additional factors that would include patient turnover, patient acuity and unforeseen emergencies such as natural disasters or acts of terrorism. (Needleman, Buerhaus, Stewart, Zelevinsky & Mattke, 2006)

Despite the fact that hospital systems, along with healthcare providing corporations and other special interest groups would view H.R.876/S.58 as adding additional cost to the already strapped U.S. healthcare system, in all reality the bill would aid in cost savings. The price in recruiting and replacing qualified registered nurses is 1.1 to 1.6 times the annual nurse salary (ANA 2011). Additional research suggests that increasing the number of Registered Nurses in the workforce can save up to $3 billion dollars annually. This would be a result of avoiding extended hospital confinement due to adverse patient events such