Cook County News Herald

Debate over nursing quotas discussed locally




A bill in the state legislature—H.F. 588, called the Standards of Care Act—calling for hospitals to follow predetermined formulas regarding the number of nurses working at a given time has generated a good deal of controversy. Some health care providers support the bill while others are very opposed to it. At the North Shore Hospital Board meeting on March 21, 2013, hospital board members learned more about the bill.

A January 4 news release from the Minnesota Nurses Association states, “The Minnesota Nurses Association is advancing legislation to establish minimum staffing standards in facilities throughout greater and metropolitan Minnesota.”

The bill would set limits on how many patients a nurse would be responsible for and penalize hospitals not adhering to the standards.

“Nearly one-third of RNs polled said they worked at least one shift per week where staffing levels were insufficient,” the press release says. “‘Patients are being put at risk because hospital management ignores valuable nursing judgment about staffing levels,’ [Minnesota Nurses Association President Linda] Hamilton said.”

A letter to State Representative Tina Liebling from the Minnesota Hospital Association states, “There is no greater calling to us than to ensure that our hospitals deliver safe patient care. From a patient safety and quality perspective, H.F. 588—the ‘Standards of Care Act’—will not advance safe and high-quality patient care in Minnesota, care that has been ranked highest in the nation for many years. … This legislation calls for standards regardless of patient needs and nursing experience and will stifle care innovation and implementation of best practices to enhance care delivery.

“…A mandated staffing quota does not allow the flexibility and innovation that a care team needs to meet patient needs and it could inhibit safe care in cases of emergency. …Hospitals must have the ability to be nimble and flexible in developing staff assignments.”

Regarding the debate going on in the legislature, Hospital Administrator KimberWraalstad told the North Shore Hospital Board on March 21 that it looks like hospitals might not be required to have quotas at this point, but they might need to report their staffing levels as part of a study of the issue. She said hospitals are opposing this because it takes nursing staff decisions out of local control and does not take individual patient needs into account.

St. Luke’s President John Strange said the legislation would not allow hospitals to reduce staff in other areas to pay for extra nursing staff. If an emergency room filled up and a hospital didn’t have enough staff to serve patients according to the proposed standards, they might have to be transported to other hospitals in other areas.

St. Luke’s Vice President Sandra Barclay said the American Nurses Association gave money to the Minnesota Nurses Association to advance this legislation.



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