Mandating nurse

We reported in 2002 that each patient added to nurses’ workloads was associated with a 7 percent increase in mortality following common surgeries, and that nurse burnout and job dissatisfaction, precursors of voluntary turnover, also in- creased significantly as nurses’ workloads increased (Aiken et al. Rep- lications in Canada, England, and Belgium produced similar findings as did other studies in the United States (Aiken, Clarke, and Sloane 2002; Needle- man et al.

N., Center for Health Outcomes and Policy Research, University of Pennsylvania, 418 Curie Blvd, Philadelphia, PA 19104-4217; e-mail: [email protected]

The new law and its regulations impose significant practical and legal restrictions on health care employers, especially those whose nurses' terms and conditions of employment are set forth in collective bargaining agreements.

New York Labor Law § 167New York Labor Law § 167 makes it unlawful for a health care employer to require a registered nurse or a licensed practical nurse who provides direct patient care to work beyond their "regularly scheduled hours of work." Examples of covered health care employers include hospitals, nursing homes, outpatient clinics, comprehensive rehabilitation hospitals, residential health care facilities, drug and alcohol treatment facilities, adult day health care programs, diagnostic centers and maternal health care consortia.

"OT can cause fatigue, emotional exhaustion and burnout, as well as diminished quality of care, errors and near misses," explained Janet Haebler, MSN, RN, associate director, ANA State Government Affairs.

"Overall, the stress can cause detrimental impacts to a nurse's health." This is not something to be taken lightly - according to the ANA 2011 Health and Safety Survey, nearly one out of 10 nurses report that job fatigue contributed to an auto accident. "This is something that's been going on in hospitals for a very long time," Welsh noted.

Hayes (2010) Professional nursing practice: Concepts and perspectives (6th ed.). California remainstheonlystateto have enacted minimum nurse staffing requirements, and as the amount of legislative and regulatory r Health Research and Educational Trust DOI: 10.1111/j.1475-6773.2010.01114.x 1 Health Services Research activity suggests, there is widespread interest in what can be learned from California’s example. A meta-analysis of 90 studies commissioned by the Agency for Healthcare Research and Quality (AHRQ) subsequently concluded that there is an evident association between nurse staffing and patient outcomes (Kane et al. Registered nurse (RN) staffing in California hospitals increased sub- stantially following the passage of the legislation and implementation of the regulations (Donaldson et al.

c) Using all of these references, develop your plan for influencing votes of legislators on nurse-patient ratios. As of September 2009, 14 states and the District of Columbia had enac- ted nurse staffing legislation and/or adopted regulations addressing nurse staffing and another 17 states had introduced legislation (American Nurses Association 2009). Researchers were unable to detect an impact Address correspondence to Linda H.

RESEARCH ARTICLE Implications of the California Nurse Staffing Mandate for Other States Linda H. When nurses’ workloads were in line with California-mandated ratios in all three states, nurses’ burnout and job dissatisfaction were lower, and nurses reported consistently better quality of care. Hospital nurse staffing ratios mandated in California are associated with lower mortality and nurse outcomes predictive of better nurse retention in California and in other states where they occur. Nurse staffing, California nurse ratios In 2004, California became the first state to implement minimum nurse- to-patient staffing requirements in acute care hospitals (Coffman, Seago, and Spetz 2002; Spetz 2004). Whether the increase in nurses is associated with improved outcomes has been more difficult to determine.

In 1999 California passed legislation setting mandatory nurse staff ratios — although the laws were not implemented until 2004.

Both opponents and advocates of the bill use California’s experience to defend their position.

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Thankfully, about 47% of nurses report never working mandatory OT.

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