Posted: March 17th, 2023

Week 4: Health Care Disparities, Lobbying and Human Resources

Week 4 Overview
Week 4: Health Care Disparities, Lobbying and Human Resources
Overview
This week students will critically analyze the role of the various players involved in the development of health policy.
Objectives
At the end of this week, students will be able to:
• Critically analyze the role of the lobbyist
• Differentiate between the role of a lobbyist, the act of lobbying and the role and actions of an advocate
Content Outline
• Analyze the role and actions of lobbyists
• Analyze the role and actions of advocates
Assignments
Read
• Longest chapter 4
• Nault, D.S. & Kettering-Sincox, A. (2014). Nursing’s voice in politics: The ongoing relationship between nurses and legislators. Michigan Nurse,17-21.
• Jarrett, S. (2015, August). Advocacy – Supporting Nursing’s Key Values. Colorado Nurse, 115(3), 1-2. Retrieved from http://nursingald.com/publication_search?query=&s=62
• Review the Association of American Medical Colleges website on Physician Shortages.
• Review the graphics for “How a bill becomes a law” Graphic 1.jpg, Graphic 2.gif, Graphic 3.gif
Optional Reading
Additional references
American Nurses Association. (2015). Legislative action center. Retrieved from http://capwiz.com/nursingworld/issues/bills/
Fang, L. (2014). The shadow lobbying complex. Nation, 298(10/11), 12-22.
AFFECTING PUBLIC POLICY THROUGH ADVOCACY AND LOBBYING An Example of Lobbying: http://www.naba-breastfeeding.org/advocacy5.htm
Activities
• In order to add to your understanding of the topics for this week, complete a literature review as needed. As with all literature reviews, peer reviewed articles within the last 5 years are preferable. Material over 10 years old is not acceptable. When citing any of your findings in your literature review, proper APA is required.
• In addition, find one or two current articles on lobbying. Integrate the information from these articles into your discussion. Lobbyists have a negative connotation in some circles. However, they serve an important purpose in terms of educating legislators and getting legislation passed on behalf of people or groups with health care disparities. Nurses’ associations have lobbyists as well as the various medical and hospital associations. DNPs are required to know how to access legislators and influence the development of legislation. They also need a working knowledge of the language of legislation and regulation. It is critically important to understand the difference between lobbying and being a lobbyist.
Discussion
Week 4 Discussion: Lobbying
• Select a current health bill from the federal or state government or an organization that deals either with a human resource issue (think nurse-staffing ratios) or one involving a health care disparity (e.g. a bill proposing that Medicaid cover dental care for pregnant low-income women). By “current”, it must be a bill either in the legislature now at some level (e.g. in a committee), or one that is being proposed. It should not be a bill that has already passed. Research this bill and then emphasizing the human resource issues involved, compare and contrast the pros and cons of the bill and provide very specific reasons for your support or opposition to the bill.
• Identify at least one Political Action Committee (PAC) that supports the bill of your choice and one that opposes it. Include the definition of a PAC in your discussion and explain where the PAC gets its funds. State whether or not you think PACs (and/or super PACs) are a good or bad influence on the political process. You may find some useful information for this part of the discussion at: https://www.opensecrets.org/ If there is no PAC for your policy, identify at least one organization or group that supports the bill and one that opposes it. You still need to provide a definition of a PAC in the discussion and state if you think they are a good or bad influence to policy development.

• Respond to at least two classmates’ postings.
• After receiving feedback from your instructor on the main part of your discussion, you are required to contact a legislator who is sponsoring/supporting the bill or one opposing the bill or contact the decision maker in an appropriate organization. If you are contacting the decision maker (e.g. the CEO) of an organization, you may try to call. If you are contacting a legislator, email is best. It is very difficult to reach a legislator by phone and letters are now sent through all sorts of security testing so they often get lost. Legislators almost never answer their own phones and you will be dealing with staff. The same may be true for the decision maker of an organization. Therefore, written communication (email) is usually best both for a legislator and a decision maker although you can write a letter if it is to the CEO (or other decision maker) of an organization. This activity is one form of lobbying. In this communication, clearly state your viewpoint using the information from the discussion forum and/or any other information that is appropriate.
• Submit a copy of your email (not to exceed one page) to your instructor prior to sending it. These are due no later than 11:59 on Sunday of week 5 .
• If you receive a response from your elected official or from the decision maker, please share it with the class in the informal discussion area.
• Do not wait to start this activity as it may take some time. If you call a decision maker, please be assertive about your need to speak to that person and not an assistant. A conversation with a secretary or staff person is not acceptable. If you have trouble getting through to the decision maker, then either write a letter or send an email. With an elected official, it is usually better to select an elected official at the local level (your state or even your city council person) if he/she is involved with your issue. With an organization that is lobbying on behalf of your issue it is often easier to talk with someone at a local branch of an organization such as the American Cancer Society, but he/she must be actively engaged in a lobbying effort. Remember that this activity is worth 5% of your grade.
• These instructions are complicated so do not hesitate to ask your instructor for clarification if necessary.
The deadline for your initial posting is 8:00am Thursday. Your contributions should:
• Add to the academic value of the conversation
• Add experiential value
• Challenge or question prevailing ideas and/or assumptions with new evidence or well-argued, substantiated alternative perspectives
• Make connections between contributions of others so that synergies are created.
The deadline for the last of your response postings is 11:59pm Sunday of this week.
Written Assignment
The human element in the health care system
This is a 2-3 page written assignment. Identify the key human resource issues in the health care system. This may or may not relate to your clinical question. The key is to describe how shortages and surpluses (supply and demand) of human resources impact the health care system in general or, if applicable, relate to your clinical question. Support your views with at least two articles from current (within the past 5 years if possible) peer reviewed journals.
Submit to the Assignments box by 11:59pm Sunday of this week.
NOTE: Points will be deducted for papers that exceed 3 pages.
Reminder: Your field report as described in week one is due by 11:59pm Sunday of next week.

Dis. 4
Health Bill: H.R. 2581
H.R. 2581: Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act of 2019 is a federal bill introduced on May 8, 2019 by U.S. Rep. Jan Schakowsky (D-IL) and it was referred to the Committee on Energy and Commerce and to the Committee on Ways and Means for considerations before it can be sent to the House or Senate. H.R. 2581 is “a bill to amend the Public Health Service Act to establish direct care registered nurse-to-patient staffing ratio requirements in hospitals, and for other purposes”
(“GovTrack,” 2019, para. 2).

H.R. 2581 is in the first stage of the legislative process.
Human Resource Issues Involved
High acuity level of care is needed among patients in hospitals and this calls for the establishment of adequate minimum direct care registered nurse-to-patient ratios. Inadequate registered nurses providing direct care jeopardizes the delivery of quality health care services to patients.
According to congress findings on the bill,
Requirements for direct care registered nurse staffing ratios will help address the registered nurse shortage in the United States by aiding in recruitment of new registered nurses and improving retention of registered nurses who are considering leaving direct patient care because of demands created by inadequate staffing
(“GovTrack,” 2019, para. 3).
If passed into law, the bill will ultimately improve the delivery of quality health care and services, guarantee patient safety and care, and reduce the incidence of medical errors.
Pros and Cons
The pros of H.R. 2581: Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act of 2019 include patient safety, nursing job satisfaction, and enhanced patient outcomes. Nurses job satisfaction is directly proportional to fewer number of assigned patients. According to a survey carried out in Pennsylvania, it was revealed that increasing the patient-to-nurse ratio by one more patient increased job dissatisfaction by 15% to 23%.
There are several cons to H.R. 2581, some of these are as a result of the concept of generalization of care denoted by the bill. A nurse-ratio system treats each similar hospital unit as the same, regardless of patient case mix or efficiency of design of nursing units. Patient care varies among medical/surgical units due to concentration of different diagnoses; also, nursing units with charting modules in patients’ rooms are more efficient than nursing units with central nursing stations, hence a fixed nurse-patient ratio will not be efficient for these scenarios.
Opposing the Bill
I am not in support of H.R. 2581. H.R. 2581 is the current version of H.R. 2392 that was introduced on May 4th, 2017 but died in congress on January 3rd, 2019. There are over 20 state legislatures within the last 2 years that have introduced legislation relating to nurse-patient-ratio but only California have been able to pass the AB (Assembly Bill) 394 which proposed setting minimum staffing levels (nurse to patient ratios) in all California hospitals in 1999. I believe ratios do not resolve the nursing shortage issue. The ratio system exacerbates it by creating a greater shortage. Till date, California falls short of nurses and “will have to hire 5,000 more nurses to oblige the legislation (“Nursing Ratios,” 2005, Slide 33). Ergonomics of the units layout and design, technology on the units, ancillary Support among others should be considered when establishing staffing requirements in hospitals.

Political Action Committees
Political action committees (PACs,) are organizations used to raise election funds. They play important roles in campaign finance and heavily influence politics. According to Ballotpedia (2019), Political Action Committees (PACs) are political committees established and administered by corporations, labor unions, membership organizations or trade associations to privately raise and spend money on elections in hopes of influencing elections. It is not run by a party or individual candidate but donates money to supported parties and/or candidates by electing candidates or defeating candidates. According Investopedia (2018), PACs can give up to $5,000 to a candidate committee per election, $15,000 annually to any national party committee, and $5,000 annually to any other PAC. Also, PACs may receive up to $5,000 from any one individual, PAC or party committee per calendar year.
The two types of political action committees that exist are Separate Segregated Funds (SSFs) and nonconnected PACs. SSFs are permitted to only raise funds from individuals associated with the groups that establish or administers it. These groups can either be corporations, labor unions, member organizations, or trade associations. Nonconnected committees are not sponsored by or connected to any groups and are free to solicit contributions from the general public.
I think PACs are a good influence on political processes because it provides corporations, nonprofit associations, and qualified others a legal means of participating in federal and state policies as “it creates avenues for nonprofit organizations to have their voices heard during federal elections campaigns and after elections”
(Alder, 2015, para. 1).
PACs for and against Nurse-Patient-Ratios
The American Nurses Association (ANA) applauds the introduction of The Safe Staffing for Nurse and Patient Safety Act of 2018 in the U.S. Senate and House of Representatives. In support of this bill, ANA President Pamela F. Cipriano said “The Safe Staffing for Nurse and Patient Safety Act empowers direct care nurses to determine the unique and variable needs of their patients to ensure the safety and quality outcomes of care.”
(“ANA,” 2018, para. 3)
Interestingly, Illinois Health and Hospital association (IHA) is an example of PAC that strongly opposes a similar nurse staffing ratios House Bill 2604 because they believe there is no conclusive evidence that staffing ratios improve quality or patient outcomes, and projections “indicate that nurse staffing ratios will drive up healthcare costs in Illinois by at least $2 billion a year – for patients, families, employers and hospitals”
(“IHA,” 2019, para. 6).

Thanks, Ms. Kenya, for this interesting and educative post. I am in total support of the bill H.R. 4194 introduced August this year by Utah Congressman Chris Steward. Suicidal rate is alarming in this country. I am concerned about the numerous things I see on Investigation Discovery Channel, but more saddening is the fact that “There were more than twice as many suicides (47,173) in the United States as there were homicides (19,510)”
(“NIMH,” 2019, para. 2).

I agree that the current Suicide Prevention Hotline which is 1–800–273–8255 (TALK) is difficult to memorize. I do home visits and I had encountered patients that were actively considering suicides (with suicidal plans). I called 9-1-1 on several occasions instead of 1–800–273–8255 (TALK) because it is easier to remember.
Interestingly, “H.R. 4194 has attracted 52 bipartisan cosponsors: 29 Democrats and 23 Republicans”
(“GovTrack,” 2019, para. 5).
The positive response that cuts across political spectrum shows the bill will most likely be enacted. Currently, it awaits potential vote in the House Energy and Commerce Committee. The Commission will vote on this proposal at its December 12 public meeting.
Passing the bill (H.R. 4194) into law will designate 9-8-8 for a national suicide prevention and mental health crisis hotline. As healthcare providers, this is a much easier number to tell our patients and I believe it is a much easier number for patients to remember.
I am not surprised that H.R. 4121 is endorsed by over 40 organizations. I hope to see more organizations endorse the bill and I do hope members of American Psychiatric Nurses Association (APNA, 2019) utilize the Digital Membership with the American Nurses Association (ANA).
Please support this bill by writing or calling the Congress about this bill. You can visit this website ‘https://www.govtrack.us/congress/bills/116/hr4194/comment’ for a walk through the process of writing or calling your representative and senators in Congress about H.R. 4194.
Reply 2
Thank you, Jim, for your interesting post. I respect your views and position on the bill- H.R. 2581. I also wrote on this bill and I was leaning towards supporting the bill earlier in my research studies but later deviated to taking an opponent stand on the bill.
Please do not get me wrong. I love and I am all for the facts that lowering nurse-to-patient ratios will decrease nurses’ burnout and allow for nurses to give better value-based care. California, the only state with statewide mandates for nurse staffing ratios “saw procedural mistakes decline as well as outcomes improve- fewer patients got sick in hospitals, more recovered, and fewer suffered post-treatment complications that required them to return”
(Votroubek, 2019, para. 2)
Mass Insight commissioned
but I believe the drawbacks of nurse-to-patient ratios outweighs the benefits.
Massachusetts is another state that is potentially following in California’s footsteps, but research from Mass Insight commissioned by the Massachusetts Health and Hospital Association (MHA) found that mandatory nurse staffing ratios would have negative financial implications for hospitals and patient care access will be limited. Imagine refusing to admit patients in emergency rooms or in hospitals despite having empty beds but not enough nurses to fulfil the nurse-patient-ratio mandate. This will forfeit the goal of providing quality care to patients. According to MHA, data suggest that a one-size-fits-all statewide implementation will be a costly and poor allocation of resources, leading to greater inequity in the provision of care, less local access to healthcare, and reduced patient choice.
I liken my stand on this bill to that of the American Nurses Association’s (ANA) “support for a legislative model in which nurses are empowered to create staffing plans specific to each unit”
(“ANA,” 2019, para. 5)
This approach aides in establishing staffing levels that are flexible and account for changes; including intensity of patient’s needs, the number of admissions, discharges and transfers during a shift, level of experience of nursing staff, layout of the unit, and availability of resources.
References
Nurse staffing crisis. (2019). Retrieved from https://www.nursingworld.org/practice-policy/nurse-staffing/nurse-staffing-crisis/
Protecting the best patient care in the country: Local choices V. Statewide mandate in Massachusetts. (2018). Retrieved November 22, 2019, from http://www.massinsight.com/wp-content/uploads/2014/04/MHA-NLR-Report-Final.pdf
Votroubek, W. (2019). The pros and cons of required minimum nurse-to-patient ratios. Retrieved from https://www.legalnursepdx.com/the-pros-and-cons-of-required-minimum-nurse-to-patient-ratios/#_ftn8

References
H.R. 4194: National Suicide Hotline Designation Act of 2019. (2019). Retrieved November 21, 2019, from https://www.govtrack.us/congress/bills/116/hr4194/summary
Suicide. (2019). Retrieved from https://www.nimh.nih.gov/health/statistics/suicide.shtml

References
Alder, H. (2015). Pros and cons to establish a political action committee (PAC) to influence obesity prevention and treatment Services. ASMBS, 11(6), S145. https://doi.org/https://doi.org/10.1016/j.soard.2015.08.222
ANA applauds nurse staffing legislation . (2018). Retrieved from https://www.nursingworld.org/news/news-releases/2018/ana-applauds-nurse-staffing-legislation/
H.R. 2581: Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act of 2019. (2019). Retrieved November 11, 2019, from https://www.govtrack.us/congress/bills/116/hr2581/text
Mandated nursing ratios – The pros and cons . (2005). Retrieved from https://www.iise.org/uploadedfiles/SHS/Events/Details/Webcasts/ProsandConsofRatios080405.pdf
Nurse staffing, mortality and burnout. Bandolier. http://www.jr2.ox.ac.uk/bandolier/band106/b1065.html (11-7-03)
Oppose Nurse Staffing Ratios – Key Committee Vote March 27. (2019). Retrieved from https://www.team-iha.org/advocacy-policy/state-issues/advocacy-tab-(1)/oppose-nurse-staffing-ratios-key-committee-vote
Political action committee. (2019). Retrieved from https://ballotpedia.org/Political_action_committee
(“Mass Insight,” 2018, p. 4-5)

References
Alder, H. (2015). Pros and cons to establish a political action committee (PAC) to influence obesity prevention and treatment Services. ASMBS, 11(6), S145. https://doi.org/https://doi.org/10.1016/j.soard.2015.08.222
ANA applauds nurse staffing legislation . (2018). Retrieved from https://www.nursingworld.org/news/news-releases/2018/ana-applauds-nurse-staffing-legislation/
H.R. 2581: Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act of 2019. (2019). Retrieved November 11, 2019, from https://www.govtrack.us/congress/bills/116/hr2581/text
H.R. 4194: National Suicide Hotline Designation Act of 2019. (2019). Retrieved November 21, 2019, from https://www.govtrack.us/congress/bills/116/hr4194/summary
Mandated nursing ratios – The pros and cons . (2005). Retrieved from https://www.iise.org/uploadedfiles/SHS/Events/Details/Webcasts/ProsandConsofRatios080405.pdf
Nurse staffing crisis. (2019). Retrieved from https://www.nursingworld.org/practice-policy/nurse-staffing/nurse-staffing-crisis/
Oppose Nurse Staffing Ratios – Key Committee Vote March 27. (2019). Retrieved from https://www.team-iha.org/advocacy-policy/state-issues/advocacy-tab-(1)/oppose-nurse-staffing-ratios-key-committee-vote
Political action committee. (2019). Retrieved from https://ballotpedia.org/Political_action_committee
Protecting the best patient care in the country: Local choises V. Statewide mandate in Massachusetts. (2018). Retrieved November 22, 2019, from http://www.massinsight.com/wp-content/uploads/2014/04/MHA-NLR-Report-Final.pdf
Suicide. (2019). Retrieved from https://www.nimh.nih.gov/health/statistics/suicide.shtml
Votroubek, W. (2019). The pros and cons of required minimum nurse-to-patient ratios. Retrieved from https://www.legalnursepdx.com/the-pros-and-cons-of-required-minimum-nurse-to-patient-ratios/#_ftn8

Dis. 4
Student Name
University

Dis. 4
Health Bill: H.R. 2581
H.R. 2581: Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act of 2019 is a federal bill introduced on May 8, 2019 by U.S. Rep. Jan Schakowsky (D-IL) and it was referred to the Committee on Energy and Commerce and to the Committee on Ways and Means for considerations before it can be sent to the House or Senate. H.R. 2581 is “a bill to amend the Public Health Service Act to establish direct care registered nurse-to-patient staffing ratio requirements in hospitals, and for other purposes”
(“GovTrack,” 2019, para. 2).

H.R. 2581 is in the first stage of the legislative process.
Human Resource Issues Involved
High acuity level of care is needed among patients in hospitals and this calls for the establishment of adequate minimum direct care registered nurse-to-patient ratios. Inadequate registered nurses providing direct care jeopardizes the delivery of quality health care services to patients.
According to congress findings on the bill,
Requirements for direct care registered nurse staffing ratios will help address the registered nurse shortage in the United States by aiding in recruitment of new registered nurses and improving retention of registered nurses who are considering leaving direct patient care because of demands created by inadequate staffing
(“GovTrack,” 2019, para. 3).
If passed into law, the bill will ultimately improve the delivery of quality health care and services, guarantee patient safety and care, and reduce the incidence of medical errors.
Pros and Cons
The pros of H.R. 2581: Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act of 2019 include patient safety, nursing job satisfaction, and enhanced patient outcomes. Nurses job satisfaction is directly proportional to fewer number of assigned patients. According to a survey carried out in Pennsylvania, it was revealed that increasing the patient-to-nurse ratio by one more patient increased job dissatisfaction by 15% to 23%.
There are several cons to H.R. 2581, some of these are as a result of the concept of generalization of care denoted by the bill. A nurse-ratio system treats each similar hospital unit as the same, regardless of patient case mix or efficiency of design of nursing units. Patient care varies among medical/surgical units due to concentration of different diagnoses; also, nursing units with charting modules in patients’ rooms are more efficient than nursing units with central nursing stations, hence a fixed nurse-patient ratio will not be efficient for these scenarios.
Opposing the Bill
I am not in support of H.R. 2581. H.R. 2581 is the current version of H.R. 2392 that was introduced on May 4th, 2017 but died in congress on January 3rd, 2019. There are over 20 state legislatures within the last 2 years that have introduced legislation relating to nurse-patient-ratio but only California have been able to pass the AB (Assembly Bill) 394 which proposed setting minimum staffing levels (nurse to patient ratios) in all California hospitals in 1999. I believe ratios do not resolve the nursing shortage issue. The ratio system exacerbates it by creating a greater shortage. Till date, California falls short of nurses and “will have to hire 5,000 more nurses to oblige the legislation (“Nursing Ratios,” 2005, Slide 33). Ergonomics of the units layout and design, technology on the units, ancillary Support among others should be considered when establishing staffing requirements in hospitals.

Political Action Committees
Political action committees (PACs,) are organizations used to raise election funds. They play important roles in campaign finance and heavily influence politics. According to Ballotpedia (2019), Political Action Committees (PACs) are political committees established and administered by corporations, labor unions, membership organizations or trade associations to privately raise and spend money on elections in hopes of influencing elections. It is not run by a party or individual candidate but donates money to supported parties and/or candidates by electing candidates or defeating candidates. According Investopedia (2018), PACs can give up to $5,000 to a candidate committee per election, $15,000 annually to any national party committee, and $5,000 annually to any other PAC. Also, PACs may receive up to $5,000 from any one individual, PAC or party committee per calendar year.
The two types of political action committees that exist are Separate Segregated Funds (SSFs) and nonconnected PACs. SSFs are permitted to only raise funds from individuals associated with the groups that establish or administers it. These groups can either be corporations, labor unions, member organizations, or trade associations. Nonconnected committees are not sponsored by or connected to any groups and are free to solicit contributions from the general public.
I think PACs are a good influence on political processes because it provides corporations, nonprofit associations, and qualified others a legal means of participating in federal and state policies as “it creates avenues for nonprofit organizations to have their voices heard during federal elections campaigns and after elections”
(Alder, 2015, para. 1).
PACs for and against Nurse-Patient-Ratios
The American Nurses Association (ANA) applauds the introduction of The Safe Staffing for Nurse and Patient Safety Act of 2018 in the U.S. Senate and House of Representatives. In support of this bill, ANA President Pamela F. Cipriano said “The Safe Staffing for Nurse and Patient Safety Act empowers direct care nurses to determine the unique and variable needs of their patients to ensure the safety and quality outcomes of care.”
(“ANA,” 2018, para. 3)
Interestingly, Illinois Health and Hospital association (IHA) is an example of PAC that strongly opposes a similar nurse staffing ratios House Bill 2604 because they believe there is no conclusive evidence that staffing ratios improve quality or patient outcomes, and projections “indicate that nurse staffing ratios will drive up healthcare costs in Illinois by at least $2 billion a year – for patients, families, employers and hospitals”
(“IHA,” 2019, para. 6).

Thanks, Ms. Kenya, for this interesting and educative post. I am in total support of the bill H.R. 4194 introduced August this year by Utah Congressman Chris Steward. Suicidal rate is alarming in this country. I am concerned about the numerous things I see on Investigation Discovery Channel, but more saddening is the fact that “There were more than twice as many suicides (47,173) in the United States as there were homicides (19,510)”
(“NIMH,” 2019, para. 2).

I agree that the current Suicide Prevention Hotline which is 1–800–273–8255 (TALK) is difficult to memorize. I do home visits and I had encountered patients that were actively considering suicides (with suicidal plans). I called 9-1-1 on several occasions instead of 1–800–273–8255 (TALK) because it is easier to remember.
Interestingly, “H.R. 4194 has attracted 52 bipartisan cosponsors: 29 Democrats and 23 Republicans”
(“GovTrack,” 2019, para. 5).
The positive response that cuts across political spectrum shows the bill will most likely be enacted. Currently, it awaits potential vote in the House Energy and Commerce Committee. The Commission will vote on this proposal at its December 12 public meeting.
Passing the bill (H.R. 4194) into law will designate 9-8-8 for a national suicide prevention and mental health crisis hotline. As healthcare providers, this is a much easier number to tell our patients and I believe it is a much easier number for patients to remember.
I am not surprised that H.R. 4121 is endorsed by over 40 organizations. I hope to see more organizations endorse the bill and I do hope members of American Psychiatric Nurses Association (APNA, 2019) utilize the Digital Membership with the American Nurses Association (ANA).
Please support this bill by writing or calling the Congress about this bill. You can visit this website ‘https://www.govtrack.us/congress/bills/116/hr4194/comment’ for a walk through the process of writing or calling your representative and senators in Congress about H.R. 4194.
Reply 2
Thank you, Jim, for your interesting post. I respect your views and position on the bill- H.R. 2581. I also wrote on this bill and I was leaning towards supporting the bill earlier in my research studies but later deviated to taking an opponent stand on the bill.
Please do not get me wrong. I love and I am all for the facts that lowering nurse-to-patient ratios will decrease nurses’ burnout and allow for nurses to give better value-based care. California, the only state with statewide mandates for nurse staffing ratios “saw procedural mistakes decline as well as outcomes improve- fewer patients got sick in hospitals, more recovered, and fewer suffered post-treatment complications that required them to return”
(Votroubek, 2019, para. 2)
Mass Insight commissioned
but I believe the drawbacks of nurse-to-patient ratios outweighs the benefits.
Massachusetts is another state that is potentially following in California’s footsteps, but research from Mass Insight commissioned by the Massachusetts Health and Hospital Association (MHA) found that mandatory nurse staffing ratios would have negative financial implications for hospitals and patient care access will be limited. Imagine refusing to admit patients in emergency rooms or in hospitals despite having empty beds but not enough nurses to fulfil the nurse-patient-ratio mandate. This will forfeit the goal of providing quality care to patients. According to MHA, data suggest that a one-size-fits-all statewide implementation will be a costly and poor allocation of resources, leading to greater inequity in the provision of care, less local access to healthcare, and reduced patient choice.
I liken my stand on this bill to that of the American Nurses Association’s (ANA) “support for a legislative model in which nurses are empowered to create staffing plans specific to each unit”
(“ANA,” 2019, para. 5)
This approach aides in establishing staffing levels that are flexible and account for changes; including intensity of patient’s needs, the number of admissions, discharges and transfers during a shift, level of experience of nursing staff, layout of the unit, and availability of resources.
References
Nurse staffing crisis. (2019). Retrieved from https://www.nursingworld.org/practice-policy/nurse-staffing/nurse-staffing-crisis/
Protecting the best patient care in the country: Local choices V. Statewide mandate in Massachusetts. (2018). Retrieved November 22, 2019, from http://www.massinsight.com/wp-content/uploads/2014/04/MHA-NLR-Report-Final.pdf
Votroubek, W. (2019). The pros and cons of required minimum nurse-to-patient ratios. Retrieved from https://www.legalnursepdx.com/the-pros-and-cons-of-required-minimum-nurse-to-patient-ratios/#_ftn8

References
H.R. 4194: National Suicide Hotline Designation Act of 2019. (2019). Retrieved November 21, 2019, from https://www.govtrack.us/congress/bills/116/hr4194/summary
Suicide. (2019). Retrieved from https://www.nimh.nih.gov/health/statistics/suicide.shtml

References
Alder, H. (2015). Pros and cons to establish a political action committee (PAC) to influence obesity prevention and treatment Services. ASMBS, 11(6), S145. https://doi.org/https://doi.org/10.1016/j.soard.2015.08.222
ANA applauds nurse staffing legislation . (2018). Retrieved from https://www.nursingworld.org/news/news-releases/2018/ana-applauds-nurse-staffing-legislation/
H.R. 2581: Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act of 2019. (2019). Retrieved November 11, 2019, from https://www.govtrack.us/congress/bills/116/hr2581/text
Mandated nursing ratios – The pros and cons . (2005). Retrieved from https://www.iise.org/uploadedfiles/SHS/Events/Details/Webcasts/ProsandConsofRatios080405.pdf
Nurse staffing, mortality and burnout. Bandolier. http://www.jr2.ox.ac.uk/bandolier/band106/b1065.html (11-7-03)
Oppose Nurse Staffing Ratios – Key Committee Vote March 27. (2019). Retrieved from https://www.team-iha.org/advocacy-policy/state-issues/advocacy-tab-(1)/oppose-nurse-staffing-ratios-key-committee-vote
Political action committee. (2019). Retrieved from https://ballotpedia.org/Political_action_committee
(“Mass Insight,” 2018, p. 4-5)

References
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