The Massachusetts Nurses Association (MNA) is trying a
second time to establish patient limits in state legislation. This comes six
months after losing a ballot question in the November 2018 state election.
As reported by the Boston Business Journal, the current legislation being reviewed now would hire an independent researcher to study issues affecting nurses, such as staffing, violence, injuries, and quality of life. The data collected by the researcher will then be used by state legislators to determine healthcare staffing needs and acute care patient limits.
“If these studies determine there is a best practice limit on the number of patients a nurse should care for at one time, that should inform future policy discussions,” MNA spokesman Joe Markman told the Boston Business Journal.
The original measure from this past election was defeated
largely because of lobbying from the Massachusetts Health & Hospital
Association (MHA), who spent $25 million to defeat the ballot. This current
bill would be revisiting the same legislation, which raises points for state
consideration regarding nurse staffing measures.
“The recent ballot measure raised important issues and challenges that our nurses still face today regarding their ability to give patients the quality care they need and deserve,” Massachusetts state Senator Diana DiZoglio, a sponsor of the current legislation, shared with the Boston Business Journal in an email. “While the policy prescription on the ballot was rejected by the majority of voters, we still need to remain vigilant in identifying best practices to ensure the very best patient care is afforded to all.”
MNA has been working to get nurse-to-patient ratios at all Massachusetts
hospitals for several years, including a ballot measure in 2014 that was removed,
after Governor Deval Patrick passed a law patient limit law. Markman said this
study is necessary to convince voters, after the 2018 election.
“The hospital industry spent … million(s) misleading people about those facts and sometimes outright lying,” Markman told the Boston Business Journal. “For example, they continuously said ED wait times would increase with safe patient limits. That is just wrong and not supported by the evidence. Based on how the industry ran its campaign, it’s clear the public will benefit from additional independent studies.”
From New Years’ Day 2019 through April 11th, the United States has reported 555 cases of measles in 20 states—the second largest measles outbreak reported since the disease was eliminated in 2000. Keep reading to learn the 10 things nurses need to know about the measles outbreak:
1. Measles is brought into the U.S. by travelers who’ve been in foreign countries where the disease is prevalent—countries in Europe, Asia, Africa, and the Pacific. It is then spread in U.S. communities via contact with pockets of unvaccinated populations.
2. Measles outbreaks, defined as three or more reported cases, are currently ongoing in Rockland County New York, New York City, New Jersey, Washington state, Michigan, and the counties of Butte County California. In addition, new cases have recently been identified in New York’s Westchester and Sullivan counties.
3. Once a person is exposed to the measles virus, it may take up to two weeks before symptoms begin to show. A person is contagious four days before the tell-tale rash appears and for four days after. Measles is an airborne virus that can be shed by those infected long before the symptoms arise.
4. There is no available antiviral therapy to cure measles—only supportive therapy for the symptoms, among which are those similar to the common cold: fever, cough, runny nose, sore throat, followed by conjunctivitis and body rash. Measles can sometimes lead to more serious and life-threatening complications such as pneumonia and encephalitis.
5. New York City Mayor Bill de Blasio has declared a health emergency in the neighborhood of Williamsburg, Brooklyn and is mandating unvaccinated residents to become vaccinated. Those not complying could receive violations and fines of $1,000.
6. Mayor de Blasio has sent a team of “disease detectives” into the Hasidic Community in the Williamsburg neighborhood of Brooklyn, where nearly half of the U.S. cases reported are identified.
7. Coincidentally, the New York State Nurses Association just reached an agreement with the NYC Hospital Alliance to hire more nurses to fill vacancies and add new positions.
8. Detroit is urging those Michiganders vaccinated prior to 1989 to receive a booster vaccination.
How Nurses Play a Role
9. The role of nurses in these outbreaks is education and the promotion of vaccination.
10. It is critical that frontline health care professionals are vaccinated themselves in order to prevent the further spread of the virus, particularly when treating those patients infected by the disease.
The Nevada Governor’s Office of Economic Development (GOED)
has rewarded the University of Nevada Las Vegas School of Nursing with a
$900,000 grant. UNLV will put the grant toward expanding new advanced training
opportunities and continuing education for nurses.
UNLV received the grant to develop nursing certificates designed
to meet specific needs around the state, such as teaching, specialty care, and
“We are excited to be able to expand the skills and competencies of Nevada nurses as clinical research nurses, genetics counselors, and clinical preceptors,” Angela Amar, professor and dean of the UNLV School of Nursing, shared with the UNLV News Center. “This funding allows us the opportunity to advance the health of Nevada citizens by increasing the capabilities of our nurses.”
The grant support, which originated from the GOED’s Workforce Innovations for a New Nevada program, is a continuation of UNLV’s plans in recent years to work on solving the state’s continually evolving medical needs. The UNLV School of Nursing has seen an admission increase of 50 percent since fall 2017 for BSN candidates. The school also has one of the top-ranked online master’s degree programs, and is also home to the Clinical Simulation Center of Las Vegas (CSCLV). The CSCLV, a technologically advanced educational facility, provides nursing and medical students opportunities to practice their skills through various simulations.
“At the UNLV School of Nursing, we educate nurses to provide the highest quality care for the citizens of Nevada,” Amar said. “The developing Las Vegas medical district and UNLV medical school make it important that nursing grows also. The increase in enrollment furthers our ability to meet the health care needs of our diverse population. With a critical need for highly trained nurses across our region and state, expanding our BSN class sizes will increase the number of graduates who can meet this demand.”
The planned certificate programs, which include Certified
Nursing Assistant Instructors, Clinical Research Administrators, and Health
Information Technology and Data Analytics, were developed in partnership with several
health care organizations across the state, such as University Medical Center
of Southern Nevada, and Comprehensive Cancer Centers of Nevada. These partners
will help with job placement for all certification program participants.
The Valley Health System, University Medical Center of
Southern Nevada, Comprehensive Cancer Centers of Nevada, and the Kenny Guinn
Center for Policy Priorities. Health care employer partners, along with
projected industry growth, will ensure successful placement of participants following
their completion of the various programs, to ensure these nurses provide the
best possible care to Nevada patients.
For more information about UNLV’s School of Nursing, click here.
Earlier this week, over 1,000 North Carolina nurses and nursing students met with state lawmakers to lobby on behalf of their patients. These discussions were part of the North Carolina Nurses Association’s 2019 Nurses Day at the Legislature. School nurses and the SAVE Act (a bill that would provide advanced practice registered nurses with more practice authority) were among the issues discussed.
Before meeting with legislators, the nurses and students
gathered for an advocacy-themed continuing education program to hear Dr. Ernest
Grant, president of the American Nurses Association, deliver the keynote
address, which included notes about why the SAVE Act is crucial for North
Carolina nurses and patients.
“In some cases, a nurse may have to wait on a physician signature or something like that in order to provide the healthcare for a patient- something they can easily sign for themselves and be on to the next patient, if you will,” Grant shared with the crowd.
As ABC11’s Andrea Blanford reported, North Carolina’s rural areas are currently experiencing a shortage of both nurses and physicians, which is why these issues are particularly crucial right now to all healthcare providers across the state. Luckily, the nurses and students already had the ears of a few legislators, like Rep. Gale Adcock. Rep. Adcock has been a family nurse practitioner for 32 years and is one of three nurses in the General Assembly.
In fact, Adcock
introduced one of the pieces of healthcare legislature that the nurses rallied
for. The bill would ensure every school in North Carolina will have at least
one nurse, as schools currently are experiencing their own nursing shortages.
“There are many districts where nurses have three and four schools they have to cover and that’s untenable,” Adcock said.
Besides advocating for nurses and patients across the state,
the North Carolina Nurses Association (NCNA) provides resources to advance
nursing practice and education. The NCNA hosts the Nurses Day at the Legislature
every other year.
Earlier this week, Johnson & Johnson started a challenge for all U.S. nurses to participate in and contribute. The “Nurses Innovate QuickFire Challenge” is designed for nurses to submit ideas for new devices, health technologies, protocols and/or treatment approaches. Participants can receive up to $100,000 in grants from this challenge, and also receive mentoring and coaching access through Johnson & Johnson Innovation, JLABS.
Innovation in patient care has a long and linear history with nursing, from figures like Florence Nightingale, Nurse Jean Ward, and Nurse Rebecca Koszalinkski. The combination of nurses’ patient experience and insight and resourcefulness provides them with a unique perspective in the healthcare field, allowing them to have significant and crucial input in addressing health challenges.
Yet a nationwide survey showed Johnson & Johnson that nearly half of Americans (41%) are unaware of the role that nurses play in developing new medical tools and solutions. However, the majority (66%) believe that all medical professionals are capable of coming up with lifesaving ideas, and 75% of those surveyed believe nurses should have platform to submit ideas and inventions for improving patient care.
Investing in nurses is part of Johnson & Johnson’s storied history, as the company has provided funding for scholarships, employment opportunities, and more since their start in 1897. Previous efforts to help nurses include the “Campaign for Nursing’s Future,” which took care of a nursing shortage and increased the nursing workforce by more than one million.
The challenge is open now through February 1, 2019. Applicants should meet the following criteria:
- Uniqueness of the idea
- Potential impact on human health
- Feasibility of the idea
- Thoroughness of approach
- Identification of key resources and plan to further idea
For more information about the Johnson & Johnson Nurses Innovate QuickFire Challenge, visit nursing.jnj.com/home.
On February 15, 2018, the newest safe nurse staffing bill was introduced to the U.S. Congress. The bill (H.R.5052 and S.2446) has bipartisan support, and is championed by Reps. David Joyce (R-OH), Suzan DelBene (D-WA), Suzanne Bonamici (D-OR), and Tulsi Gabbard (D-HI), as well as Sen. Jeff Merkley (D-OR).
In the past, several safe staffing bills have been presented in previous Congresses but have failed to pass committee. This bill, the Safe Staffing for Nurse and Patient Safety Act of 2018, is slightly different than previous iterations. Under this staffing legislation, Medicare-participating hospitals would be required to form committees that would create and implement unit specific, nurse-to-patient ratio staffing plans. At least half of each committee must comprise direct care nurses.
“It is so important for nurses on the front lines to be able to have a say in what they believe is safe staffing,” says Pamela F. Cipriano, PhD, RN, NEA-BC, FAAN, the president of the American Nurses Association (ANA). “This bill benefits bedside nurses by giving them decision-making power, control, and the ability to influence the delivery of safe care,” Cipriano continues.
A committee made of staff nurses—who would make staffing decisions that directly affect their own units—is so important because it is nurses who can best assess patient needs and the resources required to provide safe patient care. Staffing committees would be able to address the unique needs of specific units and patient populations by involving specialty nurses in the decisions, and would have the ability to modify the hospital safety plans as needed.
Overwhelmingly, research supports adequate nurse staffing. Over the last several decades, literature has demonstrated a decrease in patient morbidity and mortality and an increase in patient safety when units are well staffed. “With adequate amounts of staffing we see mortality go down and patient complications can be prevented or diminished,” Cipriano says. “It is important for nurses to have sufficient resources to care for patients, because nurses experience moral distress when they cannot provide the care they know a patient needs.”
Short-changing patients also contributes to nurse burnout, and low nursing retention is expensive. Additionally, adequate nurse staffing leads to reduced health care costs, as a result of fewer hospital readmissions, hospital-acquired infections, medical errors, and other significant measurable patient outcomes. “Patients deserve to have the right care,” Cipriano says. “They need to be kept safe, and the best way to prevent problems and complications is to have the right nurse staffing.”
Is there hope that this bill will pass, when so many previous iterations have not? “It may be difficult to pass the legislation, even this time around,” Cipriano admits. “But the most important impact is that every time we have an opportunity to have this legislation discussed, it’s another opportunity to educate another decision maker. Whether it is congresspeople, their staff, or other leaders in their communities, it gives us the opportunity to continue to reinforce why it is so important to have the right nursing care.”
It is ethically challenging when a nurse is asked to take staffing assignments that do not feel safe. On many units, nurses are expected to care for several acute and critically ill patients at a time, and are given patient loads that stretch them far beyond their reasonable care delivery capabilities. What should a nurse do when faced with an unsafe assignment? Nurses should raise immediate concerns by following the chain of command, and talking with immediate supervisors to express that they believe the situation is unsafe. “The first obligation is to make sure that no patient is left uncared for,” Cipriano says. “Short term, use the chain of command and do everything you can within in your power to make sure that you’re providing at least the minimum care the patient needs.” Longer-term, if nurses truly believe that their organization is not supporting the right staffing ratios, the ANA encourages an active dialogue with leadership, such as a conversation with responsible nursing leaders, quality directors, or patient care committees or councils to focus attention to the issue.
“Nursing care is like a medication,” Cipriano says. “You wouldn’t withhold a life-saving medication, so why would you withhold the right amount or right dose of nursing care?”
If you are passionate about safe staffing laws, consider calling or writing your congressperson and encourage them to support the Safe Staffing for Nurse and Patient Safety Act of 2018.