Why RN Staffing Needs Better Regulation

By Michele Crissman, J.D., MSN, CMA, University Dean, Allied Health and Nursing

CTU HealthCare Degree - RN Staffing RecommendationsWe all know that the care nurses provide to patients has a direct effect on quality of care and patient outcomes. With the emphasis on safety and quality in health care, there has been a bill, H.R. 1821 or the Registered Nurse Safe Staffing Act of 2013, introduced into the U.S. House of Representatives to establish guidance on RN staffing in hospitals.

What Regulation Looks Like

This bill, as proposed, would require hospitals to develop a staffing plan for nursing services that addresses the needs of patients that would lead to the delivery of safe, quality patient care. This bill would require hospitals to publicly display their nursing unit staffing. In addition, nurses would not be forced to work on units in which they do not feel they possess adequate education and experience. The hospitals would be required to establish a committee to develop an implementation plan with involvement from staff nurses. Although there are general guidelines for staffing, none of the federal regulations have provided the “teeth” for enforcement that this bill would provide. Included in the bill are provisions for civil monetary and other penalties for violating the law as well as protections for whistleblowers. The bill has not had much action since May 2013 and is currently being considered by the Subcommittee on Health.

In Progress

Seven states have already passed legislation similar to the federal legislation being recommended by the ANA. Those states include Connecticut, Illinois, Nevada, Ohio, Oregon, Texas and Washington. Eight other states and the District of Columbia have enacted legislation and/or adopted regulations related to nursing staffing. Those states include California (requires a minimum nurse-to-patient ratio), Maine, Minnesota, New Jersey, New York, North Carolina, Rhode Island and Vermont. 

Are you in one of the states that has enacted legislation or adopted regulations for safe staffing? Next time you are in the hospital, look to see where its staffing patterns are publicly displayed. If your state is not one of those listed, encourage your legislators and work with your state’s Board of Nursing to adopt legislation to protect patients and empower the nursing staff to contribute to better quality of patient care. 

CTU Faculty - Michele CrissmanMichele Crissman, J.D., MSN, CMA ., is the Program Chair of Health Sciences and Criminal Justice at CTU’s Sioux Falls campus as well as University Dean of Allied Health. She has worked in the health care industry for 24 years as a registered nurse, and manager/director at departmental and executive management levels. Crissman also briefly held positions as a law clerk and magistrate judge.


Image Credit: Flickr/Eric S.


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