By Amanda Sounart, associate editor
Texas nurses are about to become a more integral part of hospital staffing decisions, thanks to a recent state bill. As a collaborative effort between the Texas Nursing Association (TNA) and the Texas Hospital Association (THA), Senate Bill 476 (SB 476) would require that all Texas hospitals’ nurse staffing committees be comprised of at least 60 percent bedside nurses, among other guidelines.
"The whole process started about a year ago," said Jennifer Banda, J.D., senior director of government relations for THA. "The nurses’ association brought the hospital association a concept they wanted to pass about strengthening our nurse staffing. We worked together to compromise language we could both agree to so we could improve the workplace."
With more direct care nurses on the staffing committee, and a direct reporting line to the hospital board, nurses would have greater control over what the appropriate nurse staffing level for the facility should be based on their own experiences.
"Our hope is that [this bill will] really elevate the collaborative staffing process at hospitals for both administrators and nurses in the hospitals," added Banda.
Unlike previous nurse staffing bills, SB 476 does not set a universal nurse-to-patient ratio for all facilities. Instead, it allows the staffing committees to set their own ratios based on the needs of the patients and the hospital.
"The bill elevates the importance of the nurse staffing committee and their work," noted Banda.
In addition, the bill takes into account that many hospitals use mandatory overtime from their core staff as a means to compensate for a shortage of nurses.
"Mandatory overtime will be prohibited unless there is a severe shortage issue," said Elizabeth Sjoberg, RN, JD, associate general counsel for THA. "They have to make sure it’s not something done regularly and make an attempt to locate agency nurses to eliminate any mandatory overtime as soon as possible."
"Steps must be taken for mandatory overtime to be used; otherwise it is prohibited," Sjoberg continued. "And the hospital cannot retaliate against a nurse if she does not want to engage in mandatory overtime."
The bill was designed to improve the work environment for nurses and discourage them from leaving the state to seek more flexible work hours in states with mandatory nurse-to-patient ratios.
"At a time when our state is in dire need of nurses, we cannot afford to lose good hospital nurses due to mandatory overtime and grueling work schedules," said State Sen. Jane Nelson, the bill’s author, in a press statement. "This legislation will help retain bedside nurses and ensure that they have a voice in issues such as nurse-patient ratios, work schedules and other issues affecting patient care."
The bill was passed by both the state House and Senate in late May 2009. The bill is currently with Texas Governor Rick Perry where it is expected to be signed into law by June 21, 2009.
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