WHEREAS:
The shortfall of registered nurses reached six percent in 2000 and is expected to reach 29 percent by 2020. The growth in new registered nurses declined by 26 percent from 1995 to 2000; and
WHEREAS:
Analyses by the federal government show a growing discrepancy between the supply of and demand for registered nurses. The shortage is predicted to worsen in the near future, fueled by a projected 18 percent growth in the U.S. population between 2002 and 2020 and a 65 percent growth in the population over age 65, which requires a disproportionately larger share of health care services; and
WHEREAS:
There were approximately 2.7 million licensed registered nurses in the U.S. in 2001, only 2.2 million of whom were employed in nursing. Researchers have reported that more than 40 percent of nurses working in hospital jobs are dissatisfied with their jobs. Data from one city indicate that 50 percent of new nurses working in hospitals leave before the end of their second year of employment; and
WHEREAS:
Recent reports have revealed that inadequate nursing staff negatively affects patient outcomes. A study completed by the Joint Commission on Accreditation of Health Care Organizations cited a shortage of nursing staff as a factor in 24 percent of the 1,609 cases involving patient death or injury. The Agency for Health care Research and Quality found that there is a direct link between the number of nurses, the hours they spend with patients and the incidence of serious complications and death in a facility; and
WHEREAS:
One of the most significant and risky consequences of insufficient staffing is the routine and widespread use of overtime to fill gaps in scheduling. It was reported in 2003 that 75 percent of nurses regularly worked overtime and nearly half of those hours were mandatory. Both nurses and hospital administrators point to mandatory overtime as a leading cause of turnover among nurses. As many as 22 percent of nurses who leave direct care work do so in search of more regular hours; and
WHEREAS:
Some states have enacted legislation that would ban employers from requiring nurses to work overtime. Most recently the governor of West Virginia signed a law that would require nurses who have worked more than 12 consecutive hours to be given at least eight consecutive hours off. Maryland, Minnesota, New Jersey and Washington also have laws that ban mandatory overtime for nurses; and
WHEREAS:
The state of California has enacted and implemented mandatory nurse-to-patient ratios to enhance patient safety, improve the quality of care in hospitals and reduce staff turnover. The law sets minimum ratios by department that can be adjusted based on patient acuity; and
WHEREAS:
LPNs/LVNs are vital members of the health care work force. LPNs/LVNs provide hands-on bedside care, dispense medications and perform other duties that greatly improve the quality of care patients receive. While most studies to date have focused on RNs, it is clear that appropriate LPN/LVN staffing ratios are a critical component of a hospital's skill mix; and
WHEREAS:
Resolution #50, adopted at AFSCME 's 35th International Convention in 2002, addressed the issues facing the American health care system overall, which negatively impact all health care workers; and
WHEREAS:
A nurse-to-patient staffing ratio bill has been introduced in the U.S. House of Representatives by Rep. Jan Schakowsky (D-IL). The bill establishes federal staffing standards for hospitals that would improve patient safety and quality of care while also addressing the ever increasing nursing shortage that has left our nation's hospitals critically understaffed. The bill establishes minimum direct care registered nurse-to-patient staffing ratios and a study examining and establishing staffing requirements for licensed practical/vocational nurses.
THEREFORE BE IT RESOLVED:
That AFSCME continue to advance legislation at the state and federal levels to limit the ability of employers to impose mandatory overtime for nurses and to give nurses the right to refuse overtime without fear of discrimination or retaliation; and
BE IT FURTHER RESOLVED:
That AFSCME support efforts to enact federal and state legislation that would require hospitals to implement minimum nurse-to-patient ratios. The development of facility-specific staffing plans should involve nurses and should consider patient acuity and staff mix; and
BE IT FURTHER RESOLVED:
That AFSCME will work to support the nurse-to-patient staffing ratio bill introduced by Rep. Jan Schakowsky and the study to determine staffing requirements for LPNs/LVNs. The study will reveal the critical role of LPNs/LVNs in the delivery of quality health care; and
BE IT FURTHER RESOLVED:
That AFSCME work in coalition with other groups to promote changes in the work environment that will improve the ability of nurses to provide the highest quality of care; and
BE IT FURTHER RESOLVED:
That AFSCME advocate for continued support from government, educational and health care institutions for health care worker training and career pathway programs; and
BE IT FURTHER RESOLVED:
That AFSCME continue to work in coalition with patients, families and patient advocacy organizations for public policies and collective bargaining agreements that promote quality patient care and improve the working conditions of health care workers; and
BE IT FINALLY RESOLVED:
That AFSCME reiterate its support for legislative policy and bargaining strategies to improve health delivery and working conditions for all health care workers.
SUBMITTED BY:
Kathy Sackman, President and Delegate
UNAC/NUHHCE/AFSCME 1199
CaliforniaBonnie Marpoe, President and Delegate
AFSCME Council 13
Pennsylvania