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ADVANCE Perspective: Nurses

ANA Lauds Registered Nurse Safe Staffing Bill Introduced In Senate

Published May 19, 2014 10:36 AM by Guest Blogger

The American Nurses Association (ANA) collectively applauds the introduction of federal legislation in the U.S. Senate that empowers registered nurses (RNs) to drive staffing decisions in hospitals, protect patients and improve the quality of care.

The Registered Nurse Safe Staffing Act of 2014 (S. 2353), crafted with input from ANA, is sponsored by Sen. Jeff Merkley (D-OR). ANA supports a companion staffing bill introduced in the House in May 2013, the Registered Nurse Safe Staffing Act of 2013 (H.R. 1821).

“It is encouraging that members of both chambers of Congress understand the connection between nurse staffing and patient safety. There is no room for debate: when there are appropriate nurse staffing levels, lives are saved and patient outcomes improve,” says ANA President Karen A. Daley, PhD, RN, FAAN. “With federal legislation we can vastly advance the quality of patient care and improve working conditions for nurses.”

According to ANA, research has shown that higher staffing levels by experienced RNs are linked to lower rates of patient falls, infections, medication errors, and even death.  And when unanticipated events happen in a hospital resulting in patient death, injury, or permanent loss of function, inadequate nurse staffing often is cited as a contributing factor.

“As the husband of a nurse, I know firsthand the many challenges nurses face and how critical their care is to patients,” says Sen. Merkley. “Safe staffing that enhances patient care, reduces medical errors and bolsters nurse retention all at the same time would be a tremendous improvement to health care delivery.” 

The bill would require hospitals to establish committees that would create unit-by-unit nurse staffing plans based on multiple factors, such as the number of patients on the unit, severity of the patients’ conditions, experience and skill level of the RNs, availability of support staff, and technological resources.

 “As a nurse, and someone who’s been involved in both patient care and policy discussions about staffing for decades, I’m so pleased to see Sen. Merkley standing up for patients in hospitals across the country,” said Susan King, MS, RN, CEN, FAAN, executive director of the Oregon Nurses Association, a constituent member of ANA. 

“We know that nurse staffing levels impact patient outcomes and nurse retention, and—as the people providing care to patients—nurses bring an intimate understanding of patient needs to the discussion about how to most appropriately staff a facility.  This is critical legislation for every patient in a hospital and for the nurses who care for them.”

The safe staffing bill also would require hospitals that participate in Medicare to publicly report nurse staffing plans for each unit.

It would place limits on the practice of “floating” nurses by ensuring that RNs are not forced to work on units if they lack the education and experience in that specialty.

It also would hold hospitals accountable for safe nurse staffing by requiring the development of procedures for receiving and investigating complaints; allowing imposition of civil monetary penalties for knowing violations; and providing whistle-blower protections for those who file a complaint about staffing.

Additionally, ANA has advocated for optimal nurse staffing through the development and updating of ANA’s Principles for Nurse Staffing, and development of a national nursing quality database program that correlates staffing to patient outcomes. 

To date, seven states have passed nurse safe staffing legislation that closely resembles ANA’s recommended approach to ensure safe staffing, utilizing a hospital-wide staffing committee in which direct care nurses have a voice in creating the appropriate staffing levels. Those states are Connecticut, Illinois, Nevada, Ohio, Oregon, Texas, and Washington.

For more information on ANA’s safe staffing legislative efforts, please visit


This is wonderful news!  Please share methods we can use to help support the aspirin of this legislation!

peggy, nursing education - instructor, university May 22, 2014 8:55 PM
Orlando FL

Good day.

I am from Cape Town South Africa.

I would like to share that my hearta desire is that a similar campaign be encourged in not only  my country, but worldwide in nursing fraternity. For too long are we expected to "make a plan" when challenged with staff shortages and cope with high patient loads, without the powers that be recognising that the decline in quality care is directly attributed to insufficient staff totals.

Staff burn-out, high turn arounds and reluctance to relief in our unit is because of ignorant staffing needs assessments and underestimation of the labour intensiveness of providing care to another human being.

We have started a new District level hospital in our city with a community that has been promised excellent care, a facility that should compare to international standards, so surely our nurse staffing should reflect international standards.

I would like to commend the ANA and politicians involved in driving and spearheading this contentious topic, or better, battle faced by frontline managers who bears responsibility for medico-legal challenges in units that are understaffed.

I wish your country all of best with new changes and we shall surely use this as a point to prove our plight.

God bless.

Mr. Randall Rhodes

Operational Manager - Nursing

Mitchells Plain Hospital

Cape Town

South Africa

Ransall Rhodes, Trauma & Emergency - Critical Care - Mr (Reg. Nurse), Mitchells Plain Hospital May 20, 2014 9:43 PM
Cape Town

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