COLUMBUS - State Senator Michael Skindell (D- Lakewood) recently introduced Senate Bill 324 to increase patient safety by setting limits on the number of patients a registered nurse (RN) may care for at one time. The ratio requirements will be based on the seriousness of the condition being treated or the medical procedure that the respective patient is undergoing.  

The legislation would require a minimum, numerical nurse-to-patient ratio with a requirement that additional nurses be added when needed.  Some of the more critical procedures for which the requirement would be one nurse to one patient are patients in an operating room, a trauma or critical care patient, an unstable newborn or one in a resuscitation period.  An intermediate ratio level for which one nurse would be caring for three patients would include pediatric units and pregnant patients who are not in active labor.  The ratio would go down to a one nurse to five patient threshold for such patients as infants in nurseries.

For units not listed in the legislation, a hospital-wide nursing care committee would establish ratio requirements to be implemented by the hospital.  Factors to be considered in these ratio requirements would be issues such as severity of illness, the need for patient advocacy, the patient-care delivery system and the hospital’s physical layout.  Hospitals would be required to post these ratio requirements in public view. 

The legislation requires that nurse assignments based on these ratios be competent for each of the assigned units for which they are providing care.  It also prohibits such practices as mandatory overtime to meet the ratio requirements as well as the use of cameras or monitors as substitutes for the actual nurse to fulfill the requirements.

Finally, the bill gives various protections to a nurse for refusal to follow a policy he or she believes in good faith to be in violation of the legislation. It prohibits discrimination and discharge for such a good-faith refusal. 

“These policies will help ensure that patients get the best medical care based on need. They will provide nurses with safeguards to ensure that they are protected from retaliation for whistleblowing and refusal to follow potential violations of the law,” said Senator Skindell. “Genuine and enforceable safe-staffing standards will save money and lives by ensuring that patients obtain excellent nursing care.”

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