Should Legislation Mandate Care Facility Staffing Ratios?

I‘m a fan of WITF-Radio’s Smart Talk program even though it often “interferes” with my work day, as I linger to catch the entire broadcast. I’m such a fan that even when I’m out of town, I’ll often listen to the program via live streaming or podcasts — and when I’m the western part of the U.S. I can listen live without feeling guilty because of the time difference (3 hours in the summer ).  One of the recent broadcasts had me listening twice.

The program began with a report on pending legislation in Pennsylvania, that could mandate lower patient-to-nurse ratios in hospitals.  During the current legislative session, the two key items are House Bill 1500 and Senate Bill 214.  A coalition of Pennsylvania nurses hand-carried a petition with 10,000 signatures to the Capitol demanding support for  better staffing at hospitals.  On the radio program the speakers — all nurses — agreed about the need for adequate coverage, but disagreed about whether mandated ratios were the right solution.  Not surprising is opposition to mandated ratios coming from the hospital industry representatives; however the Pennsylvania State Nurses Association also resists mandatory ratios, arguing such ratios are “not flexible enough.”  HB 1500 would call for different ratios according to the type of unit, such as ratio of one nurse for every two patients in the neo-natal intensive care unit, with a higher ratio of 1 to 4 permitted in a pre-surgical unit.  

The program drew a lot of callers.  In fact there were so many callers, host Scott LaMar deferred plans for a different topic for the second half of the hour-long program in order to continue the staffing discussion.  What I found particularly interesting was that many of the callers wanted to talk about staffing ratios in rehab facilities and nursing homes, not “just” hospitals, and part of the conversation was about whether the key ratios should consider all care staff and not focus solely on registered nurses.  Here is the link to the podcast:   

https://features.witf.org/stpodcast/feed/podcast/

The calls reminded me of one terrifying, long night in a hospital with a relative after she had emergency surgery.  She was “allowed” to use the toilet in the bathroom, rather than a bed pan, but because she wanted to go frequently, the night time staff began insisting she use a bedpan, so that they wouldn’t  have to attend her in the bathroom.  The staff was hostile to my efforts to help (and in fact, I didn’t have a clue as how best to help), but also would have left their patient perched uncomfortably on the bed pan for a half hour or more if I hadn’t intervened. She began refusing to use her call button, insisting I help her to the bathroom, even though she was still attached to various lines and monitors.  It was a catch-22 situation for me as a family member — and also for the overworked staff. I remember my one firm conviction that night was that without a family member with her, we would have been adding broken bones to the list of woes for my loved one because of the staffing issues.