As GOP states shut hospitals, nurses and labor push for health care

Republican lawmakers are presiding over the shutdown of rural and other hospitals from coast to coast by starving them of funds while the nation’s nurses and the labor movement, with the support of progressive Senate and House Democrats, are pushing instead for more staffing to provide good health care to more people.

Citing nursing shortages exacerbated by coronavirus-caused burnout on the job, National Nurses United and several union and congressional allies re-launched their legislation mandating national safe-staffing standards in medical facilities.

The safe staffing measure, by Rep. Jan Schakowsky, D-Ill., a strong supporter of NNU and its goals, faces an uncertain future in the Republican-run U.S. House. Sen. Sherrod Brown, D-Ohio, is its lead sponsor there. Other union backers include the Teachers (AFT), AFSCME, and the AFL-CIO.

Safe staffing is a longtime cause of NNU, the nation’s lead union for registered nurses. Lack of it at local hospitals has led to a wave of informational picketing, one-day nurse walkouts, and other moves to draw public attention to the threat a shortage of nurses poses to patients.

Modeled on a safe-staffing law NNU pushed through in its home base, California, in 1999, the national bill mandates nurse-to-patient ratios in intensive care units, emergency rooms, critical care units, cardiac care units and other medical areas where hands-on round-the-clock care is a necessity.

Hospitals and insurers strongly oppose safe staffing and sidelined it in past Congresses. Hospital bosses, many of whom draw seven-figure paychecks, claim they must cut staff and can’t fulfill the ratios because health insurers won’t pay—or pay enough—to attract nurses to the bedside. The insurers, seeing safe staffing as a threat to their high profits, also oppose it.

“It is past time that we act on the evidence and give nurses the support they deserve and put patients over profits,” NNU co-President Jean Burger, RN, retorted at the recent Capitol Hill press conference unveiling the legislation, HR2530.

With some state-level safe staffing efforts stalled and others virtually unattainable in worker-hostile Republican-run states, NNU and its allies are turning to Congress again. Safe staffing is essential to “saving patients’ lives and stemming the exodus of nurses from the bedside,” NNU says.

Burger refutes hospital and insurer claims the U.S. has a “nursing shortage.” She says those two industries caused it by refusing to pay nurses enough and by turning a blind eye to bad working conditions, such as back-to-back 12-hour shifts and mandatory long overtime. Burger noted that as a result, one million licensed RNs aren’t in the field right now.

“This staffing crisis was manufactured by the hospital industry,” she said. “Many nurses have left the bedside because they are unwilling to risk their patients’ lives by being forced to care for them in an unsafe manner. This bill would bring them back to providing direct care at the bedside and in clinics by ensuring their patients receive proper, safe, optimal, and timely care.”

“Numerous studies have shown safe nurse-to-patient staffing ratios result in higher quality care for patients, lower health care costs, and an overall better workplace for nurses,” Schakowsky told the Capitol Hill press conference. “For years, I’ve talked to exhausted nurses who have said they go home at night, wondering if they forgot to turn a patient because they were stretched far too thin.

“The need for federal safe staffing standards is about nurses, patients, and everyone’s lives,” said Schakowsky. “This bill will improve the health of patients by improving nursing care—establishing minimum registered nurse-to-patient ratios in hospitals, providing whistleblower protection for nurses who advocate on behalf of their patients, and investing in training and career development to retain hard-working nurses in the workforce.”

Brown said much the same thing after he met with RNs in Dayton, Ohio.

“We know safe staffing levels mean better outcomes for patients. But too often, nurses are stretched too thin, caring for too many patients with not enough support. Workers are the first line of defense keeping Ohioans safe. We need to make sure there are enough of those workers on the job,” the senator said.

In a two-month NNU survey of at least 2,800 nurses in late 2022, “56.8% of hospital nurses reported that staffing has gotten slightly or much worse recently,” and half reported being forced into excessive overtime.

In the past, NNU has reported the coronavirus was a key cause, as nurses burned out and left, and as hospitals increased the number of patients each nurse must tend, to unhealthy levels for both the RNs and the patients.

The studies report that when there are too few nurses for too many patients, preventable medical errors, avoidable complications, nurse falls and injuries, longer hospital stays, higher readmission rates, and higher death rates result. Those trends are especially true, NNU adds, in understaffed hospitals serving communities of color.

“Nurses are leaving hospitals because the staffing and the working conditions are terrible,” Eric Cromer, RN, told Brown’s Ohio press conference. “The truth is that nurses are exhausted. New nurses leave the profession within a couple of years and older nurses are retiring early. We need to make the profession something people want to be a part of, where it’s not going to cost you your mental health, or physical health, or force you to risk your license. We need safe staffing ratios.”

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