Introduction
To improve the quality of health care in the United States, Barbara Boxer recognizes the shortage of nurses nationwide and drafted a bill entitled, “National Nursing Shortage Reform and Patient Advocacy Act” to address the problem. He said, “by investing in nurses and their training, we can help improve the quality of care in our nation’s hospitals and save the lives of countless patients” (2009, para. 1). This bill intends to ensure that the Public Health Act is amended.
This is to ensure that the necessary ratio of nurse-to-patient is met at the various hospitals. Consequently, this will go a long way into addressing the current high levels of registered direct-care nurses in hospitals. In addition, the move will also result in an improved nursing environment in a hospital setting. According to Boxer, the design of this bill is such that the minimum number of patient-to-nurse ratio as required in hospitals, shall be realized. Further, the design of the bill also enables investments into the training of nurses. This is to help alleviate the shortage of nurses as well as ensure that their rights are protected (2009, Para. 2).
Impact on the working environment
Since this bill provides a framework for relieving the shortage of nurses, saving lives of the patients, improving the quality of health care, legal protection and increasing nursing professionals (Government Track, 2009, para. 6), it should be adopted to reform the health sector. Section 3105 of the National Nursing Shortage Reform and Patient Advocacy Act outlines the minimum staffing requirements of nurses in a hospital.
Hospitals are expected to implement staffing plans that guarantee quality service to the patients consistent with the requirements of this act. The act stipulates the maximum number of patients a nurse can be assigned to in a hospital. In the development of the staffing plan, a hospital uses an acuity system to determine the ratio of direct care registered nurse-to-patient. This assignment not only ensures that a patient is provided with quality nursing care but also protects the nurse against work overload which may result in compromised services.
Hospitals are expected to carry out an annual evaluation of the staffing plan, update and document their patient requirements based on the national acuity system. Also, the nurses’ performance should be evaluated to provide the required level of service delivery and public confidence. Evaluation reports should be made public and forwarded to the health secretary for monitoring and approval.
In the interest of patients, the secretary of health may alter the nurse-to-patient ratio by increasing the number of patients or adding more nurses if the need arises. Lowering of nurse-to-patient ratio can result in compromised nursing services due to increased work overload in the event of a disease outbreak. The challenge for the nursing staff may be due to intermittent disease outbreaks across the nation, thereby offsetting the nurse-to-patient ratio.
The bill requires that the health secretary should establish a grant program to solicit funds to facilitate the purchase of safe patient handling equipment to comply with the standard procedures of nursing. There is the need for the Secretary of health, along with the director of Quality and Healthcare Research to issue a research directive on the staffing of licensed nurses and how this impacts the care of patients within the hospital. The results are necessary for developing and implementing the bill to keep abreast with the health requirements.
In section 3105, the bill recognizes the rights of nurses and patients. A nurse has been given the power to act as a patient advocate in advising the patient appropriately and making a professional judgment to help the patient. The nurse has a right to refuse an assignment if it violates prescriptions under this bill or requires non-professional expertise for the sake of patient safety. A nurse who has refused assignment should not be subjected to discrimination, retaliation, sacked, or sued. If this happens, the right of the nurse is violated and he/she should be compensated for the damages caused.
The bill supports the provision of a toll-free hotline number in which a nurse, a patient, or an individual can use to report a hospital that violates the provisions of this bill such as understaffing rationing, discrimination, retaliation, discharge, intimidation, and interference with their constitutional rights. These rights greatly favor the nurses begging the question of how nurses can be made subject to their respective assigned hospitals. Nurses have been given too much autonomy which may cause insubordination in hospitals.
Stakeholders
Health maintenance organizations (HMOs) are a group of healthcare providers that operate in a variety of forms. Since they do not employ nurses directly, they contract from the nursing body thus will be required to comply with the bill especially in staffing ratio so that they can provide quality and standard services. This bill will pressure these organizations as nurses’ rights have been enhanced and will not be exploited because it will violate the prescriptions of the bill.
It is important to note that the restrictive appearance that characterizes HMOs has resulted in their being the target of numerous allegations about their role in hindering necessary care. Even as HMOs arrive at medical decisions completely mindful of the needed financial resources to ensure the delivery of health care services, nonetheless, they are usually protected against several lawsuits regarding malpractice (Dorsey, 1973, Para. 4).
American Association of Retired Persons (AARP) is an organization for people of age 50 and above which is dedicated to enhancing the quality of life for the old. The AARP will benefit from this bill since the organization requires nursing services enough for the members to get quality healthcare for the old. AARP has been actively participating in health care policy debates and implementation making it the largest organization claiming over 40 million members. There was controversy on health care reform causing about 60,000 quitting of AARP members between July 1 and August 18, 2009 (AARP, 2009, para.3).
Since AARP is an insurance company, the implementation of the bill may scare members away if higher premiums are charged to gather for the new requirement of the bill in the quest of quality provision of nursing services to the members.
Conclusion
The National Nursing Shortage Reform and Patient Advocacy Act should be adopted and amended to provide the basis for solving the nationwide shortage of nurses. The bill not only deals with the problem of nurses’ shortage but also by extension will solve problems in service delivery, safety equipment, nurse competency, and rights that have compromised quality health care in nursing. Nursing professionals will greatly benefit since their job prescription has been considered avoiding work overload which had previously depended on their hospital administration.
With the implementation of the bill, nurses will have a right to refuse assignments without being intimidated or discriminated against by their respective hospitals. This bill heralds great changes in the nursing profession and should be implemented for the benefit and in the view of the hospital, nurses, patients, and other stakeholders.
Reference List
AARP. (2009). Losing Members Over Health Care, Fox News.
Boxer, B. (2009). Support Barbara Boxer National Nursing Shortage Reform and Patient Advocacy Act. Web.
Dorsey, J.L. (1973) The Health Maintenance Organization Act and Prepaid Group Practice Plan, Medical Care. Web.
Government Track. (2009). Text of S. 1031: National Nursing Shortage Reform and Patient Advocacy Act. Web.