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Dive Brief:

  • Ohio lawmakers introduced nurse staffing legislation into the state’s House of Representatives on Wednesday that aims to implement legally enforceable minimum staffing standards in state hospitals, and provides a $20 million loan-to-grant program for nurses who complete five years of nursing services in the state, either in education or at the bedside.
  • The Nurse Workforce & Safe Patient Care Act aims to address the state’s nursing shortage, which had been exacerbated by the pandemic, Ohio Rep. Haraz Ghanbari told reporters during a Wednesday morning press conference.
  • Ohio is the latest state to propose laws addressing nursing recruitment and retention. Other states, like Oregon, have approved nurse-to-patient staffing mandates this year. Hospital lobbyists have pushed back on minimum staffing proposals, arguing that ratios are inflexible and impractical in light of workforce shortages.

Dive Insight:

The COVID-19 pandemic highlighted the struggles of front-line healthcare workers including long-standing issues like staffing shortages and burnout.

Hospitals still struggle with staffing, with over 80% of healthcare executives labeling recruitment a significant business risk in a survey conducted by PwC. In a survey of state nurses conducted by the Ohio Nurses Association union between May and June, nearly 40% of nurses reported their patient care units were “rarely” or “never” adequately staffed. 

When staffing concerns are not met, nurses can exit the field. Nearly 60% of Ohio nurses who exited the profession did so because of their patient care load, the ONA survey found.

In other workplaces, staffing concerns have contributed to friction with management. In New Jersey, more than 1,700 nurses employed by Robert Wood Johnson University Hospital have been on strike for over 50 days over concerns about staffing levels and pay.

Ghanbari, a sponsor of the Ohio staffing bill, believes that introducing minimum nurse-to-patient ratios can elevate patient care and keep workers on the job.

“The nurse staffing shortage in Ohio is endangering Ohioans seeking medical care and the nurses caring for them,” Ghanbari said. “Having enforceable safe staffing standards in our hospitals will provide better patient care and working conditions.”

The Ohio bill allows for “temporary deviations from safe staffing ratios only in extraordinary circumstances in the interest of patient care,” according to the press release.

The American Hospital Association has raised concerns about minimum staffing laws, arguing that they are inflexible or that there are insufficient workers available in a geographic area to hire. 

In a statement to Healthcare Dive earlier this year, Robyn Begley, chief nursing officer of the AHA, said that minimum ratios “increase stress on a health care system already facing an escalating shortage of educated nurses” and do “not create more nurses.” 

Staffing levels have recently caught the eye of national lawmakers, including Sen. Bernie Sanders, D-Vt., who held a press conference on Sept. 13 regarding nurse-to-patient ratios.

Sanders was joined by Nancy Hagans, president of the New York State Nurses Association, a union which successfully bargained for staffing ratios at two of New York City’s largest hospitals last year, and Judy Danella, president of United Steelworkers Local 4-200, the union that represents the striking nurses at RWJUH.

“We have a healthcare system, clearly, that is in deep trouble. But to the degree that it is functioning at all because of these folks — because of the nurses,” Sanders said. “Some of us in Congress understand what you’re going through. And we’re going to fight to make sure that you all have safe patient-nurse ratios throughout this country.”

The Biden administration has signaled interest in staffing minimums to reform nursing homes.

This month, the HHS proposed a controversial rule that would mandate a registered nurse be on-site 24/7 in nursing facilities and that nursing homes provide three hours of care per resident, per day, with 0.55 hours coming from registered nurses. A recent analysis from KFF estimates that over 80% of the industry currently falls short of the proposed staffing mandate.


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