Two Oregon nurses unions are engaged in a public
wrangle with hospitals about what constitutes safe staffing levels.
The final phase of a patient safety law the Oregon Legislature passed
in 2001 and modified last year is due to take effect in January, but
the details, as worked out by the Oregon Department of Human Services
(DHS), have drawn fire from nurses.
The law limited mandatory overtime and will require each of the state’s
62 licensed hospitals to form staffing committees of nurses and managers.
The committees would develop a nursing staffing plan that would specify
how many nurses are necessary to provide a minimum standard of safe
patient care.
That’s a huge issue given the ongoing shortage of qualified
nurses. Unions have argued that increasing nurse compensation and
improving working conditions would allow hospitals to recruit more
nurses. The upshot — more nurses per patient — would mean
better patient care. Instead, unions say, hospitals are responding
to the nursing shortage by short-staffing departments, leading to
overwork and forced overtime.
The new law reined in that overtime: Since Jan. 1, 2006, Oregon nurses
can’t be required to work more 48 hours in any seven-day period,
or more than 12 hours in any 24-hour period. Prior to that, said Matthew
Rae, community organizer for AFT (American Federation of Teachers)-Healthcare
Northwest Local 5017 (formerly known as Oregon Federation of Nurses
and Health Professionals), it was not uncommon for nurses to work
16 hours at a stretch.
But as for the nurse staffing committee, Rae said the hospital association
lobbied DHS to water down committee guidelines. Nurses unions want
nurses to be able to elect the committee representatives, and want
DHS to define which units within the hospital will have their own
staffing plan. Hospitals, on the other hand, want to be able to decide
how the nurses on the committee will be selected, and want discretion
over what units need their own plan.
Lastly, the two sides disagree on how “safe patient care”
would be defined: The hospitals want it to mean absence of nurse errors;
the unions say it should be presence of good outcomes — physical
and spiritual.
DHS’ initial rules favored the hospital management viewpoint,
Rae said. In response, about 60 members of the Oregon Nurses Association
and Local 5016 turned out for a DHS hearing Aug. 24, and several dozen
testified, as did a dozen managers.
DHS will make a decision by Jan. 1.