Oregon Representative Rob Nosse (D-Portland) is chief sponsor of HB 2697, which would require hospitals to follow minimum staffing standards for nurses limiting how many patients can be assigned to a single nurse, and submit "staffing plans" to the Oregon Health Authority within three months of its passage, or risk harsh penalties. The bill could radically overhaul Oregon's nurse staffing law and make it among the first in the nation to create nurse-to-patient ratios.

Prior to COVID in 2015, Senate Bill 469 passed updating Oregon's nurse staffing laws, including requiring hospitals to establish hospital nurse staffing committees to develop and approve hospital nurse staffing plans, and required the Oregon Health Authority to audit hospitals to determine compliance with staffing plan requirements. The Center for Medicare and Medicaid Services also requires nurses to have staffing plans for every patient which is addressed through the 485 Plan of Care orders signed by the provider to ensure the care needs of the patient is met. SB 469 passed to help nurses, so were they unable to govern themselves?

Even before COVID, a nursing shortage was predicted for the U.S. A survey conducted by the American Association of Critical Care Nurses in September 2021, reports that 92 percent said the pandemic had depleted nurses at their hospitals, mostly forced to leave over vaccination requirements and dissatisfaction with working conditions. As a result, they say their careers will be shorter than they intended and 62 percent continue to consider leaving the profession due to the COVID experiences.

Oregon is one of thirteen states that addresses nurse staffing in order to deliver the appropriate quality and mix of patient care and is one of seven states which require staffing committees in hospitals. The idea of hiring traveling nurses to fill the gap is no longer an option with a national shortage, especially on the west coast.

Oregon Association of Hospitals and Health Systems initially warned that ratios could force hospitals to cut back their services. Providence reports 750 open nursing positions in Oregon. Mandating minimum staffing models when there are no nurses to be had will not create a safer healthcare environment, it will create a healthcare environment in which providers close services rather than risk excessively large fines for failure to comply. If the workforce doesn’t exist, small, rural hospitals would not stand a chance with a one-size-fits-all approach.

A D V E R T I S E M E N T

A D V E R T I S E M E N T

Nurses may think this bill will get them more help, but when 64% of Oregon hospitals are operating in the red, this added cost will produce the opposite. If HB 2697 is implemented, rural hospitals are saying the most likely outcome will be a drastic reduction in hospital and home health services. Hospitals across the nation, including our local hospitals, have already reduced services because of an inability to staff beds. This is reflective of a nurse staffing shortage, not of an unwillingness on the part of hospitals to staff those beds and provide services.

Hospitals can't find the staff, so what good is enacting staffing ratios, increasing staffing committees from one to four, imposing binding arbitration, when there isn't enough staff to go around. It seems that staff forced out when Covid vaccinations were mandated, aren't willing to return even if the mandate is lifted.

The bill poses high civil penalties of $10,000 for each day the unit is staffed below standards, plus $200 for each missed meal or rest break. The consequences is higher healthcare insurance premiums and hospitals will be forced to limit patients in order to comply. This is not the answer to better health care.


--Donna Bleiler

Post Date: 2023-03-31 11:31:10

Last Update: 2023-03-31 01:45:35