| September 15, 2006 Volume 107 Number 18
Union nurses battle hospital and DHS over safe staffing guidelinesTwo 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.