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Column

Nurses need more flexibility

One size doesn’t fit all when it comes to hospital staffing; a Senate bill would let hospitals find the right fit

Susan Swart
Susan Swart

Every day, thousands of patients in hospitals across Illinois rely on direct-care nurses to provide quality care to safeguard their physical and emotional well-being. Equipped with a unique lens built upon thousands of hours at the bedside, nurses are the best judge of what patients need hour-to-hour, day-to-day. 

Given the critical role of direct-care nurses in delivering life-saving care, smart hospitals and health-care facilities are leveraging that expertise to help determine appropriate staffing levels, based on the conditions (acuity) and care needs of their patients.

That’s why the American Nurses Association-Illinois, the largest professional organization for nurses in the state, and the Illinois Health and Hospital Association strongly support Senate Bill 3636, the Nurse Staffing Improvement Act of 2020.

This bipartisan legislation, whose sponsors include House Majority Leader Kimberly Lightford and Senate Republican Leader Bill Brady, allows for the development of flexible nurse-staffing plans with more input and contributions from direct-care nurses. It also establishes clear mechanisms for transparency, enforcement and penalties to ensure that hospitals comply with safe staffing levels and standards.

SB3636 will strengthen an existing state law, “Nurse Staffing by Patient Acuity Act,” by providing flexibility at the hospital unit level.  

As each patient’s condition changes continually, quality care requires flexible staffing plans. Staffing plans cannot be reduced to any one model or rigid mathematical formula that fits every setting or situation. It is critical that plans for staffing and how to treat patients should be made locally, by the nurses and hospitals with direct insight into those patients’ needs, not state bureaucrats.

SB3636 will allow local direct care nurses, working with their hospitals, to determine the appropriate care and staffing of the clinical care team for each individual patient based on the patient’s acuity – including the severity of the patient’s condition and the intensity of nursing care required to meet the patient’s specific needs.

This kind of staffing system coordinates the number of nurses on a shift with actual, specific patients’ needs, not according to raw patient numbers or nurse-patient ratios, as patients’ needs can change throughout their hospital stays. 

SB3636 will achieve three critical goals: 1) leverage the expertise of the direct-care registered nurse; 2) utilize the expert skill of the nursing-care committee in every hospital; and 3) hold hospitals accountable. 

After many months of discussions and deliberations on the nurse staffing issue, ANA-IL and the Illinois Health and Hospital Association present this legislation as a partnership between direct-care nurses and the state’s more than 200 hospitals and nearly 40 health systems.

In addition, SB3636 works to address Illinois’ nurse shortage (one-third of the nursing workforce will be lost to retirement in the next 5 years). Under the legislation, hospitals will provide $2 million over the next 4 years for nurse scholarships to increase the number of new graduates entering the profession. The bill also addresses the nurse faculty shortage by incentivizing nurse educators to stay in higher education through a 2.5% income tax credit.

We urge every state senator to sign on as a co-sponsor of SB3636 to support direct care nurses and to improve quality and patient safety at Illinois’ hospitals. It’s the right thing to do for the health and well-being of all Illinoisans.

Susan Swart, EdD, MS, RN, CAE, is executive director of the American Nurses Association-Illinois, which is based in Manteno.

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