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Dear Sir/Ma,

The purpose of writing is to bring to your attention that I am opposing the federal bill H.R. 2581: Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act of 2019, presented to the senate by U.S. Representative Jan Schakowsky (D-IL) on May 8, 2019. Based on the American healthcare system’s status quo, as characterized by understaffing, hospital downsizing, and budget cuts, I acknowledge the aim of the bill and ANA’S supportive stance. I understand the bill intents to address a deserved urgent call: improving the American healthcare system, including enhancing patients outcomes, improving patients’ safety and care, and promoting job satisfaction—however, the method through which the bill uses to achieve this goal (increasing nurse-patient ratio).

I think the nurse-patient ratio, which is the key strategy in H.R. 2581, will not solve the issue of nursing shortage in the U.S. healthcare but will care a more profound deficit and exacerbate the problem witnessed elsewhere. For example, Californian Assembly Bill 394 of 1999, which aimed to solve the nursing shortage in the state, did not meet its goal because California now experiences nurse burnout and staffing deficit. It has to hire over 5,000 nurses to cut the shortage.

The underlying limitation of H.R. 1581 is that it generalizes the hospital setting as it assumes all nursing units have the same design and case mix, which is practically not the case. Due to varying patient concentration, patient care services also vary among surgical units, making the general nurse-patient ratio inapplicable for all units. I believe better strategies should be considered while solving staffing issues in the country, like incentivizing nursing educators, integrating technology, and design and layout ergonomics.

Quality of care and patient safety are the primary demands of healthcare, so the policy reforms should address these metrics.

Sincerely,

 

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