Campaign for Patient Safety

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Ensuring Safe Nurse Staffing

As nurses, we know that appropriate staffing protects patients from preventable medical errors, injuries and deaths. Studies show that registered nurses intercept 85% of medical errors before there is harm to the patient. Quality nursing care can mean the difference between life and death, yet the volume and complexity of patient care continues to grow without adequate precautions in place to protect nurses and patients from the dangers of fatigue.

WSNA has worked in the Legislature, in collective bargaining, in the courts, and in good-faith negotiations between the hospital association and health care unions to ensure adequate staffing levels and safe patient care. Despite claiming economic hardship, the hospitals continue to focus on new buildings and expansions without any meaningful commitment to ensuring that nurses are not overworked and fatigued.

We have heard our members loud and clear. There is outrage over the ineffectiveness of the hospital nurse staffing committees, there is frustration with the ongoing fight to get uninterrupted meal and rest breaks, and there is anger over the increased use of pre-scheduled call to bypass the mandatory overtime law.

We are all out of patience and the hospitals are out of time!

Now is the time for bold action. We cannot allow hospitals to continue prioritizing profits over patients.

In response to this growing health crisis, WSNA is launching a new Campaign for Patient Safety to ensure safe nursing care for our patients. The campaign is comprised of three legislative bills to ensure Safe RN Staffing, uninterrupted meal and rest breaks, and an expansion of protection against mandatory overtime.

We know the hospitals will fight us every step of the way, but we cannot allow them to speak for us or for our patients on these important matters. WSNA is prepared to dedicate every resource to this battle for as long as it takes to win the real improvements we need in patient care. However, it is you—the members of WSNA—that are our greatest asset in this campaign. Legislators and the public need to hear from nurses about why these issues are so critical to patient safety. This campaign will require hard work and dedication from all of us, but we simply have no other choice. It is time for Safe Staffing Now!

WSNA is pushing three bills forward in the Legislature in collaboration with other healthcare unions, labor organizations and consumer groups. Each bill addresses a core patient safety concern and seeks to establish statewide safety standards to protect patients and nurses.

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Campaign Brochure (PDF)
Campaign Poster (PDF)

Background Info

Other Issues

Fight an All-Cuts Budget!

Limiting Mandatory Overtime

Nursing and staffing shortages have forced nurses and other healthcare professionals into mandatory overtime or risk losing their jobs. Nurses and other healthcare professionals are being forced to work long hours without adequate rest. This causes fatigue and contributes to increased risks of patient safety.

The current state law prohibiting mandatory overtime has a loophole that allows hospitals to use prescheduled call as a thinly veiled replacement for mandatory overtime. The spread of prescheduled on-call in units that have not traditionally had call to fill chronic staff shortages is alarming. House Bill 2501 brings prescheduled on-call back to its original purpose—for patient care emergencies, not a stopgap fix for unsafe staffing.

House Bill 2501 would:

Restrict the use of prescheduled on-call for immediate and unanticipated patient care emergencies only instead of chronic or foreseeable staffing shortages.
Prevent hospitals from scheduling nonemergency procedures towards the end of a nurse’ shift as another means to force nurses to work mandatory overtime.
Expand the protection to other health care professionals providing direct patient care.

The hospitals are doing everything they can to stop this bill. The information from hospital administration about what this bill will do and how you will be affected is simply NOT accurate. Get the Facts (PDF).

Uninterrupted Rest and Meal Breaks

(SB 6309 was heard and passed out of the Senate Committee on Labor and Commerce & Consumer Protection. The bill was then referred to the Senate Ways & Means Committee but did not pass out of the committee before the cutoff deadline.)

Federal regulations prohibit pilots and truckers from flying and driving fatigued. But thousands of nurses and other healthcare professionals are forced to deliver complex, demanding care to patients in emotionally-charged hospital environments without an uninterrupted break.

Nurses and healthcare professionals must be vigilant and focused to oversee an array of duties for up to 12 hours or more without an uninterrupted break. These duties include: administering complicated pharmaceutical prescriptions and treatments, constant assessment and evaluation of patient treatments and conditions, and initiating life-saving emergency procedures.

Requires hospitals to provide uninterrupted meal and rest breaks.
Preserves the nurse’s professional judgment by allowing breaks to be interrupted or delayed when the nurse on, or scheduled for, a break determines a clinical circumstance could lead to patient harm without his/her skill, expertise, or knowledge.
Addresses emergency situations by allowing breaks to be interrupted for national or locally declared emergencies or when a hospital disaster plan is activated.
Provides flexibility by allowing the rest break to be taken at any time during each 4 hour period. Hospitals are free to determine how to provide the breaks by working with the staff nurses in each unit in the development and implementation of mechanisms to ensure breaks.
Requires tracking on missed breaks and training of staff on the importance of breaks.
Prohibits retaliation or intimidation of nurses for reporting missed breaks.

New statewide Staffing Minimums
for Safer Patient Care

(A hearing was held in the House Committee on Labor & Workforce Development on HB 2519, but the bill did not pass out of the committee before the cutoff deadline. SB 6307 was heard and passed out of the Senate Committee on Health & Long-Term Care. The Senate Ways & Means then held a hearing on SB 6307, but it did not pass out of the committee before the cutoff deadline.)

Despite good-faith efforts to encourage hospitals to adopt safer staffing levels to address the staffing disparities that put patients, nurses and other healthcare professionals at risk, hospitals have failed to make measurable, meaningful changes. It’s time the State stepped up and held hospitals accountable for this dangerous trend in health care.

Establishes minimum nurse staffing standards (specific limits on the number of patients that hospitals may assign to any RN at any one time) by the Department of Health with stakeholder input to ensure a minimum level of care for every patient regardless of what hospital they go to.
Recognizes the uniqueness of each hospital and their patient population by having the current nurse staffing committees at each hospital develop staffing plans for each unit and shift based on the minimum nurse staffing standard and criteria such as census, patient intensity (acuity), and skill mix of nursing personnel.
Requires hospitals to implement the staffing plan approved by the nurse staffing committees and must not fall below the minimum nurse staffing standard.
Prevents registered nurse from being assigned to a nursing unit or clinical area unless the nurse has first received orientation in that clinical area, by mutual agreement between the nurses professional judgment and licensure standards and management, sufficient to provide competent care to that patient populations.
Public disclosure of specific nurse staffing and nursing sensitive patient outcomes.
Prompt investigation of inadequate nurse staffing complaints by the Department of Health. Corrective action required for violations with a potential civil penalty of $10,000 for each violation.

Action Steps

Use WSNA’s automated email system to send your legislators a message – be sure to include a personal story or perspective!
Visit Olympia any week day during session. WSNA staff will work with you set up meetings with your legislators or their staff. Contact Richard Burton, WSNA Political Action Coordinator at rburton@wsna.org or (206) 575-7979, Ext. 3019 to schedule a date.
Mail a letter to your legislators. (Click here for sample letters [PDF].) Use www.leg.wa.gov to look up your legislators addresses.

Call your legislators and tell them about the campaign and why these bills are so important. Dial the toll free Washington Legislative switch board at 800-562-6000. They can look up your district & legislators and then connect your call. You can keep your message brief. Simply tell them:

I am a registered nurse in your district and it is important to me that we have safe nurse staffing in our hospitals so that I can provide the best care to my patients. I urge your support for the Campaign for Patient Safety and the three legislative proposals to ensure safe staffing (House Bill 2519 and Senate Bill 6307), uninterrupted rest and meal breaks (Senate Bill 6309), and limits to mandatory call for nurses in our hospitals (House bill 2501). Thank you.

Attend a WSNA meeting in your area to participate in advocacy activities. We are scheduling dinners, hot chocolate socials and other local activities, including driving a special WSNA Mobile Action RV to hospitals across the state with all the resources you need to take action on this issue! Stay tuned to your email for details.
Connect with WSNA on Facebook and Twitter to get up-to-the-minute updates on our efforts in the Legislature.
Contact Richard Burton, WSNA Political Action Coordinator at rburton@wsna.org or (206) 575-7979, Ext. 3019 for more information about how to get involved.

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