“Code Red” Staffing Crisis Leads to Ohio Safe Patient Care Act

• Learn about Ohio’s Safe Patient Care Act and why nurses are fighting for safe staffing standards to be mandated  in legislation.
• Understand why Ohio’s Nursing Association considers the state’s nursing shortage a “code red” and their research into solutions.
• Review the process of how Ohio’s Safe Patient Care Act was introduced as House Bill 285 and how it may be passed into law.

At the start of this month, Ohio introduced the Nurse Workforce and Safe Patient Care Act to its House of Representatives. This bill hopes to improve Ohio’s nursing shortage through a minimum nurse-to-patient staffing ratio and a loan-to-grant program that forgives nurses’ debt when they work in bedside care or education.

Ohio’s nurse staffing shortage not only negatively impacts nurses, but also the patients they care for. One study found that “the odds of 30-day mortality for each patient increased by 16% for each additional patient in the average nurse’s workload.”

These numbers are especially concerning when a survey of Ohio nurses found that 38.83% feel their unit is rarely staffed adequately.

This article will detail the newly introduced legislation, the key statistics that led to its creation, and the process of turning this bill into law.

The Nurse Workforce and Safe Patient Care Act

The Nurse Workforce and Safe Patient Care Act is a bipartisan legislation that aims to retain nurses in Ohio and keep their patients safe.

The following is a list of list highlights from this bill:

• Establish minimum staffing standards in every Ohio Hospital.
• Create a universal reporting system for staffing complaints.
• Establish protection for whistleblowers who report unsafe staffing.
• Create a $20 million Loan-to-Grant program for nurses who work for at least 5 years in bedside care or nurse education.

The full Nurse Workforce and Safe Patient Care Act can be read here.

How Did We Get Here?

Ohio’s Nursing Association declared the state’s nursing shortage so severe that it is now considered a “Code Red.” Code Red is a national campaign focused on staffing shortages in healthcare.

For Ohio, the Code Red campaign focuses on the following five areas:

1. Staffing Levels
2. Working Conditions
3. Pipeline
4. Corporate Trends
5. Trust and Agency

The Ohio Safe Patient Care Act was created with the ONA’s Code Red campaign. This collaboration was preceded by a statewide survey of RNS to better understand the current staffing ratios, patient care standards, and how to retain bedside nurses.

The full survey and recommended solutions can be found here.

This survey received over 11,000 submissions, with an equal proportion of RNs to LPNs as Ohio’s current nurse population. Of the nurses surveyed, here are some of the key insights:

• 58.05% of nurses who left the bedside did so because of patient care load.
• 70.09% of direct care nurses are considering leaving the bedside because of patient care load.
•  91.44% of nurses would support a bill with minimum staffing standards.
• 88.79% of nurses would consider staying at the bedside if Ohio had legally enforceable minimum staffing standards.
• 42.80% of nurses who have left the bedside would consider returning to the bedside if Ohio had legally enforceable minimum staffing standards.

The need for enforceable, safe staffing mandates is only becoming more popular with nurses who are likely tired of repeatedly fighting and negotiating their employment contracts.

What’s Next for HB 285

On October 2nd, Ohio’s Safe Patient Care Act was introduced to the House of Representatives. Here are the following steps needed for this legislation to move forward:

Introduction

As with any other state legislation, the Ohio Safe Patient Care Act began with an introduction to the House. This introduction numbers the legislation House Bill 285 and offers the bill for its first consideration

Hearings

After being introduced, H.B. 285 has been moved to committee hearings, also known as the second consideration. This bill may be amended, postponed for later consideration, or terminated during this second consideration. These hearings may also be open to the public, allowing for testimony for or against the bill to be heard by the committee.

Floor Vote

If the bill is favorably reported by the committee hearings, it will move to the House floor. The house will then debate and vote on the bill, also considered its third consideration.

If a majority of the house votes ‘yes’ on H.B. 285, it will be moved to the State Senate. Once introduced to the Senate, the bill will repeat the prior steps and be voted on once again. If H.B. 285 receives a majority ‘yes’ vote in both chambers, it will pass to the governor’s approval.

Governor Approval

Now considered a legislative act, a bill is brought to the governor for their approval and signature. Once signed, the bill is filed with the Secretary of State and will come into effect 90 days after filing.

If H.B. 285 makes it to the Ohio governor’s desk, it may still be vetoed. The governor can veto a legislative act outright, or they may strike out parts of the bill in a line-item veto. If vetoed, the bill returns to the House of Representatives and Senate, where they may win a three-fifths vote to override the governor’s veto.

The Bottom Line

While Ohio’s Nursing Workforce and Safe Patient Care Act is debated in committee hearings, nurses across the state continue to fight for sustainable and safe staffing. Other states, such as Michigan and Oregon, have introduced similar legislation, showcasing the solidarity between nurses around the country.

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