[Congressional Record Volume 157, Number 65 (Thursday, May 12, 2011)]
[Senate]
[Page S2954]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mrs. BOXER:
  S. 992. A bill to amend the Public Health Service Act to establish 
direct care registered nurse-to-patient staffing ratio requirements in 
hospitals, and for other purposes; to the Committee on Health, 
Education, Labor, and Pensions.
  Mrs. BOXER. Mr. President, as we mark the end of National Nurses 
Week, I want to express my heartfelt appreciation to the nurses who 
serve on the front lines of our health care system. Nurses are heroes, 
not just to their patients, but to the families and loved ones who rely 
on their compassion and care.
  While we celebrate nurses this week, we must also acknowledge that 
too many nurses are overworked because of staffing levels that are 
simply inadequate.
  For decades nurses have been telling us that we need more of them to 
provide quality care to our loved ones, especially in hospitals. Study 
after study has been done, we know there is a nationwide nursing 
shortage.
  By 2020, it is estimated that the demand for full time nurses will 
exceed supply by 1 million nurses.
  That is why I am introducing the National Nursing Shortage Reform and 
Patient Advocacy Act, which will not only help address the nationwide 
shortage of skilled nurses, it will improve the quality of health care 
for all Americans.
  The National Nursing Shortage Reform and Patient Advocacy Act 
champions nursing rights, nursing ratios, and nursing reform.
  This bill protects the rights of nurses to speak out for their 
patients and to speak out for themselves, without the fear of 
discrimination or retaliation, because if there is a problem in a 
hospital nurses should be able to talk about it.
  This bill sets minimum nurse to patient ratios, because if we expect 
nurses to give patients high quality care we need to give nurses the 
time to provide it. It lays out a transparent process for establishing 
staffing plans in hospitals and puts forward the tools for nurses to 
report inadequate staffing or care.
  This bill reforms the role of hospitals not just in working with 
nurses to improve care, but also in training nurses. It creates 
mentorship and preceptorship programs to support nurses as they adapt 
to the hospital setting and grow in their profession.
  Twelve years ago, nurses in California fought and won a major battle 
for their patients and for themselves, and the results were minimum 
nurse to patient ratios in California hospitals.
  I am proud to join with nurses in their effort to improve care for 
their patients, and introduce Federal legislation that would extend 
these rights, ratios and reforms to nurses in hospitals across the 
country.
  Reports on California ratios have only begun to show what so many of 
the nurses I meet already know, that setting a minimum standard for 
safe staffing can mean the difference between life and death of 
patients.
  A 2002 study found that for every patient added to a nurse's workload 
there is a 7 percent increase in the chance of death following common 
surgeries.
  In California, the hospitals that have seen the greatest effect in 
reduced mortality were the ones that started with the worst staffing 
ratios.
  We also know that hospitals are losing good nurses because of these 
staffing shortages. A poll of nurses nationwide found that almost half 
of the nurses who plan to quit their job say that inadequate staffing 
is the reason they are leaving. The cost of replacing these valuable 
workers has been estimated at $25,000 to $60,000 per nurse. That is an 
added cost that we know our health care system cannot afford.
  Too many nurses get burned out by being overloaded with too many 
patients. Too many nurses have given up on serving in hospitals because 
the hospitals have given up on providing a better environment for both 
nurses and patients.
  Investing more in nursing staff will help hospitals avoid costly 
medical mistakes and provide better care for their patients and most 
importantly, will save lives.
  I joined many of my colleagues in supporting provisions of health 
care reform that invested in our health care workforce. At 2.9 million 
strong, nurses are the largest health care workforce in our country, 
and this investment is long overdue.
  I am pleased to share that this bill has the support of the 
California Nurses Association as well as AFSCME-United Nurses of 
America.
  Nurses are not just the face of the movement to improve health care 
in our country, they are the face of health care in our country. This 
bill is for them and the patients they so faithfully serve.
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