Letter supports Patient Safety Act

Hundreds of health care workers across the state of Pennsylvania, including more than 35 from Butler County, signed on to an open letter advocating for the passage of the Patient Safety Act (House Bill 106 and Senate Bill 240).

The letter, published in 11 newspapers across Pennsylvania over the weekend, cites the ongoing hospital staffing crisis and recommends the passage of the bill to establish staffing standards in hospitals and promote transparency.

The bipartisan bill promoted by the letter would set nurse-to-patient ratios for hospitals. State Reps. Marci Mustello, R-11th, and Jim Marshall, R-14th, were among the bill’s co-sponsors.

“Current unsafe hospital direct care registered nurse staffing practices have resulted in adverse patient outcome,” the bill reads. “Mandating adoption of uniform, minimum, numerical and specific registered nurse-to-patient staffing ratios by licensed hospital facilities is required for competent, safe, therapeutic and effective professional nursing care, for retention and recruitment of qualified direct care registered nurses and to improve patient outcomes.”

The letter encourages supporters to call Health Committee Chairwoman Rep. Kathy Rapp, R-65th, to tell her to pass the Patient Safety Act.

“When hospitals choose to understaff caregivers, patients suffer. Unsafe staffing results in more infections, falls, re-admissions, failures to rescue, heart attacks, errors and deaths in hospitals as well as longer ER wait times and lengths of stay,” the letter reads. “All independent researchers and experts have come to the same conclusion: Hospitals must staff more caregivers at the bedside.”

The letter, organized by SEIU Healthcare and Nurses of Pennsylvania, points to burnout and unsafe working conditions as driving nurses away from the profession.

Denelle Korin, a registered nurse in Centre County and a representative with Nurses of Pennsylvania and SEIU Healthcare Pennsylvania, was one of the writers of the letter, along with fellow representative Michelle Boyle. Korin said the groups gathered support and signatures through Facebook, text blasts, emailing and word-of-mouth.

“This staffing crisis is nothing new to nurses all over the state, and, quite frankly, the country,” she said. “This has been two decades of us discussing this.”

Staffing crisis

Korin said she has heard stories of ICU units in which the ratio of patients to nurses was 3 or 4 to 1.

“On a standard medical-surgical unit, I have heard numbers upwards of 10:1,” she said. “In that space, if you just break that down into a 12-hour day, and look at the needs of a person, you do not have enough time in a day to properly take care of 10 people.”

Emily Johnston, a Butler native who works at the Allegheny Valley Hospital in Natrona Heights as an ultrasound tech, signed on to the letter. She said nursing shortages can end up affecting patient care.

“We need to find a way to get more nurses on the floor, and we need to pay them what they are worth,” Johnston said. “When there’s not enough nurses, patient care is really adversely affected. People will get sicker quicker and might even die because there’s not enough people to care for them.”

Johnston said people outside the health care industry or who are not currently being cared for by nurses may not be aware of the impact of staffing shortages.

“I feel like people don’t realize how it is — unless you’re going to the ER yourself, you’re not going to see all of these people waiting for hours,” she said. “Here in Natrona Heights, when the pandemic was bad, people were waiting eight hours-plus just to see an ER doctor. A lot of that was because there were not enough nurses on the floor.”

Sam Miller of Valencia, who signed the letter and works as a nurse at West Penn Hospital, said the increasing workload on nurses has contributed to burnout.

“Staffing was a challenge pre-pandemic, and it’s even more of a challenge now,” she said. “The constantly increasing the patient load makes nurses not want to work at the bedside anymore and it’s only intensified because of the pandemic.”

Miller said the Patient Safety Act could potentially help nurses return to the field and bedside after having left.

“The Patient Safety Act could help bring nurses back to the bedside by guaranteeing them they will have a manageable patient care load,” she said. “That being across the state would make nurses willing to come back to the bedside and let them be a nurse again.”

A long-term problem

Tammy May, a nurse at Butler Memorial Hospital and Butler’s president of the Pennsylvania Association of Staff Nurses and Allied Professionals (PASNAP), said staffing ratios have been a problem long before COVID-19, but the pandemic exacerbated the situation.

“With this Patient Safety Act, statewide unions have all unified to try and push legislation, though it actually fixes something that has been wrong with health care for decades,” she said. “I’ve been a nurse for 28 years and it’s been a problem since day one that I started.”

When nurses have too many patients to take care of at once, she said, quality of care ends up taking a hit, and nurses have less time to spend with individual patients.

“You need the nurse to be at the bedside taking care of those patients and looking for those little subtle changes to prevent a catastrophe. It’s very intricate work,” she said. “Nurses have been speaking out for decades that you can’t just keep giving us more and more patients.”

At Butler Health System, May said that there are some guidelines, laid out in “grids,” for how many nurses are needed when a floor like the ICU is at full capacity, but the standards “aren’t perfect” and don’t include quotas like the Patient Safety Act would require.

“Butler has done better than other facilities, especially throughout the pandemic,” she said, citing “horror stories” she had heard from other nurses about staffing problems during COVID-19.

“If anything, the pandemic has only exacerbated the staffing crisis. It’s brought it more to the front,” May said. “Health care workers are just to a point where, OK, now we’ve gone through the pandemic and you keep making me do more with less, but I can’t. Patients deserve more, and their families deserve more.”

Not every hospital has guidelines, she added. She hopes the Patient Care Act will be able to standardize those guidelines.

“I, or my loved one, might not always be at Butler Hospital. I want to make sure those standards of care are the same in every facility,” she said. “Every person in Pennsylvania, every person in the country, deserves the same quality of care. Making standards like the Patient Safety Act spells out, to have ratios and a healthcare standard across the state, means it doesn’t matter where you go, you should get the same standard of care.”