Michigan lawmakers push nurse staffing requirements

LANSING — Telling horror stories of long hours and stressed, overtired nurses caring for patients on the verge of death, lawmakers and nurse advocates on Thursday called for a state law establishing mandatory nurse-to-patient ratios and prohibiting mandatory overtime.

Nurses around the country say they’re frequently asked to work double shifts to cover staffing shortages. Several nurses from the five state-run psychiatric hospitals, for example, told the State Journal earlier this month they're worked to the point of exhaustion because of excessive mandatory overtime.

“Understaffing makes it harder to give each and every patient the time and attention they deserve,” Lori Batzloff , a Three Rivers nurse, said at a Capitol rally. The bills pending bills would require hospitals to maintain ratios from one nurse for every five patients in rehabilitation settings and as low as one-to-one in intensive care.

“There is no way I, as a responsible nurse, would volunteer to work a 16-hour overnight shift,” Batzloff added. “We need a law that protects every patient in every hospital on every shift.”

John Armelagos , president of the Michigan Nurses Association backing the legislation, told of a Livonia nurse who couldn’t get to an elderly patient because she had too many others to care for. The patient broke his arm and hip while trying to get to a restroom by himself. He told of one nurse who was asked to oversee 13 patients with constant, life-or-death needs in an intensive care unit.

“We know from years of research and just common sense this is not safe,” one of the bill’s chief sponsors, state Rep. Jon Hoadley , D-Kalamazoo , said at the rally. “We can and we must do better.”

Some estimates peg medical errors as the third-leading cause of death in the U.S. and nursing groups said mistakes and overworked nurses go hand-in-hand.

At least a dozen states already address nurse overtime and staffing levels through statute, though many states exempt state-run facilities. The bills announced Thursday would apply to public facilities.

The legislation, called the Safe Patient Care Act, would establish fines for violations and require hospitals to publicly disclose staffing levels.

Officials with the state Department of Health & Human Services said a prohibition on mandatory overtime would make it difficult to adequately staff state hospitals. They said they already struggle to recruit and retain nurses.

And Laura Wotruba , a spokeswoman for the Michigan Health & Hospital Association, said Thursday that "mandating clinical care from Lansing is something we do not support.”

State nurses say they work too much OT

Staffing is a question best left to local hospitals who best know the needs of their staff and patients, she said. Especially for rural hospitals who can struggle to recruit staff, trying to meet mandatory ratios could mean limiting patients’ access to care. Instead, the hospital group supports more and better training for nurses, such as legislation allowing community colleges to issue four-year nursing degrees.

At the Capitol, state Rep. Larry Inman , R-Williamsburg , a cosponsor on the nurse staffing legislation, also called for more training but said “this is a bill that will open all those discussions.”

Nurses are “overworked, they’re overstressed, and they’re burning out," he added. "Let’s have some public policy discussions on this issue.”

Opposing similar legislation in other states, hospital administrators have also said adding staff would hike costs. Advocates of the change say hospitals staffed by nurses who are less overworked have lower rates of rehospitalization and shorter hospital stays, helping to bring down costs. A report out earlier this year from the California Healthcare Foundation showed a larger number of profitable hospitals in that state, even after minimum staffing levels and overtime bans were implemented.

Michigan lawmakers pushed nurse staffing bills last term, but they failed to advance.

This time, supporters come armed with polling commissioned by the nurses union that shows Michigan voters would broadly support the legislation and any politicians who voted for it.

About 85% of Michigan voters think minimum nurse staffing levels would increase the quality of patient care at least a little, according to the poll from the Boston-based Anderson Robbins. Seven in 10 voters would support the staffing requirements even if health care costs increase, the poll found, and 78% would support a ballot proposal to establish staffing requirements.

There was broad support among both Democrats and Republicans. About half of the respondents said they had friends or family members who were nurses or were nurses themselves.

To some, the legislation may not go far enough.

The bills would only cover registered nurses, not nursing aides or licensed practical nurses. A union official said nursing aides at state psychiatric hospitals are overburdened with mandatory overtime, too.

Though data wasn't immediately available, mandatory overtime is "a serious problem" for nursing aides, said Nick Ciaramitaro , legislative liaison for the American Federation of State, County & Municipal Employees Council  25, the union representing the aides. "I don't know about you, but if I work 16 hours a day five days in a row, my productivity is going to go down."

Anderson Robbins polled 600 likely Michigan voters between Sept. 8 and 14. The poll had a margin of error of plus-or-minus 4 percentage points.

Contact Justin A. Hinkley at (517) 377-1195 or jhinkley@lsj.com. Follow him on Twitter @JustinHinkley.