Nevada committee considers mandating nurse staffing ratios

CARSON CITY, Nev. (AP) -- An Assembly panel decided Wednesday to gut a bill sought by nurses to ensure they're not overwhelmed by too many patients in Nevada health care facilities.

Instead, the Health and Human Services Committee called for an interim legislative study. That leaves the proposal up in the air for at least another two years.

AB313 would have mandated strict staffing ratios for registered nurses to patients at all medical facilities across the state, with the ratio dependent upon patients' needs.

Assemblywoman Chris Giunchigliani, D-Las Vegas, sponsored the bill and presented it to the committee -- but also recommended assigning the issue to an interim study.

Giunchigliani said there's enough support to pass the bill, but the study will give lawmakers time to resolve other issues, such as ratios for other types of nurses, data collection from hospitals and a more accurate look at how such legislation would affect rural counties.

The committee heard testimony that nurse staffing ratios are directly related to patient recovery and mortality.

"Adequate staffing allows nurses the time they need ... to provide the level of care that our patients deserve," said Lisa Black, executive director of the Nevada Nurses Association.

The committee also was told implementation of ratios in California decreased hospitals' turnover rates and enhanced patient care.

AB313 would have mandated a 1-to-1 ratio for nurses and patients in trauma centers and operating rooms, a 1-to-2 ratio in intensive care units and a 1-to-3 ratio in emergency rooms and pediatric units. The bill would have established ratios for less-traumatic units, as well.

Also included in the bill was statutory limits on mandatory overtime.

James Wadhams, a lobbyist for the Nevada Hospital Association, told the committee the nurses' information wasn't specific to Nevada, and the bill didn't establish a reasonable staffing standard.

"What this bill does is legislate arbitrary, mandatory staffing ratios," Wadhams said.

He also said legislating these numbers was the wrong approach because it would be impossible for hospitals to immediately meet them due to the nursing shortage, and because they couldn't be promptly changed if they were deemed unsuccessful.

Giunchigliani said having the Legislature establish ratios was appropriate, as was mandating the amount of overtime allowed.

"We have requirements for driving trucks, for flying airplanes, for driving a school bus, but we don't have one for nurses," Giunchigliani said.