The New York State Nurses Association, representing over 42,000 nurses in New York State, responded to the highly-anticipated study on nurse staffing enhancements just released by the New York State Department of Health. The study was mandated in the 2019-2020 New York State Budget, after substantial mobilization by frontline nurses and patient advocates across the state, including NYSNA and other nurse unions. NYSNA members presented formal testimony to the state in two public hearings in the summer and fall of 2019, outlining the importance of safe staffing for quality patient care. Though slated to be released by December 2019, the report was released at 7 PM Friday, August 14, 2020.
Unfortunately, this is just the latest example of the Department of Health’s failure to listen to frontline nurses and incorporate our expertise into the policy-making process. This report demonstrates a staggering lack of understanding of how nursing care is provided and its methodology is fatally flawed. Estimates of the economic impact of minimum staffing standards are wildly overstated, and the report fails to incorporate any key lessons from the first wave of COVID-19:
- The DOH estimates that New York hospitals would need an additional 24,779 RNs to meet the proposed staffing ratios under consideration in Albany. Of these, 10,416 (42% of the total) would be new Operating Room nurses, needed to meet the staffing ratio of 1:1. However, the state of NY already passed a law in 2013 requiring 1 RN in every OR during surgical procedures. Correcting this one error would reduce the DOH’s cost estimate for New York hospitals by 42%, between $767 million and $1 billion.
- In the nursing home setting, the DOH estimates that New York would need to add 10,181 RNs (130% increase) to ensure at least 45 minutes of RN care per patient per day. However, according to publicly available data from the Centers for Medicare and Medicaid Services, nursing homes across New York are providing an average of 41 minutes of RN care per patient per day, 9% less than the staffing ratio of .75 hours of RN care per patient per day proposed in pending legislation. Correcting this error would reduce the DOH’s estimate of additional RNs needed by 9,416, and lower estimated costs between $567 and $610 million.
- The study’s release was delayed by 8 months, supposedly to incorporate New York’s COVID experience. However, the DOH ignored one of the most widely reported findings from the past 5 months, the glaring disparities in COVID-19 death rates by race and zip code. Creating a minimum staffing standard is a proven strategy to ensure hospitals serving New York’s Black, Latinx, and Asian communities have enough RNs and other healthcare professionals to provide quality patient care.
It’s deeply troubling that at a time when New Yorkers are relying on the DOH to keep us safe, the department seems more interested in protecting the financial interests of the state’s largest hospitals and nursing home operators, releasing a report that validates the frequently repeated claim that proposed safe staffing legislation would cost over $2 billion and be prohibitively expensive.
Nurses, and the labor unions that represent them, have pushed for the Safe Staffing for Quality Care Act in the state legislature for years in an effort to guarantee equitable, quality care for all New York.
While this study has proven useless for policy-making purposes, we will continue to work with legislators, academics, and other researchers interested in an evidence-based approach to this addressing the staffing crisis in New York’s hospitals and nursing homes.
“Unfortunately, as COVID-19 demonstrates, establishing a guaranteed level of staffing care in every hospital across the state is literally a matter of life and death. The Department of Health’s shoddy report is a slap in the face to frontline nurses who sacrificed so much during this crisis. Safe staffing could have saved lives during the COVID pandemic. And if the legislature is willing to act on real research, there’s still time to improve New York’s capacity to respond to a resurgence of the virus. Uniformly implemented statewide staffing standards will improve patient outcomes and save lives. New Yorkers are worth it, and it’s time for Albany to take action,” said Pat Kane, RN, Executive Director of the New York State Nurses Association.
The New York State Nurses Association (NYSNA) represents more than 42,000 members in New York State. We are New York’s largest union and professional association for registered nurses. For more information, please visit our website at www.nysna.org.
Photo credit: New York State Nurses Association nurses and de blasio.