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Patient-to-Nurse Ratios and Mandatory Overtime

Jessica Foster
University of Saint Mary

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April 1, 2015
Congresswoman Renee Ellmers
406 W. Broad Street
Dunn, NC 28334
Dear Representative Ellmers,
As a critical care registered nurse for the last five years, I urge you to support the bill H.
R. 1602 Nurse Staffing Standards for Patient Safety and Quality Care Act of 2015. This bill
addresses two current critical issues nurses encounter on a daily basis. These issues include;
unsafe nurse-to-patient ratios and mandatory overtime.
When nurses are overworked it can decrease productivity, retention, patient satisfaction
and unit moral. Accurate staffing ratios have shown to have "safer patient care, increased job
satisfaction, and better recruitment and retention for nurses" (Osborne, 2014, p. 7). Under Sec.
3401. Minimum Nurse Staffing Requirement this bill list the appropriate number of nurse-topatient ratio. North Carolina currently has no restrictions or allows organizations to set nurse-topatient ratios.
North Carolina currently has no restrictions on the use of mandatory overtime for nurses.
Personally I have worked at organizations that require a two weeks per month with four, twelve
hour shifts and two weeks per month with three, twelve hour shifts. Studies show that working
long hours increases patient mortality, needle sticks, musculoskeletal injuries, motor vehicle
accidents (due to drowsy driving by nurses), nosocomial infections and patient dissatisfaction
(Bae & Yoon, 2014). Under Sec. 3401. Minimum Nurse Staffing Requirement, this bill prohibits
hospitals from using mandatory overtime to meet nurse-to-patient ratios. Currently nurses work
200 hours over the national average each year (Bae & Yoon, 2014).

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When you help support this bill you support nurses that are in desperate need of working
regulations. Everyone is entitled to excellent healthcare and should trust that nurses are working
at their optimal levels. The Guide to the Code of Ethics for Nurses states, "the nurse promotes,
advocates for, and strives to protect the health, safety, and rights of the patient" (American
Nurses Association [ANA], 2010, p. 23). When nurses work beyond their human capacity the
patient is in jeopardy and that does not help hold nurses to the ethics we pledge. Would you want
your nurse to serve you tired, distracted and sleep deprived that could cause fatal accidents?
When this bill becomes law it will be a historic moment for the nursing profession. Please help
support this bill to become law and help improve health care, not only the patient but the nurses
that provide that health.
Sincerely,

Jessica Foster RN, BSN, CCRN

164 Independence Drive
Raeford, NC 28376
913-709-4561

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References
American Nurses Association. (2010). Guide to the code of ethics for nurses: Interpretation and
Application [reissue of 2008 with new cover]. Silver Spring, MD: Nursebooks.org.
Bae, S., & Yoon, J. (2014). Impact of states nurse work hour regulations on overtime practices
and work hours among registered nurses. Health Services Research, 49, 1638-1658.
http://dx.doi.org/10.1111/1475-6773.12179.
Osborne, K. (2014, May 28). Australian staffing ratios have led to safer care and motivated
nurses. Nursing Standard, 28, 7. Retrieved from
http://web.b.ebscohost.com.stmary.idm.oclc.org/ehost/pdfviewer/pdfviewer?sid=6a00092
d-8c0e-46d3-adfa-b2449adbb2f2%40sessionmgr113&vid=9&hid=123