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Leaders of the legislature’s Public Health Committee said Monday they are committed to tackling a health care worker shortage by exploring mandated nurse staffing ratios, closing a loophole that allows hospitals to impose mandatory overtime, and examining recruitment and retention strategies to boost employee numbers.
“This is a crisis. And this is rapidly moving toward disaster,” said Sen. Saud Anwar, D-South Windsor, a committee co-chair. “This disaster is preventable. That is the reality — we have to intervene at this time.
“If you don’t have adequate staff, more people die. If you do not have adequate staff, you are increasing the risk of medical errors.”
Workers with the American Federation of Teachers in Connecticut, which represents about 7,500 health care workers, pleaded with lawmakers Monday to address an employee shortage that they say poses risks for both staff and patients.
A February 2022 poll found 23% of health care workers, nearly one in four, were “likely to leave the health care field soon,” AFT officials noted in a national study.
“Staffing is bad. I think, hospital-wide, we have been hovering around a 30% to 35% vacancy rate. And we’ve been using a lot of [traveling nurses],” Sherri Dayton, a registered nurse at the Plainfield Emergency Care Center, a standalone emergency department that is part of Backus Hospital, told the CT Mirror.
On any given day, the nurse-to-patient ratio at her facility is one nurse to every six patients, she said. Sometimes it is one nurse to every eight patients. A 4-1 ratio is safe and ideal in an emergency department, Dayton said.
Labor officials asked legislators to pass a bill with mandated staffing ratios or required levels of staffing. California has mandated staffing ratios, and Dayton said she hopes Connecticut legislators look to that state when crafting a local law.
Officials with the Connecticut Hospital Association oppose the staffing ratios.
“There is a lot to be done to expand and support the nursing workforce in Connecticut,” said Jennifer Jackson, CEO of the hospital association. “Patients need a strong health care workforce, and hospitals and health systems are working with their employees and partners at the state, in education, and across health care to educate, train and retain more nurses and other health care professionals in Connecticut.”
“A focus on government-mandated nurse staffing ratios will stall the work we need to get done,” she said. “In fact, staffing ratios would exacerbate the problem, causing delays in care and raising costs with corporate nurse staffing agencies as the likely beneficiaries.”
Anwar did not offer any specifics on what ratios he and other lawmakers might propose.
Mandatory overtime is also driving some nurses out of the industry. Connecticut law prohibits mandatory overtime for hospital nurses, except under certain scenarios, such as adverse weather conditions, widespread illness or catastrophe, public health emergencies, if a nurse is participating in a surgical procedure, or if a nurse is staffed in a critical care unit and has not been relieved by the worker on the next shift.
Some union contracts include a perk for mandatory overtime — double pay during those hours — and hospital administrators believe the contract language allows them to mandate overtime, despite what state law says, labor officials said.
"They’re using that as a loophole for the law,” said John Brady, a retired registered nurse and vice president for AFT Connecticut.
Nurses at Dayton’s facility typically work 12-hour shifts, she said, but some are mandated to work another four hours of overtime on top of that.
Labor officials called on the General Assembly to address mandatory overtime by closing the loophole caused by some collective bargaining agreements. A bill expanding restrictions on hospitals’ ability to mandate overtime was voted out of the Public Health Committee last year but was not ultimately taken up in the House or Senate.
They also asked legislators to craft policies that promote recruitment and retention, such as student loan forgiveness.
“I am here today to say ‘Help us,’” Randi Weingarten, president of AFT, told lawmakers Monday. “If you help us, we will be able to help the patients more. People who go into health care want to make a difference in the lives of others. Help us do it. Don’t let us deal with the dangerous conditions that are getting worse and worse and worse.”
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