An end to mandatory overtime? In February representatives Pete Stark (D-CA) and Steven LaTourette (R-OH) introduced the Safe Nursing and Patient Care Act of 2005 (HR 791). Senator Edward Kennedy (D-MA) introduced a similar bill (S 351) in the Senate. If passed, it would prohibit health care facilities that receive Medicare funding from forcing nurses to work extra shifts but would allow nurses to work overtime if they so chose. A nurse could never be required to work more than 12 hours in a 24-hour period or for more than 80 hours in a two-week period. In addition, nurses refusing to work overtime or those cooperating with investigations of overtime at their facility would be protected against such penalties as dismissal or license revocation (which currently can occur if the employer reports the nurse to the state board of nursing for patient abandonment). The ban on mandatory overtime would be lifted only in the case of a national, state, or local emergency; staffing deficiencies or management problems would not qualify as emergencies.
Ten states-California, Connecticut, Maine, Maryland, Minnesota, New Jersey, Oregon, Texas, Washington, and West Virginia-have already passed legislation restricting mandatory overtime for nurses, but no such federal law exists.
Staffing ratios revisited.
In the Senate, senator Daniel Inouye (D-HI) reintroduced the Registered Nurse Staffing Act of 2005 (S 71), which would require hospitals receiving Medicare funding to develop minimum nurse-to-patient ratios according to the level, variability, and intensity of care, set with input from the nursing staff, as well as the chief nurse executive. Hospitals would also have to abolish practices deemed unsafe, such as having nurses "float" from one unit to the next without proper training, and would be required to post on every unit daily lists indicating the number of licensed and unlicensed nursing staff directly responsible for patients.
While the bill percolates at the federal level, New Jersey has embraced the public disclosure of nurse-to-patient ratios. In January acting governor Richard Codey signed a law requiring all New Jersey hospitals to post daily lists of the RNs, LPNs, nurses' aides, and other licensed staff providing care on each unit. Illinois is the only other state with a disclosure law, though in that state hospitals provide the lists only upon request. (For more on these bills, see The Politics of Caring, April.)
Transparency at the NIH.
After a year of internal and congressional investigations, the National Institutes of Health is still embattled over how best to police its employees' activities with pharmaceutical and biotechnology companies, health care providers and insurers, or health-related professional organizations. Reports of resignations apparently have led director Elias Zerhouni to rethink policies requiring employees to liquidate or limit any stock holdings that might create a conflict of interest, according to an April report in the Baltimore Sun.-Dalia Sofer