When it gets down to it, all registered nurses whether at the bedside, teaching students, administering health care services, or doing research have the same primary goal — to assure that the patient/client receives quality nursing and health care. Since the nurse is the provider of the nursing care, nurses also have many legitimate concerns about their working conditions. Hospitals have cut costs, reduced staffs including the backbone of the hospital, REGISTERED NURSES, and replaced professional nurses with unlicensed assistive personnel. Today more than ever before, nurses are realizing that if they really are going to provide quality care to people, they MUST become knowledgeable about and active in political and legislative issues.
The first step in the process is to increase one's knowledge about current legislation. The American Nurses Association publishes bimonthly articles about key legislation in The American Nurse. This is an excellent way to know what has happened or will likely be happening in the United States. However, the information cannot be completely up to date due to a two month publication period. In addition, whereas some legislation will be of interest to all nurses, there may be particular pieces of legislation that you will want to monitor yourself.
The purpose of this column is to introduce you to an electronic medium where you can review current national legislation that interests YOU by accessing the Internet. This site can be accessed from the Web with the URL http://thomas.loc.gov/, or by clicking the underlined information in this sentence. This service, Thomas Legislative Information, is sponsored by the United States Congress. There are 3 major sections pertaining to bills.
- Hot bills or bills that are subjects of floor action, debate or hearings in Congress in the current week. They are accessible by topic, popular/short title, or by bill number/type. This section also contains bills enacted into law during the current week.
- Bill summary and status which contains searchable summaries, legislative histories of bills/amendments, browsable lists of public laws, and vetoed bills.
- Searchable versions of the full text of House and Senate bills, as well as browsable lists of bills by number and type.
Thomas Legislative Information also has information on the Congressional Record, Congressional Advisory Board Reports, the legislative process, legislative branch, Internet sites and U.S. Government Internet Resources.
A current bill, of interest to all nurses in the U.S., is H.R. 3355,"The Patient Safety Act of 1996." It was introduced by Representative Maurice Hinchey(D-N.Y.) and initiated by the American Nurses Association with the help of the New York state nurses. It goes a long way towards assuring that our patient/clients receive quality nursing and health care. There are three parts to the legislation:
- Health care institutions would be required to make information public about staffing levels, personnel providing direct care (including unlicensed personnel ), average numbers of patients per registered nurse, patient outcomes (mortality rates, adverse patient care incidents), and complaints filed with HCFA, a state agency, or accrediting agencies related to Medicare conditions of participation.
- Nurses who report unsafe conditions would be protected and institutions would be ineligible to participate in the Medicare program for a period of time if they violated this provision.
- The U.S. Department of Health and Human Services would be required to review all health care institution mergers and acquisitions for their impact on patient health and safety. Items that would be considered include the availability and accessibility of services for mothers, children, elderly, the under-served, and specialized services for substance abuse, mental health and prevention, and detection and treatment of HIV. Employee concerns would also be considerd. These include the status of collective bargaining contracts and plans for retraining, as well as the impact on overall employment in the community.
- A negative review by the U.S. Department of Health and Human Services would be tied to a monetary penalty as the institution would be ineligible to participate in the Medicare program for a designated period of time.
There are numerous other bills that affect you and your patient/clients. Frequently, I will select a bill to highlight that I believe has general appeal to registered nurses. In the interim period, let your fingers do the walking and explore the new horizons of Thomas Legislative Information. Remember that the first step is to inform yourself. Your knowledge must be translated into ACTION. Bon Voyage!
Keywords: Patient Safety, United States, Electronic Public, Legal Databases, Legislation Nursing as a Profession
Greer Glazer, PhD, RN, FAAN
Director, Parent Child Nursing
College of Nursing
Kent State University
Kent, OH 44202
E-mail Address: GGlazer@Kent.Edu
Dr. Glazer is Professor and Director of Parent Child Nursing at Kent State University College of Nursing. Besides her many research activities in the field of women's health and stress, Dr. Glazer is chairman of the Ohio Nurses Association Government Affairs Committee, a combination legislation committee and PAC. She is currently the legislative liaison to congressman Steve LaTourette and has previously been on health care committees at the state and national level. Locally she serves on the Board of the Cuyahoga County (Ohio) Children's Trust Fund and recently completed four years on the Health Care Committee allocation panel for United Way in Cuyahoga County.
To access H.R. 3355, "The Patient Safety Act of 1996"
1. Go to Thomas.
2. Go down until you see Bill Summary and Status.
3. Click on 104.
4. On the next screen click on Bill/Amendment No.
5. A search screen appears. Click in the top box under Bill/Amendment Number.
6. Type HR 3355.
7. Click on Search. You will be at the bill.