Safe staffing standards

The legislature must continue its work in establishing safe staffing standards to make sure that all patients receive the level of care they deserve, ensuring patient safety, and so that our health care providers have reasonable workloads.

Close loopholes, enforce overtime and rest breaks

Recent improvements to overtime and breaks standards for healthcare workers should be adequately enforced, with loopholes closed, to deliver on the promise made by the legislature in 2019.

Functional and responsive staffing committees

The current structure for staffing committees at hospitals has not led to improvements on the ground. It is time to make these more functional and ensure that these committees’ work guides the staffing structure that delivers care when patients need it the most.

Additional reading

Under current law, nurses are only able to seek workers compensation for a single event that causes PTSD. But the reality is, the most common cases of PTSD among nurses aren’t the result of a singular incident but rather the constant toll of being on the frontlines of the deadly pandemic. The legislature should amend the statute to allow nurses to get the resources they need to address their mental health diagnoses resulting from on-the-job exposures.

To grow our nursing workforce pipeline, the state legislature must invest in our state’s nursing faculty at four-year universities. The 2019 funding from the legislature for nurse faculty at community and technical colleges has led to increased retention and expanded programs at those schools. Despite the investment, Washington state’s nurse faculty vacancy rate (14%) is double the national average (7%). It is time for the legislature to invest in the schools that graduate the majority of nursing students — four-year universities.

In recent years, private health plans lowered payments to Washington practices when services are provided by an advanced registered nurse practitioner (ARNP) and not a physician. Reduced ARNP reimbursement saves the insurers money, but it costs clinics and the patients they serve by making it harder to keep practices open. And studies comparing patient safety, patient satisfaction, and care quality consistently find similar results between ARNP and physician care.

To justify reduced ARNP reimbursement, private insurers point to outdated Medicare practices. Medicare’s 85% reimbursement rate was set in 1977 primarily for rural health clinics, but this rate expanded to broader reimbursement classes over the years, including ARNPs. In contrast, Washington’s Medicaid and L&I reimburse 100% for ARNP services. Private health plans should follow the lead of state payers and reimburse ARNPs the same amount as physicians for the same service.

Legislation and funding are needed to create statewide standing orders allowing school nurses to purchase and administer emergency medications, like epinephrine. This will ensure that students receive immediate care in the school building without relying on outside healthcare providers to shoulder this responsibility. It also ensures that the legislature’s authorization for schools to stock these emergency medications can be put into practice.

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