The Legislative Process and Healthcare Lobbying
Michael Abreu
Ohio University
May 18, 2015 Part 1
The Legislative Process and Healthcare Lobbying
The legislative process is composed amongst a series of well-defined networks that guide the transformation of adopting a bill into a law. A bill must first pass through legislature in a process known as the legislative process. In its path to transformation a bill will navigate itself through a series of committees and take part in several deliberations, publications, and ballots before approving the ultimate vote from our President elect. Throughout this legislative process, bills stand a chance of an impediment and the possibility of becoming ousted from any further consideration. This dissertation
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One significant concern relates to nurse to patient ratios, and is defined by the maximum number of patients a registered nurse is simultaneously allowed to undertake in a given shift. This ratio is a growing concern and is one of the most dynamic triggers that spark the clashing of bedside nurses and upper management personal. Many states have already implemented state regulations for this problem and have propelled other states such as Florida, to decide whether they should or should not execute the same authority. The decision lies on whether or not Florida should bring about this regulation and the reasoning for those who oppose or favor the …show more content…
As a nurse, there is no greater danger than that of losing your nursing license or the life of a patient. It is the constant fear that creeps into every employees mind as they clock in to begin their shift. It is a concern often demonstrated in the context of an emergency room or intensive care unit. Both these departments see in influx of patients and because acute life threatening disorder never happen expectedly, these departments face the possibility of an overflow on any day of the week. So much that hospitals even have protocols in place to control an “over capacity” as called by many facilities. In the E.D many nurses feel that it is impossible to accurately document and treat any more than five patients at a time. It becomes an even greater liability to these nurses when some of those patients take on an emergency service index of a level one or two. Those working in the ICU face a similar matter when they are forced to take on more than two patients at a time. ICU patients are usually composed of several drips running simultaneously while having most patients intubated for respiratory support. It is a scenario that requires the upmost attention to detail and the expertise to catch any declining trend in the patient’s
The law making process is a lengthy process. First, a representative must have an idea for a new law and they become the sponsor of this bill. The representative must present to the bill to the Clerk of the House if it is in the house (H.R. Bills), or in the Senate (S Bills). The Government Printing Office, GPO, then prints the bill and distributes it to each representative. The Speaker of the House, for further study, then assigns this bill to a standing committee within the house. The standing committee studies the bill and its contents and has two options, either to release the bill with a recommendation to pass it or lay it aside so it cannot be voted on. If the bill is released, it may be voted on or sent into debate within the house and needs a majority vote for the bill to move onto the Senate. Within the Senate, the bill must go through one of the Senate’s sixteen standing committees, and as with the House of Representatives, the bill is either released or pigeonholed. If it is released, a simple majority passes the bill. The bill takes another step into a conference committee, which is made up of members of the Hou...
In the case of nurse staffing, the more nurses there are the better outcome of patient safety. When there enough staff to handle the number of patients, there is a better quality of care that can be provided. The nurses would be able to focus on the patients, monitor the conditions closely, performs assessments as they should, and administer medications on time. There will be a reduction in errors, patient complications, mortality, nurse fatigue and nurse burnout (Curtan, 2016). While improving patient satisfaction and nurse job satisfaction. This allows the principle of non-maleficence, do no harm, to be carried out correctly. A study mentioned in Scientific America showed that after California passed a law in 2014 to regulate hospital staffing and set a minimum of nurse to patient ratios, there was an improvement in patient care. Including lower rates of post-surgery infection, falls and other micro emergencies in hospitals (Jacobson,
Most individuals with a general background knowledge of the United States Federal Government system are aware that in order for a bill to become a law, it must first pass a majority vote in Congress. There is, however, a very important step in the legislative process that sometimes goes unnoticed. The committee system of the legislation process ensures that the appropriate attention is given to each bill introduced to Congress. Each member of both chambers are assigned to committees and subcommittees, and are expected to become subject matter experts in their respective roles as committee members.
Monitoring staff levels is an important factor. Also leveling the flow of patients in and out institutions could help to reduce wide fluctuations in occupancy rates and prevent surges in patient visits that lead to overcrowding, poor handoffs, and delays in care. Studies show that overcrowding in areas such as the emergency rooms lead to adverse outcomes, because physicians and nurses having less time to focus on individual patients. One study found that for each additional patient with heart failure, pneumonia, or myocardial infarction assigned to a nurse, the odds of readmission increased between 6 percent and 9 percent (Hostetter and Klein, 2013). All of which costs the hospital money.
The procedure for approving a bill and making it a law involves many steps. The following description is a short summary from “How Our Laws are Made”, an in depth description of the legislative process that can found on the website of the Library of Congress. After a bill is drafted, a member...
On April 17th 2013, Senator Barbara Boxer (California) introduced a federal bill that is aimed to reduce nursing shortages by establishing a minimum nurse-to-patient ration in hospitals. She is also ordering whistleblowing protection for nurses who report quality-of-care violations. The law requires that every hospital implement a written hospital-wide staffing plan that will guide the assignments to...
Current literature continues to reiterate the indicators of a major shortage of registered nurses (RNs) in the United States. The total RN population has been increasing since 1980, which means that we have more RNs in this country than ever before (Nursing Shortage). Even though the RN population is increasing, it is growing at a much slower rate then when compared to the rate of growth of the U.S. population (Nursing Shortage). We are seeing less skilled nurses “at a time of an increasingly aging population with complex care needs and an increasingly complex technological care environment” (Mion). According to recent data from the Bureau of Labor Statistics and the Department of Health and Human Services, it is estimated that “more than a million new and replacement nurses will be needed over the next decade” (Diagnosis: Critical).
Otto von Bismarck once said, “Laws are like sausages, it is better not to see them being made.” The arduous process that a bill undergoes in order to become a law may seem grueling and pointless; however, the processes high caliber of difficulty allows for the extreme prestige and exclusivity of bills that are passed. Because the process is so exhausting, and filibusters, subsequently requiring a super-majority vote to pass a bill, have always been such a threat in Congress, historically, bills that attempt to reform sensitive issues have not fared well in the legislative branch. However, when Congress does pass controversial laws, it then also faces the task of effectively enforcing them. But, when the process is carried out to completion, laws that are enforced have significant impacts on the everyday lives of the American people—such as laws concerning abortion rights. In the United States, the government and Congress have significantly affected the rights of women with regard to abortions through laws that either restrict or guarantee their legality and availability, while the government’s capacity to do so is affected by the principle of federalism along with that of the separation of powers.
It is clear that statewide mandated nurse-to patient ratios result in drastic financial changes for every hospital impacted. Hospitals often have to compensate for hiring more nurses by laying off support staff. Mandated ratios also result in an increase in holding time in emergency rooms . (Douglas,
Since the 1990’s, the interest in nursing and the profession as a whole has decreased dramatically and is still expected to do so over the next 10-15 years according to some researchers. With this nursing shortage, many factors are affected. Organizations have to face challenges of low staffing, higher costs for resources, recruiting and reserving of registered nurses, among liability issues as well. Some of the main issues arising from this nurse shortage are the impact of quality and continuity of care, organizational costs, the effect it has on nursing staff, and etc. However, this not only affects an organization and community, but affects the nurses the same. Nurses are becoming overwhelmed and are questioning the quality of care that each patient deserves. This shortage is not an issue that is to be taken lightly. The repercussions that are faced by both nurses and the organization are critical. Therefore, state funding should be implemented to private hospitals in order to resolve the shortage of nurses. State funds will therefore, relieve the overwhelming burdens on the staff, provide a safe and stress free environment for the patient, and allow appropriate funds needed to keep the facility and organization operational.
Patient’s safety will be compromised because increase of patient to nurse ratio will lead to mistakes in delivering quality care. In 2007, the Agency for Healthcare Research and Quality (AHRQ) conducted a metanalysis and found that “shortage of registered nurses, in combination with increased workload, poses a potential threat to the quality of care… increases in registered nurse staffing was associated with a reduction in hospital-related mortality and failure to rescue as well as reduced length of stay.” Intense workload, stress, and dissatisfaction in one’s profession can lead to health problems. Researchers found that maintaining and improving a healthy work environment will facilitate safety, quality healthcare and promote a desirable professional avenue.
Thousands of nurses throughout the nation are exhausted and overwhelmed due to their heavy workload. The administrators do not staff the units properly; therefore, they give each nurse more patients to care for to compensate for the lack of staff. There are several reasons to why
Nurse to patient ratios are extremely paramount in assisting with overall patient mortality and wellness of our nurses. It is an issues which unfortunately affected by legislation of our government (which is affect specifically on a monetary basis). My research via Academic Search Complete allowed me to identify topics that assist my PICOT question, and enables me to further analyze and research to find out what issues directly affect is matter. Proper nurse to patient ratio, operational costs, government regulation, nurse work life and health, patient wellness, and nursing procedures and duration of those procedures are all affected by this topic and we must ensure that all are properly balanced.
These articles have many similarities when discussing the issue of staffing shortages. For patients, their loved ones and the general population, they don’t understand the ramifications and strain that staffing shortages have on nurses. People expect and deserve complete, competent and safe care when they are patients. These articles bring to light all the struggles that nurses have to deal with. Nurses are fearful that they will make mistakes, will harm patients, and will harm themselves. (Bae, 2012; Erlen, 2001; Martin, 2015) Overtime can be overwhelming and exhausting, which can lead to errors being made. (Bae, 2012; Erlen, 2001) These articles perceive that it may be beneficial for nurses, patients, and healthcare facilities to decrease the nurse-to-patient ratio, however, this option is not always
West Virginia Legislature. (2011). How a bill becomes a law. Retrieved October 14, 2011, from