Written by Deborah Skeen, MSN, RN, CEN, CPEN 2022 COENA GAC Chairperson February 25th, 2022
A very smart woman once told me that legislation passed at the state level impacts our daily lives even more than the bills passed at our nation’s capital. As I have learned more about government affairs within Colorado these past few years, I have to say I agree! So here’s a quick blog entry to give you a sense of what’s on the agenda early in the 2022 Colorado Legislative Session that might be of interest to emergency nurses. Enjoy!
In 2020 Colorado passed a bill HB20-1415 protecting workers who raise a concern about health or safety during a public health emergency from employer retaliation. Evidence suggests that the bill is working Democrats want to extend whistleblower protections for Colorado workers beyond public health emergency – The Denver Post. SB22-097 Whistleblower Protection Health & Safety expands the protection for all health and safety concerns regardless of whether there is a declared public health emergency or not C:\097_01.txt (colorado.gov).
HB22-1065 Emergency Mental Health Treatment and Evaluation Standard looks at updating the 72-hour hold law. It does broaden the net for 72-hour holds to be placed on individuals who are of “substantial” risk to harm to themselves or others, rather than of “imminent risk” C:\1065_01.txt (colorado.gov). The bill is still in its early stages and will most likely evolve as it goes through the legislative process Mental health holds: Colorado lawmakers want to improve them (coloradosun.com). Keep an eye out for updates on this bill because it may change as it is debated and discussed by stakeholder groups and lawmakers at the Capitol.
If you have a passion for injury prevention, you might be interested in hearing about HB22-1064 Prohibit Flavored Tobacco Regulate Synthetic Nicotine. This bill prohibits the advertising, marketing, and sale of flavored tobacco products in the state of Colorado. Electronic cigarette use among youth was declared an “epidemic” in 2018 by the office of the surgeon general in the U.S. Menthol cigarettes and other flavored tobacco products have been shown to be “starter” tobacco products for youth. The nicotine can harm the adolescent brain and affect attention, mood, learning, impulse control, and become habit-forming C:\1064_01.txt (colorado.gov). This bill does not impact products used for smoking cessation.
Last, but not least, there is a lot of interest at both the state and national level to find ways to address Safe Nurse Staffing. On the state level, Representative Kyle Mullica, an emergency room nurse, is working with legislators and stakeholder groups including the Colorado Nurses Association, physician groups, the hospital association, & the governor’s office, to craft legislation to address this issue. Final details are still in the works. However, we expect them to be made public in the very near future.
I can tell you that amendments were approved in October 2021, but have not yet gone into effect, that address nurse staffing regulations through CDPHE as a requirement for obtaining facility licensure in the state. This involves a master nurse staffing plan based on the different types of patients cared for in each hospital unit along with the skill mix, specialized qualifications, and level of competency necessary for nursing staff to ensure that the facility is safely staffed. This master nurse staffing plan must be reviewed with each member of the nursing staff annually and be reviewed periodically (no less than every 3 years). Each hospital must establish a nurse staffing oversight process which shall have at least 50% or greater participation by clinical staff nurses, in addition to auxiliary personnel and nurse management. This is great…nurses will have a seat at the table!
Guidelines must be developed and document the process for how complaints and feedback from hospital staff related to nurse staffing will be received and processed, how decisions are made, and how the staffing plans will be monitored, evaluated, and modified over time. A report of the nurse staffing oversight process findings shall be made available to hospital nursing staff. If the results indicate that the current master nurse staffing plan has not resulted in adequate staffing and met the healthcare needs of the patients, the staffing plan must be modified through the nurse staffing oversight process. Accurate reporting by hospitals to the governing body will also be required including current best practices (considering community standards, benchmarking, or evidence-based metrics), data on patient census, patient acuity or workload, patient outcomes, skill mix, RN education, and workforce metrics and staff feedback. This report must be issued for approval by the governing body following each review of the staffing plan.
At the national level, two Congressional Democrats in Washington, D.C. have introduced a bill that sets minimum nurse-to-patient staffing requirements Congressional Bill Seeks to Set Federal Nurse-to-Patient Staffing Requirements HealthLeaders Media|. There is also a peaceful protest sponsored by Nurses Against Violence that focuses on safe staffing ratios taking place in Washington, D.C., on May 12th Nurses’ March on Washington Planned to Address Workplace Violence and Other ‘Serious Issues’ | HealthLeaders Media. There is a branch of this group, National Nurses March-Colorado, that currently has 1.2k members in its Facebook group, advocating for safe staffing and workplace violence for Colorado’s nurses and healthcare professionals (https://www.facebook.com/groups/608042213592271/) They are planning an 11 am meeting at the Colorado State Capitol on May 12th, followed by a march at 12-noon, and then closing remarks back at the Capitol from 2-2:30 pm. Specifically, National Nurses March – Colorado is demanding safe nurse-to-patient ratios, legislation to end workplace violence and racism, and fair and realistic wages. Currently, neither the Emergency Nurses Association nor the American Nurses Association support mandated nurse-to-patient ratios.
What are your thoughts on this topic? Do you think hospital-based staffing plans with nurse staffing oversight processes required for facility licensure will work? Do you think the Whistleblower Protection bill will be enough additional support to allow nurses to speak openly about their workplace environments? Other suggestions to help nurses feel safe speaking about their workplace to legislators include allowing nurses to submit their testimony anonymously through a notarized statement, then present the notarized statements in bulk to legislators.
Please consider telling your member of Congress your story regarding nurse staffing and what your work environment needs @ RN Action: Tell Your Story: Nurses Need Better, Safer Work Environments (p2a.co)
Please feel free to post any comments or questions. Thanks for taking a moment to check in on our Colorado Government Affairs Blog!
Colorado ENA Government Affairs Blog 