Enforcing Staffing Ratios Collective Bargaining Legislation Alice L Barden MSN, RNC-MNN

HPAE Local 5004 Safe Staffing Plan CBA language Non-nursing services Core Staffing Acuity System Positions Work availability Staffing Data Floating

HPAE Local 5004 CBA language Non-nursing services Environmental services Washing/maintaining equipment, cleaning rooms Transport services Transporting patients or equipment Dietary services Distributing and/or collection of food trays Secretarial coverage Monitor tech coverage

HPAE Local 5004 CBA language Staffing Guidelines from NJDOHSS & Joint Commission Professional standards from specialty organizations (ENA, AWHON) Core staffing - minimum acceptable staffing levels (Schedule J-1) Staffing ratios Shortfall will not exceed 1 RN

HPAE Local 5004 CBA language Acuity System Committee of 50% union 50% management Cross divisional, cross shift Review acuity data regularly to determine validity and reliability Pt data indicators, pt focused indicators, structure indicators Dispute resolution

HPAE Local 5004 CBA language Positions The Medical Center will be required to post positions on units when the need is established through the regular use of overtime or per diems Notification to Union regarding positions every 14 days Internal for 14 days then becomes external If position in specialty area posted and advertised external remains vacant for more than 6 months, Medical center may repost for internal bidding and offer required education and training Positions with staggered start must state stagger and cannot be more than a 2 hour stagger

HPAE Local 5004 CBA language Work Availability Prior to posted schedules Time od posted schedule Additional availability Cancellation notice Unplanned needs

HPAE Local 5004 CBA language Staffing data Quarterly and annual staffing reports on OT and use of per diems Per unit and shift Post schedules By unit and shift including sick calls, absent calls, LOA Requests for information Agency nurse contracts Daily census data Floating reports

HPAE Local 5004 CBA language Floating Minimize floating Float pool, seniority, per diems, OT, extra time Limited to Area of Clinical Practice Float pay New grads don’t float for 8 months after orientation Transfer to new area won’t float for 2 months after orientation Current core clinical competencies

NJ Safe Staffing Bill NJ A1470/NJ S989 Hospitals, Ambulatory Surgery Facilities, State Developmental Centers, Psychiatrics Hospitals Direct care registered professional nurse Staffing Ratios Based on type of unit/care being provided Acuity System & Staffing System Pt classification/acuity, professional standards, skill mix, staff nurse/BU buy in, forecasting, operational factors, contingency plans DOH to monitor & enforce Periodic inspection, complaint