HF 2505

as introduced - 90th Legislature (2017 - 2018) Posted on 05/22/2017 01:41am

A bill for an act
relating to health; establishing requirements for the assignment of direct-care
registered nurses; prohibiting retaliation; proposing coding for new law in
Minnesota Statutes, chapter 144.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

new text begin [144.591] REQUIREMENTS FOR ASSIGNMENT OF NURSING
PERSONNEL.
new text end

new text begin Subdivision 1. new text end

new text begin Definition. new text end

new text begin For purposes of this section and section 144.592, "direct-care
registered nurse" means a registered nurse, as defined in section 148.171, subdivision 20,
who is nonsupervisory and nonmanagerial and who directly provides nursing care to patients
more than 60 percent of the time.
new text end

new text begin Subd. 2. new text end

new text begin Requirements; factors. new text end

new text begin A hospital must assign nursing personnel to each
patient care unit consistent with the hospital's staffing plan. For each patient care unit, a
direct-care registered nurse shall evaluate the following factors to assess and determine the
adequacy of staffing levels to meet patient care needs:
new text end

new text begin (1) composition of skill mix and roles available;
new text end

new text begin (2) patient acuity;
new text end

new text begin (3) experience level of registered nurse staff;
new text end

new text begin (4) unit activity level, such as admissions, discharges, and transfers;
new text end

new text begin (5) variable staffing grids;
new text end

new text begin (6) availability of a registered nurse to accept an assignment; and
new text end

new text begin (7) nursing intensity.
new text end

new text begin Subd. 3. new text end

new text begin Prohibited acts. new text end

new text begin A hospital shall not:
new text end

new text begin (1) assign a direct-care registered nurse to a hospital unit unless the direct-care registered
nurse is able to demonstrate current competence in providing care in that unit and has
received orientation to that hospital's unit sufficient to provide competent care to the patients
in that unit;
new text end

new text begin (2) assign nursing personnel from a supplemental nursing services agency to provide
patient care on a hospital unit until the agency nurse is able to demonstrate validated
competence in providing care in the assigned unit, and has received orientation to that
hospital's unit sufficient to provide competent care to patients in that unit; or
new text end

new text begin (3) assign unlicensed personnel to:
new text end

new text begin (i) perform direct-care registered nurse functions in lieu of care delivered by a direct-care
registered nurse;
new text end

new text begin (ii) perform tasks that require the assessment, judgment, or skill of a direct-care registered
nurse; or
new text end

new text begin (iii) perform functions of a direct-care registered nurse under the supervision of a
direct-care registered nurse.
new text end

new text begin Subd. 4. new text end

new text begin Inadequate staffing. new text end

new text begin (a) If any direct-care registered nurse determines that
staffing levels are inadequate and so notifies the unit's charge nurse and a manager or
administrative supervisor, the manager or administrative supervisor shall consider the
following:
new text end

new text begin (1) current patient care assignments for potential redistribution;
new text end

new text begin (2) the ability to facilitate discharges, transfers, and admissions;
new text end

new text begin (3) the availability of additional staffing resources; and
new text end

new text begin (4) the hospital-wide census and staffing.
new text end

new text begin (b) If the staffing inadequacies cannot be resolved and resources cannot be reallocated
by the manager or administrative supervisor after considering the factors in paragraph (a),
the hospital shall call in extra staff to ensure adequate staffing to meet safe patient standards.
new text end

new text begin (c) Until extra staff arrive and begin to receive patient assignments:
new text end

new text begin (1) the hospital must suspend nonemergency admissions and elective surgeries that
routinely lead to in-patient hospitalization;
new text end

new text begin (2) the charge nurse for the unit with inadequate staffing levels is authorized to close
the unit to new patient admissions and in-hospital transfers; and
new text end

new text begin (3) a direct-care registered nurse is authorized to refuse an assignment that is unsafe, in
the nurse's professional judgment.
new text end

Sec. 2.

new text begin [144.592] RETALIATION PROHIBITED.
new text end

new text begin A hospital shall not retaliate against or discipline a direct-care registered nurse, either
formally or informally, for:
new text end

new text begin (1) refusing to accept an assignment if, in good faith and in the nurse's professional
judgment, the nurse determined that the assignment is unsafe for patients due to patient
acuity and nursing intensity; or
new text end

new text begin (2) reporting a concern regarding safe staffing levels.
new text end