Legislative Worksheet (SBAR): How a Bill Becomes a Law - Nurses' Hours

This legislative worksheet, completed in the SBAR (Situation, Background, Assessment, Recommendation) format, addresses the issue of long working hours for nurses in hospitals. The assignment identifies the problem of extended shifts leading to fatigue, medical errors, patient dissatisfaction, and nurse burnout. The student proposes limiting daily working hours to a maximum of 8 hours and increasing nursing staff to improve efficiency and patient care. Research supports the proposal, citing studies on the negative impacts of long shifts and highlighting existing legislation in California. The assessment considers the financial implications, with potential positive economic effects on hospitals and increased revenue. Stakeholders supporting the bill include nurses, medical staff, patients, and government health departments, while healthcare organizations prioritizing profit and some nurse leaders may oppose it. The recommendation includes a request for a meeting with a legislator to discuss the proposal and advocate for improved working conditions and adequate nurse-patient ratios. The assignment includes references to support the arguments made.

Legislative Worksheet (SBAR Format) –
How a Bill Becomes a Law
SITUATION: IS THIS SOMETHING THAT CAN BE LEGISLATED?
Long working Hours for nurses in the hospitals
 Identify the problem/concern: Nurses have to work for long hours in the hospitals.
In most of the cases, they work for extended shifts resulting in loss of fatigue which may lead
to medical mistakes. Due to long working hours, there are increased levels of patient
dissatisfaction and burnouts amongst the nurses. It also causes loss of sleep, an inability of
recovering between the shifts and daytime sleepiness amongst them. As a result, the nurses
report decision regrets and occurrence of negative emotions when the real outcomes vary
from the desired outcomes (Gooch, 2019). This problem is also related to inadequate staffing.
Due to the availability of less nursing staff in the hospitals, nurses have to work for more
than 12 hours in a stretch.
 State your proposal/idea. The daily working hours for nurses should be limited along with
the number of working days. Their shifts should not exceed beyond 8 hours. Besides this,
their work processes and workspace should be designed in such a way which makes them
more efficient and less prone to a commission of errors. • More nursing staff should be
appointed in the hospitals so that the existing staff does not have to work for prolonged
hours.The appointment of nursing staff should be proportional to the number of patients
in each hospital and laws should be enacted regarding the issue (Science Daily, 2019).
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BACKGROUND: DO YOUR RESEARCH
 Include studies, reports, personal experience, or anecdotal stories related to your
proposal. As per a study conducted by the Pennsylvania Patient Safety Reporting System, 12
hours working hours for nurses proved to be troublesome for them in staying awake during their
working hours. It caused the reduction of their sleep time and increased the chances of
committing errors to about three times. It also indicated that those nurses who worked for 12.5
hours or more commit the most significant errors during their shifts (On Course Learning
Corporation, 2018).
 Has there been similar legislation introduced and/or passed in other states? If so, include
it. California has enacted the Nursing Staffing Standard for Patient Safety and Quality
Care Act 2013 which states the minimum staffing ratios of nurses. The state has proposed
a plan for formulating an appropriate ratio of nurses for each unit proportionate to the
number of patients along with restricted mandatory overtime shifts (Shin, Koh, Kim, Lee
& Song, 2018).
ASSESSMENT: FINANCES AND STAKEHOLDERS
 Identify financial impact if any (e.g., added costs, cost savings, increased revenue): There
would be a positive economic effect on the hospitals if this act is enacted. It would also
improve the rating of the hospitals. It would also increase the revenue of the hospitals as
nurses working in shorter shifts would be more alert and efficient in taking care of their
patients.
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 Identify stakeholder groups that would support this bill: The stakeholders who would
support the bill would be registered nurses, other medical staff of the hospitals, patients and
the Health and Public Welfare Department of the government. The policymakers at the state
and national level would also support this bill as they play an important role in formulating
better safety regulations and working conditions for nurses.
 Identify people/groups that would oppose this bill: The healthcare organizations who
aim at mere making profits at the cost of the health of nurses would surely oppose this bill.
They would argue that if nurses work for longer hours, then they don’t have to hire more
nursing staff for the hospitals. In that case, they would spend this amount on buying new
equipment for patients. Some of the nurse leaders and leaders of the opposition house can
also oppose the bill by debating that working for longer hours would help them to indulge in
leisure activities outside their work (Grand Canyon University, n.d.). Furthermore, their
managers would be flexible in allowing them to execute their duties and take breaks as per
their wishes (Shoes for Crews (Europe) Ltd, 2019).
RECOMMENDATION
 Make an appointment with your legislator to discuss your proposal. In order to discuss
this proposal regarding the enactment of the bill mandating less working hours for nurses
along with maintenance of adequate nurse-patient ratio, I respectfully request to meet with
XYZ on 2nd March 2019 between 1.00 p.m. to 3.00 p.m. I am a constituent from Ohio and a
member of the American Nurse Association. Therefore, it is recommended that more
attention should be given to increase the work force of nurses along with implementing
© 2013. Grand Canyon University. All Rights Reserved.

policies which would improve the working environment of nursing fraternity along with a
reduction in their work shifts.
© 2013. Grand Canyon University. All Rights Reserved.

References
Gooch, K. (2019). 5 of the biggest issues nurses face today. Becker's Healthcare. Retrieved
February 28th, 2019 from https://www.beckershospitalreview.com/human-capital-and-
risk/5-of-the-biggest-issues-nurses-face-today.html
Grand Canyon University (n.d.). How a Bill Becomes a Law [Video file]. Retrieved February
28th, 2019 from https://lc.gcumedia.com/nrs440v/how-a-bill-becomes-a-law/v3.1/#/
On Course Learning Corporation (2018). Long hours, shift work still plague nurses Retrieved
February 28th , 2019 from https://www.nurse.com/blog/2017/03/01/long-hours-shift-
work-still-plagues-nurses/
Science Daily(2019). Nurse survey shows longer working hours impact on quality of care.
Retrieved February 28th , 2019 from
https://www.sciencedaily.com/releases/2014/09/140922110426.htm
Shin, J.H., Koh, J.E., Kim, H.E., Lee, H.J. & Song, S.(2018). Current Status of Nursing Law in
the United States and implications . Health Systems and Policy Research,5(167), 1-7.
Shoes For Crews (Europe) Ltd(2019). The pros and cons of nurses working 12 hour shifts.
Retrieved February 28th , 2019 from https://blog.sfceurope.com/the-pros-and-cons-of-
nurses-working-12-hour-shifts
© 2013. Grand Canyon University. All Rights Reserved.