How Politics Affect Nursing

Nurse is standing at a podium in a political setting like a the Senate or House of Representatives.

Most people avoid political conservations, but like it or not politics and nursing goes hand and hand. To make a difference to our working environments, we must get political. There are many bills in Congress right now that can help or hurt the field of nursing. Learn how bills pass through Congress, which ones are currently being talked about, and how you can help support those that are good for nurses.

Nurse is standing at a podium in a political setting like a the Senate or House of Representatives.

How do bills move through Congress?

First, let’s talk about how bills move through Congress. There are six steps that each bill must go through:

Step 1- Introduction: A representative in the House of Representatives, or a senator from the Senate will introduce a bill.

Step 2- Committee study: The bill is assigned to a subcommittee, which will research and negotiate the contents of the bill.

Step 3- Calendar: After the committee reviews and researches the proposed bill, they bring it back to the House of Representatives or Senate to debate, amend, or vote on.

Step 4- Vote: The Bill must pass in both the House of Representatives and Senate.

Step 5- Conference Committee: This committee will negotiate any changes needing to help the bill pass.

Step 6- Presidential Action: The Bill is sent to the President for their signature.

It looks like a straightforward process, but many bills do not make it to the President’s desk because it does not get enough votes in the House or the Senate. If it does make it to the President, they may or may not sign it. If it is not signed, then it does not become law.

Types of Bills

So, what types of bills are currently working their way through Congress? These are just a few:

Nursing staffing standards

H.R. 2530, Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act of 2023. This bill was introduced on April 6th, 2023. The purpose of it is to establish national direct care nurse-to-patient ratios. The current proposed ratios are:

1:1 for trauma emergencies

1:1 operation circulator

1:2 critical care areas

1:3 emergency departments, pediatrics, and other specialty areas

1:4 medical/surgical, psychiatric, and other specialty areas

1:5 rehab and skilled nursing homes

1:6 postpartum or 3 couplets (1 mom and 1 baby = a couplet)

This bill would legally require hospitals to meet these ratios. If passed it would dramatically change the healthcare environment for both nurses and patients. Currently, this bill has been introduced and referred to the Subcommittee on Health, and it has a long way to go before it is passed into law.

Workplace Violence

H.R. 1195, Workplace Violence Prevention for Health Care and Social Service Workers Act. This bill will require hospitals and other employers to implement measures to help protect healthcare workers from violence. The new measures are not defined, but the act would hold employers accountable if a nurse were injured because of a violent incident. It was introduced in the House of Representatives on February 22, 2021. It was passed in the House on April 16, 2021, and is now in a Senate subcommittee.

Iowa House Bill 2391

This is a state bill introduced on February 28, 2024. The purpose of this bill is to limit the pay for travel nurses in the State of Iowa. While this may sound like a fair deal to staff nurses currently working in Iowa it does create the risk of opening the door for other states to cap travel nurse pay or any other nurse pay. Nurses already struggling to get paid what they are worth. Passing any type of law reducing the potential for nurse’s pay to increase is dangerous. This bill already passed in the Iowa House of Representatives and is now with the Senate’s subcommittee which has recommended it should pass. The Senate still need to vote on it. You can help stop this bill and others like it.

How to make changes?

Write or call representatives.

While the Iowa House Bill 2391 will only affect nurses in Iowa, it could open the door for other states to follow suit. If this is something you do not want passed, even if you are not an Iowa nurse, you can reach out to the congressmen and women who will be voting on the bill next. Write letters, call, or post on social media. Use any measure to make your voice heard.

On a more local level, learn about your local representatives and how they would vote on healthcare bills in your state or on a federal level. Support those who support nurses.

Join an organization.

Support an organization making big changes.

American Nurses Association

The American Nurses Association (ANA) sets our nursing standards of care and lobby and advocate for the interest of nurses on a state and federal level. Being a member of the ANA helps support their lobbying efforts and keeps you in the loop about important bills. Many states have a local chapter that you can become active with.

Commission for Nursing Reimbursement

Commission for Nursing Reimbursement is a nurse led organization making big changes in nursing. One of their current initiatives, along with the Nursing Is Stem Coalition, is to add the nursing profession as a science, technology, engineering, and mathematics (STEM) field. Designating nursing as a STEM field would open government funding and resources to encourage school-age children to learn more about the field of nursing. You can help this movement by going to to learn more about it.

The Commission for Nurse Reimbursement also wants to change how nurses are paid. Currently, nurses are paid through a patient’s room rate. In other words, when a patient is admitted to a hospital their insurance company will pay for the cost of the room they stay in. This flat rate is divided among nurses, other healthcare professionals, and supplies. This is why it is so hard for hospitals to meet safe nurse-to-patient ratios. Hospitals make more money if they have fewer nurses to pay per patient. Understaffing is almost the only way hospitals make money.

Hospitals will never be able to afford safe nurse to patient ratios if we don’t change the way nurses are paid. This is why hospitals work so hard to decrease or cap the amount of money nurses make. The Commission for Nurse Reimbursement want to change this. If they can achieve this, it can change the healthcare environment for the better.

So, how do politics affect nursing? 

There are countless ways in which politics influence nursing. It will literally take an act of Congress to change the current healthcare environment. How can you help?

–      Stay up to date on what is happening on a local, state, and federal level.

–      Write to your state representative about which bills are important to you.

–      Join an organization that supports nurses politically.

–      Vote for representatives who will support nurses.

Now more than ever your vote counts. Stay informed and vote.

If you want to learn more about the Commission for Nurse Reimbursement, or how nurses can make a difference on a grand scale, watch or listen to our latest conversation on The Brink.

To find out more about travel nursing visit: Stability Healthcare

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