Nurses union proposes minimum 1-to-5 staffing ratio

The Associated Press
Tuesday March 13, 2001

SACRAMENTO — Hospital nurses would have to care for at most five patients under staffing ratios suggested Monday by the state’s largest registered nurses’ union. 

The California Nurses Association’s ratios for different types of registered nurses allows about half the number of patients requested by the California Healthcare Association, a group representing hospitals. 

The hospital association numbers – which range from a 1-3 ratio for postoperative care to a 1-16 ratio for patients in transitional care – allow for hospital flexibility while maintaining safe care standards, said CHA spokeswoman Jan Emerson. 

But many nurses say the higher ratios reflect current staffing levels that have forced nurses out of hospitals for fear they will be unable to adequately care for patients and lose their license. 

“I go home every day thanking God that we haven’t killed anybody,” said Karen Rothblatt, a nurse at Alameda Hospital. 

The final ratios will be set by the state Department of Health Services and go into effect Jan. 1, 2002. California is the first state to implement minimum staffing requirements for hospital nurses. 

Draft regulations are expected to be released early this summer. 

Minimum ratios of one nurse for every two patients are already in place for Intensive Care Units. Patients under anesthesia or in labor must be in the care of one nurse. 

Emergency, psychiatric, postpartum, surgical and pediatric nurses, among others, would be assigned between two to four patients and five healthy newborns could be assigned to nurses under CNA’s ratios. 

Industry officials say minimum ratios set at the lowest levels will do little to relieve nurses’ stress levels. California is expected to be short 25,000 registered nurses by 2006, said CHA’s Emerson. 

“A low ratio will not solve that,” she said. “Our concern is that hospitals can’t find nurses now but what if we can’t find enough for a lower ratio? Is the state going to shut down the hospital? Nobody wins then.” 

Union officials say improved ratios will help improve work conditions and eventually encourage more nurses to work in hospitals. Only about 60 percent of registered nurses work in hospitals, said Jill Furillo, a nurse and CNA’s government liaison. 

The ratio’s effect on the market will be analyzed by the state, although it will not play a role in the final ratios, said Gina Henning, who is overseeing the ratio project for the state. 

State policy makers are expected to make surprise visits to many state hospitals in the next few months to judge staffing needs. The state has also contracted with experts through the University of California to advise on the ratios, Henning said. 

Two other nurses’ organizations have submitted ratio proposals that closely mirrors CNA’s. 

On the Net: 

Department of Health Services: http://www.dhs.cahwnet.gov 

California Nurses Association: http://www.calnurse.org 

California Healthcare Association: http://www.cha-cahhs.org/