• E-mail
• Print
• RSS

California’s nurse-to-patient staffing ratios upheld

Nurse Leader Weekly, May 28, 2004

Want to receive articles like this one in your inbox? Subscribe to Nurse Leader Weekly!

A California superior court judge upheld the state's new mandatory nurse-to-patient staffing ratios on May 26, rejecting a hospital industry group's lawsuit that argued hospitals would not be able to comply with the regulations when nurses were at lunch or on breaks.
 
The California Hospital Association claims that 85% of California's hospitals are unable to comply with the nurse-to-patient ratio regulations that went into effect January 1. The biggest single problem area for hospitals is not having enough additional nurses available to provide break coverage.

But Judge Gail D. Ohanesian defended the regulations, saying in a 12-page decision that the ratios would be meaningless if they weren't applied "at all times."

"This is a searing indictment of the hospital industry's illegitimate attempt to deny patients safe care as required by the legislature, the Governor, and the Department of Health Services- and a huge victory for RNs and patients." said Rose Ann DeMoro, executive director of the California Nurses Association on the group's Web site.

The state Department of Health Services, which oversees the regulations, offers the following suggestions for hospitals struggling to comply with the "at all times" requirement:

* The regulations specifically permit a charge nurse, or nurse manager to fill in for a licensed nurse during breaks or lunches.
* In a Post Anesthesia Recovery Unit (PACU) an OR nurse can cover if there are no surgeries as long as the nurse has current competence in the PACU.
* Any nurse in the hospital can "float" between units to cover as long as that nurse is competent to perform tasks required in that unit.
* Nurses from a "higher acuity" unit can always cover for a nurse in a unit with lower acuity patients.
* If a patient is being taken for tests and can be accompanied by a technician, that may reduce a nurse's assignment on a temporary basis, so they could assist another nurse.
* A hospital can delay new admissions or cancel elective surgeries that would result in new admissions. Hospitals have done this when they didn't have sufficient numbers of critical care nurses.
* Hospitals could contact physicians to see if any patients could be safely discharged sooner than scheduled. Often hospitals discharge patients at certain times of the day, even though the patient could go home or to another level of care sooner.
* Except for patients who might be admitted through the ER, hospitals know the number of new admits or possible discharges at any given time. Each charge nurse plans for staffing the next shift prior to the end of the current shift. This is a normal and continuous process that can be adjusted to accommodate available staff.

This list was adapted from "Nurse-to-Patient Staffing Ratios for General Acute Care Hospitals, Frequently Asked Questions," (January 2004) which can be found at http://www.dhs.ca.gov.

Want to receive articles like this one in your inbox? Subscribe to Nurse Leader Weekly!

• E-mail to a Colleague
• Print
• RSS
• Archive