Parties Take Positions As State Set to Revisit Nurse Staffing Levels

By LAURENCE DARMIENTO
Staff Reporter

Just months after Gov. Gray Davis released proposed regulations on nursing staff levels, unions and the hospital industry are ready to go head-to-head over the issue again.

The January regulations, which were released after more than a year of debate, are subject to change following hearings to be held in the coming months by the Department of Health Services.

In anticipation of that, the Service Employees International Union plans to rally later this month on the Capitol steps, during which it will call for tighter ratios closer to the union's own proposal.

At the same time, the California Healthcare Association, the state's hospital industry trade group, wants a relaxation of the ratios, which it feels are either too costly or difficult to meet, given a widely recognized nursing shortage.

The California Nurses Association, which has been at odds with SEIU as both seek to organize hospital nurses, is pressing the Davis Administration to speed up the review process and implement the ratios as they are.

"(The ratios) are a historic sea change in the delivery of nursing care in this country, and the hospital industry is going to do everything it can to undermine the process," said Chuck Idelson, spokesman for the CNA.

The Davis proposal calls for staffing medical/surgical wards, the largest in hospitals, with one nurse for every six patients a ratio that would be increased to one-to-five after an 18-month phase-in period. There also are specific ratios for labor and delivery wards, emergency departments and other hospital units.

The SEIU, which represents both registered nurses and licensed vocational nurses, seeks to beef up the ratios governing medical/surgical wards, and pediatric, telemetry and psychiatric wards. As an example, it calls for one nurse to every three patients in medical surgical wards. (The hospital industry's proposal called for one nurse for every 10 patients.)

"Nurses have made it very clear to us that in most cases they felt the (state) ratios were not adequate for safe patient care," said Glenda Canfield, nursing policy director for the SEIU's Nurse Alliance.

The hospital trade group has also specified which ratios it is targeting: those governing night shifts, emergency rooms and psychiatric units.

The industry says uniform ratios for day and night shifts on medical surgical nurses make little sense because most patients sleep at night. It also wants the emergency room ratios to account for the fact that the units can face rushes of patients from a single accident. And it is seeking a reduction in the psychiatric staffing ratios, which the state set at one nurse to every six patients, twice the association's proposal.

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