Hospitals Will Challenge New Nurse Staffing Ratios

By LAURENCE DARMIENTO
Staff Reporter

Although labor emerged as the clear victor last week when the state finally issued nurse-to-patient staffing ratios, the hospital industry is likely to fight at least some of the plan.

Industry officials said they are mostly concerned about meeting the ratios affecting emergency rooms.

The California Healthcare Association, the industry's trade group, sought ratios of one nurse for every six patients, while the California Nurses Association and Service Employees International Union sought ratios of one-to-three patients, depending on if the patients were trauma, critical or regular ER visitors.

The state essentially sided with labor, proposing individual nurses care for no more than either a single trauma patient, two critical care cases and four regular patients.

The industry's primary concern about the ratios is that there aren't enough nurses around to fill them, a concern in particular with ER nurses since they have specialized training. The region's and state's emergency rooms have become notoriously overcrowded, routinely turning away patients when they are filled.

"There aren't enough nurses there (in ER) now," said Jan Emerson, vice president of external affairs for the trade association. "If you have a 10 bed ER department and you only have enough nurses to supply five of those beds you may have to shut down half your treatment bays.

The hospital industry will have a chance to make its case again. Before the ratios can be implemented, which even Gov. Davis acknowledge will not happen before the summer of 2003, the state's health agency must release detailed regulations and data.

That will open up a comment process, and the possibility that ratios could be altered. However, the nurses unions are not expected to budge on the proposed ratios.

The SEIU is saying that if anything, it may push for tougher ratios in some hospital wards, while the CNA, which sponsored the 1999 bill that gave rise to the ratios, took a dim view of any changes.

The industry can also forget about using the courts for any relief, since the regulations emerged from a 1999 state law, said Jim Lott, executive vice president of the Healthcare Association of Southern California.

Overall, the ratios call for one nurse to every six patients in medical-surgical wards, the largest wards in hospitals. That ratio would be reduced to one-to-five after an 18-month phase in period.

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