California Sets Nation’s First Safe Nursing Standards

California Sets Nation’s First Safe Nursing Standards
Gov. Davis Announces Nurse-to-Patient Ratios
‘Most Effective Plan in U.S. to Curb Nursing Shortage,
Protect Patients,’ Says California Nurses Association

California has opened a new era for safe and effective patient care with the introduction of minimum nurse-to-patient ratios for California’s acute care hospitals - an innovative step that the California Nurses Association terms “the most comprehensive and effective approach in the nation to reduce the nursing shortage and improve patient care protections.”

Governor Gray Davis announced the new standards in a Los Angeles press conference Tuesday morning, standing shoulder to shoulder with top officials of the CNA which has campaigned for 10 years for enactment of this sweeping reform.

California is the first state in the nation to establish minimum nurse-to-patient ratios, and nurses and policy makers across the U.S. have been closely watching the announcement of the ratios which are expected to be a model for the country.

“With these ratios, patients will be much safer, they will get much better care, we will be able to do the job we want to do, and nurses everywhere who have left will feel they can come back into the profession,” said CNA President Kay McVay, RN.

In his statement, Gov. Davis called the ratios a “big step forward. We have to provide better care for people who come into the hospital, and more nurses means better care.”

The new rules spell out minimum numbers of licensed nurses needed to assure patient safety throughout the hospital setting, depending on the unit. For example, the ratios would be at least one nurse for every four patients in Emergency Rooms, and one nurse for every five patients in Medical and Surgical units after an initial phase in period of one year to 18 months. Next up is a public comment period, probably over several months, after which the ratios will be finalized.

McVay noted that the ER ratios, which are effectively 1:3 because the rules specify that the triage nurse is not to be counted in the numbers, are especially significant due to “an alarming crisis in emergency care with closures and long patient waits often because of poor staffing.”

The ratios are mandated by AB 394, the CNA-sponsored Safe Staffing Law signed by Governor Gray Davis in October 1999. Next up will be a public comment period probably including statewide public hearings over the next few months after which the ratios will be finalized.

CNA President Kay McVay, RN, said the new ratios a “will produce profound improvements in the hospital patient safety net. Ratios will make a dramatic difference to patients and their families who live in fear of long waits for access to medical care or whether there will be safe nursing care when they need to go to the hospital.”

With ratios, there will be a minimum, consistent, enforceable standard for all hospital units. California has had ratios for intensive care units for a quarter century - and the law has worked spectacularly well. Now all hospital patients can expect the same level of protection.

“Safe ratios should also have a substantial impact on the hospital nursing shortage,” McVay continued. “Dissatisfaction with unsafe hospital conditions has produced an exodus of nurses who are no longer willing to work in hospitals they believe have unsafe staffing and other deteriorating conditions. With safe, enforceable, and effective ratios, we finally have a basis to stabilize the nursing infrastructure, retain current hospital nurses, and recruit additional nurses.”

A common sense plan for the nursing shortage

The key to ending the shortage is 3 Rs - retention, recruitment, and retraining - all made much more likely with the implementation of safe hospital ratios.

CNA has a systematic program for retention of hospital nurses, based on improving hospital conditions through collective bargaining and increased representation for nurses. CNA is also working with Governor Davis and other elected leaders to launch a major effort for recruitment and retraining of additional nurses as well as expanded nursing education programs. Another CNA-sponsored law signed by Governor Davis last year allocates $5 million for training programs in California Community Colleges this year to expand the numbers of specialty care RNs.

“CNA and the nurses of California express our profound gratitude to Governor Davis, and State Sen. Sheila Kuehl, author of our Safe Staffing Law, for their bold vision and commitment to improving the lives of California patients and nurses with this law,” said McVay.

“Nurses and patients have long looked forward to this day with hope and anticipation that safe patient care standards can be restored in our hospitals. With the ratios no longer a dream, but a reality. We have entered a new stage. As the process unfolds, CNA will continue to be there, at the hearings to make sure the voices of direct care nurses are heard and to press for final implementation in a rapid manner.”

For more information on the ratios, see the CNA website, http://www.calnurse.org.




Charles Idelson
California Nurses Association
(510) 273-2246
(415) 559-8991