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NURSE STAFFING RATIOS
California Hospital Association California Hospitals Remain Committed to Providing Appropriate Nurse Staffing to Meet Needs of PatientsProposed Nurse Ratios Add Focus to
Nursing Shortage, OPEN printable Microsoft Word® document — .doc file. (23 Kb) Governor Gray Davis today released a set of proposed nurse staffing ratios, as required by state law (AB 394, 1999). The proposed ratios are the first-ever attempt by any state in the nation to establish a predetermined ratio of nurses to patients in the various services of acute-care hospitals. These proposed ratios will be subject to the normal state regulatory process. This process will involve numerous opportunities for public input. The Governor's announcement represents more than two years' of work by the state Department of Health Services (DHS), which was charged with developing the proposed ratios. DHS' efforts were far from easy, since research on staffing ratios is limited. California's hospitals already do whatever is necessary to provide adequate nurse staffing to meet the needs of their patients. This includes staffing based on the acuity of the patients' condition, innovative recruitment and retention efforts, and the use of nurse registries and traveling RNs. Whatever staffing standards are ultimately adopted following the regulatory process, California's hospitals will comply with the new law. However, because we face the most serious nursing shortage in the nation, some hospitals may have to shut down some services or significantly reduce the capacity of their services in order to comply with the law. Statewide, California hospitals currently are operating with a more than 15 percent RN vacancy rate - meaning that more than one out of every 6 nursing positions in hospitals is not filled with regular hospital employees. Nurse registry and traveling nurses are used to fill the gap. California hospitals are under severe financial stress. Nearly two out of every three hospitals lose money on operations. Manufacturing money to pay for more nurses is not possible, and the continual ratcheting down of payments to hospitals by government agencies and private payors is making the situation even worse. Several California schools of nursing have closed or cut back their enrollment, thereby reducing the number of nurses who are available. With an average age of 47 years, the California RN workforce is headed for disaster. Once the proposed staffing ratios are in effect, the nursing shortage may become even more acute and access to patient care services may be jeopardized. For example, if a hospital has 10 treatment bays in its Emergency Department (ED) but only has enough nurses to staff five of those beds and be in compliance with the law, half of the hospital's ED capacity may have to be taken out of service. The net result would be less access to emergency care services in a local community. The California Hospital Association (CHA) has consistently maintained that it is in the best interest of patients to base staffing decisions on the actual needs of patients at any given time. Patients' conditions often change by the hour, and hospitals face a continual turnover of patients with diverse medical needs, all of which impact staffing requirements. Hospitals have deployed nurses on this basis for more than a decade. CHA will analyze the proposed nurse staffing ratios released today and will comment and provide input to DHS officials throughout the regulatory process. Contact: Jan Emerson, (916) 552-7516. |
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