California proposes nurse-patient ratios

CNN.com ^ | 23 January, 2002 | Associated Press

[ThJ1800]

LOS ANGELES, California (AP) -- Gov. Gray Davis has proposed strict staffing rules in hospitals that would mandate the number of nurses assigned to each patient.

The new rules, which still must go through a normal regulatory review process, would make California the first state in the nation to set minimum nurse staffing levels.

[KantianBurke]

And the moral of this story is?

[marajade]

And if a hospital can't staff enough nurses does that mean they have to turn away patients?

[LaineyDee]

California ranks second to last among all states in terms of nurses per capita, Emerson said.

I hate to burst their bubble....but it isn't just staff/patient ratio that keeps nurses away....IT'S PAYOLA. I haven't had a pay raise in 5 years. What other industry would tolerate that?

[Whey]

I am taking a wait and see on this one. While I DETEST regulating ANYTHING, I do see where this is coming from.

I am a nurse and I know that hopitals will pile the patients on even when they lose and drive away their nurses. It makes NO SENSE! Patient ratios are so high that nurses are leaving in droves (I being one of them) yet the hospitals continue to understaff, over load and under pay.

Seems like when a hospital has to close a unit because of a lack of nursing staff they would get a clue. But they just don't.

[ThJ1800]

Good question. Another point. If hospitals must have a particular nurse to patient ratio, then they will have to hire more nurses, which in turn will increase the cost of health care for individuals, thereby requiring the state to provide more assistance to these individuals. Or else, they'll just take over the health system.

[ThJ1800]

I too understand where they are coming from, but if hospitals do not want to pay their nurses in the first place, might they attempt to cut costs in other areas?

[Whey]

I worked at a University Hospital in Dallas. That hospital closed an entire floor and told the specialized nurses that they employed to find another area or leave. Most left. These nurses had YEARS of experience. One month later the floor was "re-opened" and staffed with new graduates. The most dangerous thing a nurse can get is experience. When you work hard, make the cut, you get laid off so the hospital can hire new grads making much less than an RN with years of experience.

[a_witness]

And the moral of this story is? States' Rights

[a_witness]

I too understand where they are coming from, but if hospitals do not want to pay their nurses in the first place, might they attempt to cut costs in other areas?

Sure, what do you advise when you require hospitalization ?
1. The cheapest doctor money can buy
2. The cheapest equipment money can buy
3. More patients per room, preferably in the open air
4. No food service, the family can bring it in or you do without.
5. No pharmacy service, the family can bring it in or you do without.
6. No lawsuits or insurance, if they make a mistake tough for you.
7. British Medicine
8. Canadian Medicine

[Faraday]

The consequences, "unintended" or not, are clear. An increase in costs, which the state, i.e. tax payers, will bear a large part of via Medicare and Medicaid. Insurance costs will increase to cover it as well. Marginal hospitals will close. Nurse wages may increase, but not necessarily. This is creeping Hillary Care and should be opposed. The government does not belong in the health care sector (except to ensure access to the most indigent). Social engineering to redirect social investment from other sectors to health care does not further liberty, but does further restrict it.

[ThJ1800]

When you work hard, make the cut, you get laid off so the hospital can hire new grads making much less than an RN with years of experience.

Obviously shooting for quality care.

[Dog Gone]

I want the government to mandate a DMV clerk-to-people in line ratio, and leave private enterprise alone.

If this becomes the trend, then let's take it to its logical consequences. Every business is subject to having its employees amounts set by bureaucrats. Not enough cashiers in the checkout lines at the supermarket? Write your congressman!

Want more flight attendants on the planes? Write your senator.

Want faster service at Kinko's? Write the Governor!

Government can't even run government right. Now we want them to run hospitals, even the private ones.

Yes, I know the problems nurses face, which is why they are quitting. The free market tends to take care of those things, such as hospitals without nurses CLOSE.

This is nothing but another Gray Davis government power grab, and an attempt to buy the Nurses Union vote.

[a_witness]

The free market tends to take care of those things,

Aside from the fact Gray Davis is Governor instead of Ronald Reagan, would you really want a state in which anyone could practice medicine without a license ?

I think the State has a bona fide interest in regulating medical care as long as there is due process.

Should they make a mistake and overregulate the industry, what's the worst that could happen ?
It's not like they could lose their electrical power ...

[unamused]

How 'bout taxpayer/flea ratios??
No taxpayer can be expected to support more that one parasite...
Naaahhh....never happen...
Politicians are all fleas....

[Holden Magroin]

Too bad most Californians are too stupid to see what is going on. The problem is that we have 3 million illegal aliens in this state who are overcrowding hospitals and don't pay taxes. But Red Davis and MALDEF insist that these "undocumented workers" be allowed to stay on the public dole at the expense of others becaue they add "diversity" to this state.

[HangThemHigh]

The word 'politician' comes from two root words

poly = many
ticks = blood sucking insects.

[unamused]

Who've never had a job...

[DoughtyOne]

Interesting thread.  Boy have I waited years to participate on it.

Nurses.  I respect what you do.  I respect the fact that some of you are treated unfairly.  I respect the fact that you are required to do more than you have ever been required to do before.  But I have to tell you something.  Believe it or not, there are actually other people that work in hospitals besides you. They are also have to provide more services than every before. And here's how they see things.

In the late 1980s and early 1990s, hospitals came under extreme pressures to reduce their costs.  What startedout as the state and federal government refusing to pay for full services in the mid 1980s, spread to insurance industry concerns doing the same thing.  How would any of you like to provide a bill for services rendered only to have the purchaser inform you that they would only pay sixty cents on the dollar?  That's what the states and federal government did.  When the insurance industry did the same thing, hospitals were screwed.  During those times (and I'm going to refer to California hospitals since I have worked in them for close to thirty years) employees across the spectrum lost wages.  Some had their wages frozen.  Others took ten or twenty percent cuts and then had their wages frozen.  Others lost benefits.  At one point I went for seven years without a raise.  I know people who went as long as twelve with a raise.  During that period of time, guess who did get raises.  Yes, it was nursing.

California has had a severe nursing shortage for fifteen years that I know of.  I'm fairly confident the shortage extended beyond that point.  The problems with nursing is that a high number of nurses enter the field, then drop out.  Some surely do it for money.  But others do it because they get married, they find they don't like the work, they take positions elsewhere in the industry or something else comes up.

Too many positions and not enough nurses creates a situation where premium salaries exist.  Nurses, I'm not sure which state you're commenting from, but during the seven year period where other staff members didn't get raises in our hospital, our nurses got five of them.  Not only that our administrators never missed a chance to stroke the nurses.  National nursing day, aw we'll give them a boquet of roses and a health club membership.  First cloudy day in March, aw well give them a gift certificate to one of three restaurants.  Let me tell you how that looked to the rest of us.  We hadn't had raises in seven years and yet the nursing staff was not only getting raises, but bonuses to boot.

As for staffing shortages and the nursing patient ratios, some of you are being more than disingenuous.  The fact is, we've had to close certain units in our hospital because we couldn't find the personel that would work.  For years we had to hire in registry nurses who would only do the work for two times the wages of a normal nurse, a premium on top of that being paid to the registry.  A lot of nurses work full time for registries.  They get double the pay and no benefits.  That may sound bad, but if the spouse has medical, they don't need the benefits anyway.  These nurses will pick up two to three shifts per week and make as much or more money that they did working full time.  And this adds to the nursing shortage.  And what's more, you know this ladies.

Let me tell you another little story.  At one point I was hospitalized with blood clots in my legs.  This created a situation where I was bed ridden and very weak.  At one point I had to ask the nurse to help me get on the bed pan.  After about fifteen minutes I started buzzing the nurse to return, because the bed pan was cutting into me.  It was quite painful and I could not move off of it.  At 45 minutes my wife came on the unit to visit.  I was in total agony when she entered the room.  She helped me. Then she wheeled around and went to the nurses station.  There she found all the nurses on the unit having pizza.

I have personally had nurses attempt to start the wrong I.V. on me.  I have had ones that were so lame that I had to help them start an I.V. on myself.  Sorry ladies.  I appreciate you stories, but you're being quite sellective in your grief.

You guys do a great job for the most part.  What you do is important and you are the front lines.  Some of you are brilliant at what you do.  To those of you who are treated unfairly, I sympathize.  I just wanted to express the view that there are more things at work than some of you intimated.

[holyscroller]

"I too understand where they are coming from, but if hospitals do not want to pay their nurses in the first place, might they attempt to cut costs in other areas?"

They could save millions in all the free health care they give to all the illegals.