Nurses at Sutter Solano say ratio isn't being met

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Nurses at Sutter Solano say ratio isn't being met
By Rachel Raskin-Zrihen, Times-Herald staff writer

Nurses protested on Sutter Solano Medical Center's front steps Monday, claiming the hospital is defying new nurse-to-patient ratio regulations.

A news conference on the Vallejo hospital's front steps followed a two-hour protest as day shift nurses refused to take over for the night shift without the proper nurse-to-patient ratio, nurses' union representatives said. Hospital officials said they are, and have been, staffing within the letter of the new law.

Nurses and hospital administrators are at odds over the fine points of the new rules that were mandated to go into effect Thursday. Hospital administrators insist the new law permits scheduling licensed vocational nurses (LVNs) as well as registered nurses (RNs) to meet ratio requirements. The RNs disagree.

Sutter Solano, which union officials call "one of the worst-staffed hospitals in the Bay Area," is part of a lawsuit filed by California Healthcare Association on Friday against the state's Department of Health Services. The suit demands the wording of the new nurse staffing regulations be modified to make compliance easier.
The Sacramento Superior Court lawsuit seeks to change the language that calls for staffing ratios to be maintained "at all times" - making compliance difficult for most hospitals, officials said.

"Each hospital has a different situation, and its own challenges with recruiting and hiring nurses," said Barbara Harrelson, regional vice president of the Hospital Council of Northern and Central California.
"Sutter, I'm sure, is making its best effort, but most hospitals are not in compliance with the (mandated) ratios at all times. That means if a nurse goes to the bathroom, there needs to be another nurse ready to step in. This could mean that some emergency rooms would have to close, or hospitals curtail services or shut down beds (if they're short a nurse at any given time)."

Kaiser Permanente Medical Center-Vallejo officials say their hospital isn't experiencing such a nursing shortage. Kaiser officials said that's because of early and aggressive recruiting.
Harrelson said it's a case of comparing apples to oranges. "Kaiser is a very large organization with a lot of resources," Harrelson said. "Sutter is a much smaller community hospital. They're doing everything they can to recruit and retain nurses. It's not a good comparison."

Allan Brill of the California Nurses Association (CNA) led the nurses' action Monday. He and Liz Jacobs, a CNA spokesperson, said they don't accept the hospital's explanations.
"There's been a problem with Sutter Solano historically," Jacobs said. "They give the nurses very large workloads. They're very profitable - the whole Sutter chain is. But they're not even close to meeting the ratio. We don't feel Sutter has been dealing with this in good faith."

Jacobs and Brill said it's not unusual for RNs in Sutter's medical-surgical unit, where the ratio is supposed to be a maximum of six patients for every nurse, to be caring for up to 12 patients at once. Sutter officials said they've been in compliance with the mandated ratios for more than a year, since they have LVNs taking care of patients, too.

The protest began at 7 a.m. Monday when the day-shift nurses showed up to work but refused to take their assignments because there were too few RNs scheduled, Brill said.
Members of the other hospital workers' union , which include LVNs, have forged an alliance with the RNs. As a result, four LVNs were sent home Monday as punishment, said their union representative, Noah Kincaid of the Service Employees International Union (SEIU) Local 250.

The nurses said they believe Sutter administrators are trying to "divide and conquer," by pitting RNs against LVNs and other support staff. Brill said the nurses won the first round when at about 9:30 a.m. hospital officials agreed to the mandated 6 to 1 RN staffing ratio, but it was a hollow victory.

"It was a trick," Brill said. "They swore the 6 to 1 ratio would never happen here, so this is a major victory for our nurses. But they discovered, when they got on the floor, that their support staff had been sent home."

Terry Glubka, Sutter's chief of patient care, said the hospital just didn't need the extra help.

"We are absolutely confident we are meeting the letter of the law, and are not required to exceed our ratios," Glubka said. "We were very surprised and concerned when the RNs refused to take care of patients. The disruptions this caused created patient-care problems, so we decided to agree to the union demands for the day shift. But our needs didn't require more nurses."

Brill said it's more than providing more jobs for higher-paid RNs. Lives are at stake, he said.

"We know patients die from nursing mistakes - when you have 10 balls in the air at once, you're bound to drop one once in a while," Brill said.

The hospital has offered to use more licensed vocational nurses who receive less training and less pay than RNs, to take up the slack, but union officials say that's not the answer.
"They want to use more LVNs on primary care assignments, but that's not safe," Brill said. "We need them as part of the team.

It's a miracle we haven't had more tragedies here.

"The nurses are determined to set this right because they really care about the patients, here. They're not going to endanger their patients, or their licenses, not to mention their consciences."
Glubka, an RN, said Sutter is meeting the letter of the law and also regards patient care as its main priority. She said the patient-care team the nurses say they want is exactly what the hospital wants, and has been doing "for years."

Nurses intend to stage actions similar to Monday's "every shift, every day," until hospital officials agree to "staff appropriately, instead of trying to go on the cheap, until they see they can do it, and it can work," Brill said.

"It will be good for everyone, because they'll be better able to recruit and retain nurses, instead of having them make the 10-minute walk to Kaiser where they have safe staffing levels," he said.