Traveling nurses help hospitals obey new law

Thursday, January 1, 2004
Traveling nurses help hospitals obey new law
By EMILY BERG/Staff Writer

VICTORVILLE — A new state law becomes effective today, causing local hospitals to find innovate ways to meet mandated minimum nurse staffing levels and possibly curtail elective surgeries or turn away patients.

St. Mary Medical Center and Victor Valley Community Hospital are struggling to find enough nurses to meet the nurse-to-patient staffing ratios due to a national nursing shortage. Both plan to use traveling nurses to cover positions in the short term, hospital officials said.

But once they have enough nurses hired, hospital officials worry about an influx of patients beyond their ability to staff, which would force them to close beds and deny care to patients.

Victor Valley Community Hospital officials expect long emergency room waits and eventually having to deny patients care as a result of the ratios.

"We'll reach a point where we have no nurses to access, then we won't be able to admit patients," said John Zimmerman, the chief nursing executive.

The Victorville hospital plans to use registry personnel and traveling nurses — nurses that travel to fill hospital vacancies on a temporary basis — to fill the holes in its staffing levels. But already there aren't enough traveling nurses to meet the area's need for nurses, Zimmerman said.

The hospital recruited 15 new nurses from the Philippines. Officials are also making sure the hospital's salaries are competitive for the area and offering signing bonuses, as well as recruiting bonuses, to current employees who attract new nurses.

St. Mary Medical Center is working with a contract company and traveling nurses to meet the required ratios, but all the nurses won't arrive before the law goes into effect. The hospital will ask the state for approval to adjust the ratios as they're able to meet them, said Judy Austin, senior vice president and chief nursing officer.

Austin expects the hospital to be ready by late January.

The hospital hired new nursing graduates from Victor Valley Community College, who won't be able to handle a full load of patients right away, Austin said.

The hospital must track nursing ratios 24-hours a day and report any problems to the state, Austin said.

"This would not compromise any care," she said.

If staffing levels don't meet patient demand, the hospital would look at closing elective procedures first, then close beds, Austin said.

"That's no different than what we've done in the past," she said.

Desert Valley Hospital is prepared to meet the new ratios, said Carl Tate, spokesman for the hospital.

Hospital officials worry that an influx of patients could force them to deny care or violate the staffing levels, Tate said.

Hospitals that violate the staffing levels must come up with a corrective plan, but there are no fines or other form of discipline in place, according to the California Department of Health Services.

The ratios are part of a 1999 law signed by former Gov. Gray Davis that made California the first state in the nation to require nurse-to-patient staffing ratios. The mandate extends staffing levels to hospital departments that previously did not have nursing ratios — medical-surgical, psychiatry, oncology and telemetry units.

The ratios for burn, post-anesthesia care, labor and delivery units will be one nurse for every two patients.

For pediatric, emergency rooms and "step down" wards — the level of care between intensive care and a regular hospital room — the ratio will be one nurse to four patients.

Oncology and telemetry wards will have a one-to-five ratio, and medical-surgical units, psychiatric and mixed units will have a one-to-six ratio.



Emily Berg can be reached at emily_berg@link.freedom.com or 955-5358.