"ratios"? and pay in California?

  1. I keep seeing some mention of "ratios" in the "everybody moving to California" thread. But I have not seen any explanation of what that means. I'm wondering if someone could tell me.

    Also I am wondering what is thry typical pay in California for a starting R.N.... I have seen everything from high twenties per hour to 40 per hour in that thread. Is there really that drastic of a fluctuation from one place to the next?
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  2. 48 Comments

  3. by   norcalRNstudent
    pay can really differ from area to area. Here in the bay area, new grads start at about $40 an hour. Ratios dictate how many patients one RN can have, med-surg is 5-1, and icu/ccu is significantly lower. When I was in Peds, it was 4-1, if I remember correctly. Mother baby is 2 couplets, so 4-1.
  4. by   Sheri257
    It's actually the Ratio Law, which the California legislature passed in 2000 and took effect in 2005. We're the only state that has it.

    It basically mandates maximum patient loads that can be assigned to each RN in hospitals. For example, in Med-Surg, an RN can't get more than five patients. Same for Telemetry ... five patients. For units like ER and Stepdown ... it's four patients. Maternity ... two couplets (mother and infant). Peds ... it's also four.

    The ratio law ensures safe staffing levels. In other states, for example, it's not unusual for RN's to have eight patients in Med-Surg ... instead of only five mandated by California law.

    And, by the year, 2008, the ratio law will reduce patient loads even further. For example, ratios in Med Surg and Telemetry will drop from five patients to four.

    The ratio law basically ensures better working conditions for RN's. I hope this explains it.

    :typing
    Last edit by Sheri257 on Oct 8, '06
  5. by   Halinja
    Pay in my area of california starts at about 23 an hour for new RN. Yes, there is the ratio law. But there are ways for hospitals to get around it, they can say they have a staffing emergency and poof, there go the ratios. Not saying it happens all the time, but it does happen.
  6. by   Sheri257
    Quote from Halinja
    But there are ways for hospitals to get around it, they can say they have a staffing emergency and poof, there go the ratios. Not saying it happens all the time, but it does happen.
    Well ... if they're doing that, it's illegal and should be reported.

    Schwarzenegger tried to get the ratios suspended for emergencies but several courts ruled he couldn't do that.

    If they're suspending ratios they can also lose their Medicare and MediCal funding. The RN's at that facility should report them.

    :typing
  7. by   gauge14iv
    And some cut all of the Nursing assistants and techs and secretaries loose too to reduce costs...meaning the RN's do more work, even though they may have fewer patients.
  8. by   Sheri257
    Quote from gauge14iv
    And some cut all of the Nursing assistants and techs and secretaries loose too to reduce costs...meaning the RN's do more work, even though they may have fewer patients.
    Although I haven't seen it personally (all of the hospitals I've been in still have aides), I have heard of NA's being cut. I haven't heard or seen unit secretaries or techs being cut. One hospital did cut all of the NA's in a union dispute the RN's. Two days later, a patient committed suicide because without the NA's, there wasn't enough sitters. That made the paper ... not good for the hospital.

    Nevertheless ... if a hospital wants to cut the NA's ... there's plenty of other places for RN's to work that still have aides. If they want to anger the RN's and prompt them to quit ... so be it. The hospital is only hurting themselves because without enough RN's, they can't take more patients.

    :typing
    Last edit by Sheri257 on Oct 8, '06
  9. by   gauge14iv
    Quote from lizz
    because without enough RN's, they can't take more patients.
    Can't and Shouldn't are two different things. There are many ways to get around the ratios, any number of people will tell you that.

    I'm sorry - I know you are a big fan of the ratios, and they have helped in some places, they just are not the panacea for every overload. Just because it's a law doesn't mean there are not ways to get around it. And sure nurses can quit and go elsewhere, but a lot of them don't. That is exactly what the problem is to begin with. Not that there are or are not ratios.

    I know that as we evolve in our careers we learn to see different aspects of problems. I remember thinking a lot of the same things that you do 15 years ago. Time and experience will show you things that no one can tell you. Much of it is stuff you have to see and experience on your own in order to have a full view of it. I'm not belittling you - I appreciate where you are, but by the some token, I would ask that you appreciate where some of us are too.
    Last edit by gauge14iv on Oct 8, '06
  10. by   Sheri257
    Quote from gauge14iv
    I'm sorry - I know you are a big fan of the ratios, and they have helped in some places, they just are not the panacea for every overload. Just because it's a law doesn't mean there are not ways to get around it.
    I'm a big fan of ratios because I've seen it with my own eyes. Is it a panacea? Of course not. But I have not personally seen any violations of ratios in the hospitals I've been in.

    I invite any California RN to post any ratio violations they've seen personally. Maybe it should be a separate thread, even.

    :typing
  11. by   pickledpepperRN
    I am certain patients are now alive who wouldn't have been saved before the ratio law.
    I have been working in California hospitals in five decades.
  12. by   Sheri257
    Quote from spacenurse
    I am certain patients are now alive who wouldn't have been saved before the ratio law.
    I have been working in California hospitals in five decades.
    Spacenurse:

    What's your take on ratio compliance? Have you seen many violations?

    Because I haven't seen any. I've worked in two hospitals and, done clinicals in a dozen hospitals as well. If there was an ongoing problem with compliance ... I would think I'd see at least one violation due to the fact that I've been in these facilities day in and day out ... but I haven't.

    I've only heard of two violations on other units (not ones to which I was assigned) ... but I was also told they were quickly corrected.

    What's your experience?

    :typing
  13. by   Halinja
    Okay, I 'fess up. I haven't actually SEEN ratio violations. I was told by someone who has been a CNA in the area hospitals for several years that she had seen it happen a lot. I did take her word for it, as I have little actual experience. It bummed me out that they could 'get out of it', so if the hospitals can't, and are actually living up to the ratio's then WOOHOO!
  14. by   Sheri257
    Quote from Halinja
    Okay, I 'fess up. I haven't actually SEEN ratio violations. I was told by someone who has been a CNA in the area hospitals for several years that she had seen it happen a lot. I did take her word for it, as I have little actual experience. It bummed me out that they could 'get out of it', so if the hospitals can't, and are actually living up to the ratio's then WOOHOO!
    Well ... maybe she's confused. CNA's don't have ratios, although they really should because the patient loads they get are horrible.

    CNA's do need ratios but, the law only mandates ratios for RN's in hospitals, not CNA's.

    :typing
    Last edit by Sheri257 on Oct 9, '06

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