Emergency' Ruling on RN Ratios Endangers Patients

U.S.A. California

Published

http://www.calnurses.org/cna/press/

For Immediate Release November 4, 2004

Contact: Charles Idelson, 510-273-2246

California Nurses Blast Gov. Decision to Erode Safe Staffing Law

'Emergency' Ruling on RN Ratios Endangers Patients

The California Nurses Association condemned a decision by Gov. Arnold Schwarzenegger today, at the behest of the multi-billion dollar hospital industry, to suspend major provisions of California's law requiring safe registered nurse-to-patient staffing ratios, an action "that puts tens of thousands of Californians at risk," said CNA President Deborah Burger, RN.

Schwarzenegger issued an emergency regulation that means:

* Ratios for Medical and Surgical units, where about one-third of all hospital patients are placed, will not improve on January 1, 2005, as required by the 1999 law sponsored by CNA. The ratios are currently one RN for every six patients and were to improve to one RN for five patients on January 1, 2005. The ruling says that the safer staffing will be delayed for three years while the Department of Health Services conducts a study of the effects of the law.

* Emergency Room ratios would be seriously undermined. The ER ratios, Burger noted, have improved the quality of care in emergency rooms and reduced waiting times. By rolling back those gains, patients will have longer waits for care, and more patients will undoubtedly leave without getting the medical care they need.

Under California's rules for emergency regulations, Schwarzenegger has the authority to suspend laws or regulations for up to 120 days, subject to approval by the state's Office of Administrative Law. However, the law permits extensions beyond the 120 days.

CNA said it will take its own emergency actions in response to the announcement, including a mobilization at the Governor's office at the Capitol on December 1, one month before the improved ratios in Medical and Surgical units were scheduled to go into effect.

"The governor's action today shows a disregard for patient safety in hospitals at a time when every major medical institution in the nation has documented that safe RN staffing saves lives," Burger said. (See examples of those studies below)

"With his action today, Gov. Schwarzenegger has shown he is more concerned with hospital industry profits than with the safety of all of us who will one day be patients," said Burger.

Schwarzenegger's ruling also "threatens the progress we have made in California in reducing the nursing shortage. This irresponsible public policy could actually exacerbate the nursing shortage at a time when those hospitals that have complied with the law have seen their vacancy and turnover rates sharply fall. The ratio law is a major reason why more nurses are coming into California and why more RNs are staying at the bedside."

Since June 30, 2000 (six months after the law was signed) the overall number of actively licensed RNs in California has increased by more than 43,000 in the past four years, from 250,123 to 293,493 as of September 30, 2004.

CNA noted that despite a long campaign by hospital industry opponents to overturn the law, the state has issued only 9 citations of violations of the law based on hospital industry complaints to the state.

CNA also rejected the hospital industry arguments that California hospitals or emergency rooms have closed and that the industry as a whole is in economic peril as a result of the ratios. "The closures that have occurred are not related to the ratios, but to long term economic problems that far predate this patient safety law," said Burger.

"A major reason for economic problems for psychiatric units are cuts this governor has made in mental health funding for counties, including money that counties use to reimburse private hospitals for in-patient psychiatric services," Burger added.

"Overall, the data clearly shows that the vast majority of California hospitals continue to make substantial profits, and when hospitals go on the market, there is a rush by others in the industry to acquire them," said Burger.

* California hospitals reported about $3.9 billion in profits just in 2002, hardly a sign of a floundering industry. $20.4 billion was spent in California on hospital mergers from 1993-2003, an average price per bed of about $338,000.

CNA cited at least three major studies linking ratios to patient safety.

* Inadequate staffing precipitated one-fourth of all sentinel events - unexpected occurrences that led to patient deaths, injuries, or permanent loss of function - reported to JCAHO, the Joint Commission on Accreditation of Hospital Organizations, the past five years.

* Research in the Journal of the American Medical Association found that up to 20,000 patient deaths each year can be linked to preventable patient deaths. For each additional patient assigned to an RN the likelihood of death within 30 days increased by 7 percent. Four additional patients increased the risk of death by 31%. (JAMA, October 22, 2002

* A New England Journal of Medicine study documented that improved RN-to-patient ratios reduce rates of pneumonia, urinary infections, shock, cardiac arrest, gastrointestinal bleeding, and other adverse outcomes. (NEJM, May 30, 2002)

PDF flyer:

http://www.calnurse.org/press/1104_Ratios_RN_Alert.pdf

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What you can do:

* Email the governor at [email protected] and cc CNA at [email protected]

* Call Governor's office at 916-445-2841, ext 7, during business hours (M-F, 9-5) and leave a message telling the Governor

"I am a Registered Nurse from (city) and I oppose any weakening of the safe staffing law

* Come to the Capitol on Wednesday, December 1 to protest these changes

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Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac.

Thanks. Hmmmm.....a republican catering to big business. Opps...wrong thread, sorry. Only joking.

Seriously, it's a maddening situation for them to have come so far to get slapped in the face like that. Thanks for the post.

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Thanks. Hmmmm.....a republican catering to big business. Opps...wrong thread, sorry. Only joking.

Seriously, it's a maddening situation for them to have come so far to get slapped in the face like that. Thanks for the post.

Tweety:

Many others agree with you. He even said he wants to get rid of the pesky regulations that businesses have to contend with!

Will it soon be OK for restaurants to have pet rodents and insects?

http://arnoldwatch.org/

ArnoldWatch Web Log: - Nov 05, 2004 - 09:55 AM

Terminating Patient Care

by: Jerry Flanagan

Sign up to receive free web logs via email

It was stories of patients who died of neglect in California hospitals, like 47 year-old Dwight Lobb, that led to the state law requiring adequate nurse-to-patient ratios. But, flush with $150K from hospital giant Kaiser, Arnold has suddenly targeted these ratios for termination.

The Lobb family already knows what other California families will soon find out under Arnold's plan: hospitals become death traps when company executives look to increase profit margins by cutting back on first-responders -- the nurses. David Lobb died of internal hemorrhaging while left unattended and unmonitored for an hour and a half after complaining of severe pain and abdominal spasms. There were simply not enough nurses on duty to care for even the sickest patients.

Under the governor's plan, hospitals - like big contributor Kaiser - will be allowed to under-staff surgeries and medical procedures until 2008. For the most critical care patients in Emergency Rooms, Arnold's changes will allow hospitals so much flexibility that enforcing the rules will be all but impossible. In addition to the kind of life saving attention that only ER nurses can provide, the new rules have improved the quality of care in emergency rooms and reduced waiting times. By rolling back those gains, patients will have longer waits for care, and more patients will undoubtedly leave without getting the medical attention they need.

Apparently Arnold's adrenaline rush of special interest support during the election has made him numb to plight of patients. What the gov didn't say when he pledged to be a "governor for the people" was that hospital owners and their shareholders, not patients, were the people he meant to serve.

Read more at http://www.ArnoldWatch.org

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All those steroids he took years ago must have rotted his brain....idiot. :angryfire

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AND I'll say it again. Arnold is an ACTOR..............not a governer!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!ARGGGGGGGG!

It reminds me of a construction worker doing cardiovascular surgery.....or VISE VERSA.

or my husband, a fireman, coming to take care of my patients!!!!!!!!!

It DOESN'T GO....................

Stick to the body building, and he's not such a great actor either. :uhoh3:

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AND I'll say it again. Arnold is an ACTOR..............not a governer!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!ARGGGGGGGG!

It reminds me of a construction worker doing cardiovascular surgery.....or VISE VERSA.

or my husband, a fireman, coming to take care of my patients!!!!!!!!!

It DOESN'T GO....................

Stick to the body building, and he's not such a great actor either. :uhoh3:

If Arnold's proposal to negate the staffing ratios is accepted, he will truly become The Terminator!

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I just wrote and got my tickets to attend in Sacramento December 1st from 11:00 am to 1:00 pm.

If you cant go you can still e-mail or write the Governor.

http://www.calnurse.org/press/1104_Ratios_RN_Alert.pdf

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