[nursebedlam]

June 14, 2004
County hospitals meeting nurse quotas

By SHANNA McCORD
Sentinel staff writer
SANTA CRUZ — Dominican Hospital and Watsonville Community Hospital, the county’s two main hospitals, are in compliance with new state-mandated nurse quotas nearly all of the time, according to hospital officials who see the adherence as a success.

The nurse-to-patients ratios were mandated by the state at the beginning of the year in an attempt to improve patient care and prevent job burnout among nurses.

Many hospitals had worried that the new law was too ambitious — that hiring nurses to meet quotas would be difficult amid statewide nursing shortages and tight health-care budgets. At least one industry group sued in an attempt to soften the requirements of the new law.

The difficulty for local hospitals in meeting the law comes during the lunch hour, when nurses leave the work area and patients are left with fewer nurses. Still, hospital officials estimate that overall noncompliance is only about 2 percent of the time.

"It’s still very difficult for us (at break times)," said Linda Starn, Dominican Hospital’s nurse executive. "The nursing shortage is still here."

Watsonville officials say they face the same dilemma during breaks.

"Complying with that minute-by-minute requirement is hard," said Suzan Rowan, Watsonville’s interim chief nursing officer. "We struggle on some days."

The new law specifies there must be one nurse for every two patients in a critical care unit; one nurse for every two patients in active labor; and one nurse for every four patients in the emergency department.

Repeated noncompliance could prompt an investigation by the state and in the most egregious cases, denial of Medi-Cal and Medicare payments.

A lawsuit filed by the California Healthcare Association — the lobbying arm of the hospital industry — sought an exemption during break periods. But the suit was rejected last month by a Superior Court judge in Sacramento.

A Dominican nurse since 1980, Barbara Williams, 59, attended a rally at the Capitol on the day the court’s decision was made. She was among several hundred registered nurses from across the state who gathered in support of the new ratios.

"The ratios make nurses feel safer and less frustrated," said Williams, a nurse in the psychiatric emergency unit. "Now they’re doing what they went into nursing to do."

Mary Kelly, 46, a medical surgical nurse at Watsonville Community Hospital said the new law has been a great relief, despite not being able to take a lunch break at least once or twice a week.

"Personally I like to spend time with families when they’re in the room and explain how the disease is going to progress," Kelly said. "With more patients, I don’t have time to do that."

Dominican administrators are heavily recruiting, but still find it difficult to balance retirements and nurses who move out of the area.

There are roughly 40 open nurse positions on Dominican’s 420-member staff. Most of the vacancies are currently filled by traveling nurses.

"Every month we’re hiring," Starn said.

Watsonville has about five nurse openings on its staff of 245.

http://www.santacruzsentinel.com/arc...es/02local.htm