California's Nurse-to-patient Ratio Law -- Update

  1. As predicted by many, California's nurse-to-patient ratio law (also known as AB394) may not go into effect after all. Bowing to the serve nursing shortage in the State and at the suggestion of both the hospital industry and the union (SEIU) possible changes include:
    -- inclusion of LVN's and RT's to replace RN's in filling the ratios
    -- higher ratios (more patients per nurse) for the ER and
    psychiatric units
    -- different ratios for night shifts than for days
    -- delays in implementations

    The State's other nursing union (CNA) is fight these changes.

    Also, the CNA and SEIU instead of joining forces to unionize the State's medical personnel, are at each other's throats to see which will get the bigger share of the nurses' $$$$$$$$. Stay tuned for more news on this on-going soap opera.
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  2. 54 Comments

  3. by   Peeps Mcarthur
    Legislation at work for you.

    If you believe that politicians will suddenly help you after all the years of apathy over the nursing crisis, then you are a person of great faith indeed. After they have been screwing you with taxes, social security and then throwing that stolen money away on extravagant programs that never work, then I guess you would believe that they really have your best interests in mind too

    This is no suprise to me since it's well known that big business OWNS the legislators since it controls campaign contributions. I'm sure these strategies were discussed with the hospital systems before it was presented for a vote.

    Yes,unions are struggling for power. As long as we buy into these distractions the hospitals will have no fear of a CONTRACT. They know that enforcement from a government agency would be weak even if the law was written with the nurses in mind(which it wasn't).

    They're just putting off what we know is inevitible, a national union.
  4. by   Gomer
    Sorry Peeps, but AB394 was totally a union (CNA) sponsored bill with complete backing from the state/local nursing organizations.
    And CA is known to be the leader in anti-business legislation. (Just look at our wage and hour laws and the newest piece of anti-business legislation is our possible amendment to the FMLA where employers would have to pay (through taxes) up to 55% of an employee's wage if they went out on FMLA)

    I see no "conspiracy" here. But rather a good idea (staffing ratio)that was presented at the wrong time (during a nursing shortage)
  5. by   Peeps Mcarthur
    There is no shortage. There are plenty of nurses. It's a hoax to stall for time untill they can replace a bedside nurse with a more docile breed like foreign recruits, aids, assistants, clerks and anyone else that will think it's a step up.

    The bill that was proposed by the union could not have made it through as it was written, because it is merely being sidestepped with the same old lame excuse. I don't think they would have worded it so the hospitals could shirk thier responsibility once again..........do you?

    What I'm saying is that legislation is impractical and unenforceble isn't it? If the hospitals are indeed understaffing anyway, then what good is the legislation? Why didn't this get taken care of in the original wording or get put in if they really meant to enforce it? It seems there was a built in "out" for the hospitals.

    Answer: because they never meant for it to be enforced.

    I imagine that the original document bares little resemblance to the finished one.

    By the way, why would a union want to go to the trouble of getting a law passed when it could simply put the wrording on the negotiating table where it would have some teeth? Anybody closely associated with the bill could have seen this comming.
    Last edit by Peeps Mcarthur on Jun 24, '02
  6. by   Gomer
    Darn if I can answer your questions...I don't belong (and never will) to a union. Maybe you can find the answer(s) on the CNA website. (That's where I got my information)
  7. by   Peeps Mcarthur
    The seiu looks like they're trying to represent more of thier membership, not change ratios. Even thought there's a local chapter in my hometown, I don't think I would be part of a union that didn't have nursing as its only interest. What a freaking smorgasborg of issues to have to deal with effectively without having a conflict(as is the case in California). The way you worded it, your post implied that the seiu and the hospitals were BOTH in bed together on the changes.

    Looks as if the CNA is upholding their end of the bargain but the legislators, hospitals, and the seiu through representing the interest of as many of its members as it can, has delayed progress. It looks as if the CNA has alot of contract talks going. It looks like they're getting nurses what they want.

    I can not understand why you would be opposed to unionizing unless you are on the recieving end Since you seem to feel that is "anti-business". Maybe it just makes you uncomfortable. Some people think it's like the teamsters smashing heads or something.
    It's just contracted morality.

    What is FMLA?

    It looks as if the bill was killed successfuly before they had to resort to the wording changes. The politicians get credit for "trying", The hospitals get credit for presenting "solutions", and the nurses................the usual.
  8. by   Gomer
    FMLA is the Family Medical Leave Act

    I'm anti-union because I was born (many, many moons ago) and raised in the West. We are an independent lot, very rarely part of a group, strong believe in being self-sufficient, individual.

    If I have a problem with my boss(es) or he/she with me I meet with that person face to face. I don't want or need a third party speaking for me.
  9. by   Peeps Mcarthur
    I lived on the "Left Coast" for awhile and I get what your saying.

    If that strategy works(and your a nurse) fill us all in. I have seen many a discussion on the subject of communicating with management"suits" and they never seem that straightforward.

    If you're in management, then I can understand your apathy over changing your bonus schedule to suit a few nurses that you think should be lucky to have a job to manipulate them with.

    If you are a nurse, then we all want to work for your boss who treats you so nicely. I don't sense any of the typical nursing issues with you.

    Good for you.
  10. by   -jt
    <By the way, why would a union want to go to the trouble of getting a law passed when it could simply put the wrording on the negotiating table where it would have some teeth?>

    Because its not so simple to get wording on staffing ratios into the contract, facility by facility. And because even when you do, it only applies to the nurses at that facility - what about all the other working nurses who do not have a contract or a union?

    In NY, our state assoc has many contracts with this wording - and its the nurses at each facility who get to decide what that staffing ratio will be. Our nurses at one hospital have had staffing ratios in their contract since the early 1980s - but the majority of the hospitals fight tooth & nail to resist putting this into the contract at all. This is what the last 3 yrs of RN strikes have been about.

    Last year nurses in upsate NY were on strike for 6 months for it... & finally got it. Nurses on Long Island just succeeded in getting this language also - after 111 days of strike recently. At my hospital, we came down to the wire 2 years ago & took a strike vote because the hospital was refusing to even consider discussing staffing ratio language. We gave an overwhelming 98% vote to strike over it & 6 days later the hospital agreed to our staffing ratios & we called off the strike before it happened. We now have unit by unit, floor by floor ratios - along with the ability to enforce it thru arbitration.

    But that language doesnt come easy or simply by any means.

    We do not yet have safe staffing laws passed in this state but those bills (written by nurses in our state assoc) are in the legislature - being lobbied hard against by the hospital associations - so who knows how long it will be before all working nurses are protected from unsafe staffing. The solution would be for all of them to unionize & then do what they had to do to get it into their contracts. Still, too many nurses are not willing to go the distance on this one.

    One other thought, The problem with a union that represents all categories of workers, no matter how good or strong it is, is evident in the part of the article that says the SEIU is pushing for RNs to be replaced with lesser skilled workers. Most of its members are those workers & some of its members are RNs. How can it fight for RNs issues when it has to promote the majority of its other members - which may be at the expense of its RN members?

    If its giving in to the hospitals on an issue that is of major importance to the RNs, because it will benefit the rest of its workers & add jobs for them, thats not really well-representing ALL of its members. Its playing the larger group against the smaller group.
    A conflict.

    Thats why I personally prefer being part of an RN-only union that can concentrate on just my issues as an RN & not have to give in to everyone elses concerns.
  11. by   -jt
    <the seiu and the hospitals were BOTH in bed together>

    Thats exactly what it is. SEIU has a "partnership" with many hospitals - including the Kaiser system in CA. Another conflict when you look at what that entails, what the union has agreed to give up in the way of rights, & how it weakens the unions strength. Kaiser & SEIU teamed up together in objecting to the RN ratio law. How a union can do that to its members - and still keep them, I just dont know.

    In the Bronx, we have a hospital where the RNs are in our union & everybody else is in SEIU & SEIU has one of these "partnerships" with the hospital. The interns & residents want to unionize with the Committee of Interns and Residents Union - a branch of the SEIU - but the SEIU wont help them because it doesnt want to upset their "partner" - the hospital - which would not take kindly to their MDs unionizing or to the partner union helping them to do it - even though its THAT union the docs are trying to organize with!

    So who's helping the MDs organize with SEIU if SEIU wont, you may ask?? Why the long-unionized RNs of SEIUs own rival - the New York State Nurses Assoc - which DOESNT have any of these conflicting partnerships & owes nothing to any facility.
    Last edit by -jt on Jun 24, '02
  12. by   -jt
    <We are an independent lot, very rarely part of a group, strong believe in being self-sufficient, individual.
    If I have a problem with my boss(es) or he/she with me I meet with that person face to face......... I don't want or need a third party speaking for me>


    You meet, you vent, he says ok ......... and then what? Youre still at his mercy.
    Staff nurses have been trying that individual talking tactic for years. They go to the "boss" & tell him they need better benefits - do they get it? They tell him they need a pension theyll be able to live off of? Do they have that? They tell him they want higher salaries & compensation for education & experience but a lot of those nurses are still earning less than $15/hr. You tell him you need safe working conditions, safe staffing & safe hours to protect your pts and licenses. Does he say "Sure - anything you need - just say the word because you are such valuable professionals and we want to keep you here!"?

    Do you have to pay for your familys health benefits? I dont.
    Do you get to decide the staffing ratios for your unit & have them legally binding? I do. Do you get to determine what you will be financially compensated for & then get to decide the amount - and have that legally written in stone so it cant change at somebodys whim? I do.

    What a lot of people cant seem to grasp is that, in a nurses union, it is the nurses who are speaking for themselves. There is no outside third party speaking for them.

    I think us union nurses are a bunch of pretty damn self-sufficient, strong individuals. And collectively, we're a force to be reckoned with.
    Last edit by -jt on Jun 24, '02
  13. by   NRSKarenRN
    CNA's slant:
    http://www.calnurses.org/cna/newthreat61902.html

    ---------------
    Also interesting to note at CNA site...

    The Board of Vocational Nursing and Psychiatric Technicians ( BVNPT ) has proposed regulations permitting LVNs to administer IV medications integral to hemodialysis, pheresis, or blood bank procedures.
    http://www.calnurse.org/np/lvnbrd61002.html
  14. by   Peeps Mcarthur
    That's a great idea!

    Come to think of it, there are some routine procedures like intubating and doing cut-downs that we could be using aids for.:chuckle

    Gomer,
    You're opposed to someone getting 1/2 thier income while thier incapacitated? You don't think an employer has an obligation to an employee who has an obligation to the employer? That seems like a one-way street.(very administrative of you)

    Pay it in taxes huh.........................Can anyone else see a....... LOOPHOLE!.....I hate to assume though I can't see why history would not repeat itself. I really don't think the poor billion dollar corporation will actualy end up with the bill. If they do though, they have an OBLIGATION to that employee to provide thier livelyhood while they are employed with them.


    Does your employer,in fact, take action on your behalf when you request something........anything?

    Jt,
    You would think those reasons would be obviouse............If you look at the archive on the CNA site alone you will see nothing unreasonable in the way of "demands". Why won't these people see "the light".
    You'll notice that my thread "why not union" has had no definitive opposing views except for the ones that you offered.
    They must believe what the hospitals tell them.

    It would seem that those hospitals that were forced to implement staffing ratios did not have to turn the lights out and shut the place down after all. .............Somebody's missing a bonus this year though......

    NrsKaren,
    Thanks for the post. I had been on the site just yesterday and I don't remember seeing that.

    I'm not shocked though. I think we can expect more of the same "avoidence" of the issues strategies.

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