***Get CALIFORNIA STAFFING RATIOS here***

  1. hot off the press from cna:
    http://www.calnurse.org/

    california staffing ratios
    the ratios must still be finalized following
    a public comment period.
    the official minimum nurse-to-patient ratios set by the department of health services.

    icu/ccu/neo-natal intensive care 1:2
    burnunit 1:2
    or/pacu
    under anesthesia 1:1
    post anesthesia 1:2

    er (triage rns not counted in ratios)
    general 1:4
    critical care 1:2
    trauma 1:1

    medical and surgical (initial ratio) 1:6
    12 to 18 months phase-in 1:5

    step-down/intermediate care/dou 1:4
    step-down/telemetry 1:4
    telemetry 1:5
    oncology/speciality care 1:5

    labor and delivery 1:2
    post partum*
    couplets 1:4
    mothers only 1:6
    pediatrics 1:4
    intermediate care nursery 1:4
    well baby nursery 1:8

    psychiatric/behavioral health 1:6
    mixed units (initial ratio) 1:6
    12 to 18 months phase-in 1:5

    notes:
    * if maternal child has ante partum and post-partum - 1:3

    ---------------------
    california governor expected to release nurse staffing ratios

    california gov. gray davis is expected to call for nurse staffing ratios of one nurse to every six patients on general medical floors of hospitals. it is a compromise between nurse groups, which wanted one-to-three, and the hospital industry, which wanted one-to-10.

    san francisco chronicle, jan. 22, 2002
    http://www.sfgate.com/cgi-bin/articl...22/mn19896.dtl
    Last edit by NRSKarenRN on Jan 22, '02
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  2. 13 Comments

  3. by   hoolahan
    I would really like to see home health nurses included in this!! How about max number of visits per day? Karen you and I have discussed this, but I have also heard from many HH nurses via my web site who are doing way more than the seven visit limit per day. And what is mandatory OT for HH nurses? Having to work on your weekend off if it's short?

    (Karen, not picking on YOU, just kevtching in general.)

    PS e-mail sent
  4. by   night owl
    Looks good for the LPN who wants to work in the hospital setting. It seems that they'll be hiring more and for those hospitals who weren't hiring them at all, will probably start now. What do you think Karen?
    I wish they'd come up with a better staff ratio for LTC! Those poor old folk, when will they get a break??? Or should I say those poor nurses...
  5. by   -jt
    the California law only addresses acute care hospitals. It has no input on staffing for LTC or HH as far as I know.

    Question: Did the law specify these ratios are for RNs to pts or is it just "nurse" to pt?

    If its nurse to pt, then on a med-surg floor an LPN can have 6 pts & the RN can have her own 6 pts plus be responsible for the LPN's 6 pts too - for a total of 12????? I hope Im reading it wrong.
  6. by   oramar
    Thanks for posting this Karen, I knew you would pounce on this one. I saw this over at calnurse and then ran into the article I mentioned above. Could not help but think there was a connection.
  7. by   CJM
    Can anyone explain how nurse's aids or UAP fit end to the staffing ratios? Here in Ohio the rules for UAP staff is pretty much up to what the hospital wants it to be. I'am curious about this.
  8. by   -jt
    <California Staffing Ratios
    The ratios must still be finalized following
    a public comment period.
    The official minimum nurse-to-patient ratios set by the Department of Health Services. >

    I just realized I misread all this. I mistakenly thought that they had finally come to agreements in the numbers and the law was being finally put into effect. In re-reading, I see that these numbers are just a proposal by the Gov & DOH and now even this will be held up with the "comment period". Of course that will be the opportunity for the hospital assoc to lobby against them. Good that the Gov finally came up with acceptable numbers to satisfy nurses but its probably going to be a long time still before the law is actually finalized, numbers set, and the thing actually put into effect. What a let down!
  9. by   Teshiee
    With ratios like that I may dabble in Med/surg afterall.
  10. by   Furball
    Originally posted by hoolahan
    I would really like to see home health nurses included in this!! How about max number of visits per day? Karen you and I have discussed this, but I have also heard from many HH nurses via my web site who are doing way more than the seven visit limit per day. And what is mandatory OT for HH nurses? Having to work on your weekend off if it's short?

    (Karen, not picking on YOU, just kevtching in general.)

    PS e-mail sent
    Agree enthusiastically here Hoolahan as a former HH nurse. Geesh...it used to take me an hour to reach my first visit (large rural county and everyone HAD to leave from the office rather than home) So 2 hours round trip and then say 1/2 hour -1 hour travel time between visits didnt leave a helluva lot of time in a 7 hour payday for, the visits, documentation, communication with docs, PT's, HHA's, APS and the scores of other supporting staff. Working on your laptop at home to catch up is mandatory OT but I ALWAYS put in for my time (many nurses didnt ) grrrrrr HH nurses are buried. Happy to be back in a hospital.
  11. by   teeituptom
    I live in wonderfull Texas, I think Im going to download and take it to work with me. Ive been working ER as an assistant nurse manager for almost 15 years now. And I have recently gone back to plain staff nursing in the ER. I could use this.
    Maybe even mail it to the Govenor, maybe even to Bush jr. even though I didnt vote for him, It looks good to me.
    Howdy yall from deep in the heart of Texas
    EEEHHHAAAAWWWWWWWWW
    Thomas
  12. by   mattsmom81
    Shame, shame Tom for not votin' for our deah Guvnah! <G> Moving to California sounds pretty good right now with those great nurse patient ratios and the strong union representation out there. California nurses are a beacon for all of us..just gotta luv 'em!
  13. by   -jt
    I just read this article:
    Nurses and Politics
    http://www.examiner.com/warren_hinck....hinckle.0129w

    It sounds like some nurses are not in favor of the Gov's 1:6 proposals because these hospitals last year already agreed with their nurses 1:4 ratios. It seems the writer is saying that the Gov's proposal is not enough & his motives are questioned because its already been shown by some hospitals in that state that they can do better than the gov's proposed ratios.

    The article doesnt mention if the Gov's proposal for a 1:6 med-surg ratio will cause those hospitals that already had a better staffing ratio to now want to change to the gov's higher ratio. But if the proposal goes thru, surely the 1:6 med surg ratio will still help nurses who now have 1:10 and worse.

    Any thoughts from CA nurses as to why the Gov wouldnt just propose the same 1:4 ratios that some hospitals there already have in place?
    Last edit by -jt on Feb 12, '02
  14. by   NRSKarenRN
    SanFrancisco Examiner
    Op-Ed opinion
    Publication date: 02/07/2002
    http://www.examiner.com/opinion/defa....letters.0207w

    Hinckle off-base

    IN his specious attack on the California Nurses Association, Warren Hinckle has managed to turn the world on its head ("Nurses and Politics," The Examiner, Jan. 30).

    The minimum nurse-to-patient ratios established by Gov. Gray Davis and the state of California will, when finalized after regulatory review, be a quantum leap forward for patients and nurses across California.

    No other state or governor in the United States has taken such a profound and courageous step - in the face of the heated opposition of the powerful health care industry, led by the very Kaiser Permanente corporation which Mr. Hinckle apparently adores.

    By contrast, Kaiser, joined by its SEIU partners, lobbied against the law, and then proposed a five-year delay in implementation.

    Kaiser's latest move looks like little more than a PR stunt, claiming it will move forward with ratios that do not have the force of law and can be changed with Kaiser's next lurch in staffing practices - as when it laid off 1,600 RNs in the mid-1990s.

    These ratios will lead to improvements in care for virtually all California hospitals, especially San Francisco, which is plagued with frequent ambulance diversions and long waits for patient care while unstaffed beds sit empty.

    These ratios will help us bring nurses back to the bedside, reducing the time patients wait for access to a hospital bed or to receive care from a registered nurse.

    Gov. Davis deserves our thanks.

    Kay McVay
    Concord
    President, California Nurses Association

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