Arizona nurses gather Tuesday to advocate nurse/patient ratios

Nurses' union wants minimum staff ratios put into AZ law

PHOENIX — They don't have the support of hospitals, but a group of nurses is back at the state Capitol lobbying for minimum staffing ratios and whistleblower protection.
If the Arizona Hospital Patient Protection Act passes, it would make Arizona only the second state in the nation to pass such a measure....

http://www.azstarnet.com/sn/hourlyupdate/275742.php

Speaking up from California...... We have ratios here, but they took away ALL of our support staff to make up for it. In the ICU, there is one nurse for every 2 patients. You'll not see a unit secretary or monitor clerk on any shift. Depending on the hospital, you may very well become a one man band.

The bottom line is that patients and nurses rely on ancillary support staff in the provision of care. The California Department of Health Services commissioned a study, prepared by the University of California. The study included the existing model of care in hospitals, and it was used as a basis to determine the minimum, safe RN to patient ratios.

Sure, some employers cheat and try to "punish" nurses by attempting to change the model of care and decreasing or eliminating ancillary staff. This is not very ethical behavior and hospitals violate the letter and the intent of the regulations if they do this. The regulations exist to protect the public's health and safety.

According to Title 22 Section 70217. Nursing Service Staff.
Staffing for care not requiring a licensed nurse is not included within these ratios and shall be determined pursuant to the patient classification system.
SUPPLEMENTAL STATEMENT OF REASONS:
In order to clarify that a hospital cannot reduce overall staffing by assigning licensed nurses to duties customarily and appropriately performed by unlicensed staff, it is stated that staffing for care not requiring a licensed nurse is not included within these ratios and shall be determined pursuant to the patient classification system. At 22 CCR 70053.2 and 70217(b), the PCS is defined as a system that is established to determine the amount of nursing care needed by each unit, on each shift, and for each level of licensed and unlicensed staff. Setting a minimum level of staffing for licensed nurses is not intended to alter the current requirement of the PCS to determine needed staffing levels for licensed and unlicensed staff.

As a patient advocate, it's up to you to change circumstances that are against the interests or wishes of your patient. You should organize with your colleagues and act collectively, and in unity to be most effective at getting management to comply with the safe staffing standards. Safe staffing is an imperative, if patients are to receive therapeutic and competent care from an RN. We are obligated by law to be patient advocates. The ratios apply to all acute care hospitals, whether or not the RNs are represented by a union for the purposes of collective barganing.

With our union, CNA/NNOC, we are able to hold management accountable for providing safe staffing by filling out an assignment despite objection form (ADO), which transfers liability for any harm that befalls a patient due to unsafe staffing to management. The ADO eliminates administrative deniability. Most managers understand that they can be held personally liable if they fail to provide additional staffing that is required, once they're notified by the RN responsible for the patient(s), that an unsafe condition exists.

Way to go, Arizona RNs, for your collective advocacy in working to win passage of the Arizona Patient Protection Act.

In solidarity,
RN4MERCY

Yes, sometimes it's the old be careful of what you wish for.

One major problem is that hospital reimbursements are controlled, and costs are not. Medicare leads the way, giving private insurers a reason to also limit their payments.

Stupid prioritization of capital expenditures is also common, and that fall squarely on hospital management.

PA's been working on this issue a few years: MOT passed last year while ratio law never got out of House Committee:


10/09/08 PA Legislation: Mandatory Overtime signed law; Nursing Ratios stalled.

California had a ratio of two or fewer patients per nurse in the ICU since 1976.

When did the hospital illegally eliminate your support staff?

July 2008.....But we're not doing our own laundry (yet) we contract out. There's usually one phlebotomist for the entire hospital at noc. (Not that it matters in ICU.....most times, the patients have lines.) There's one lab tech. Routine labs drawn at 0300 in the ICU do not usually get resulted until 0630. Really sucks for them there criticals ya find out about at the last minute.

Sigh.............I can remember working at hospitals when you'd go to work and there was staff trippin' all over each other. And the patients had much lower acuity. As far as that goes....I can remember when I only associated the word acuity with someone's IQ level. Hah!

Your hospital is wrong. They may blame the ratio law but that cannot be because critical care ratios were in place for 32 years before they cut your staff.
This hurts patients and nurses.

I think if your colleagues work together you can show that the hospital will have fewer sentinel events, VAP, decubiti, and falls if your secretaries and nursing assistants return.
And improved patient satisfaction.

Just because drivers run red lights does not mean we don't need traffic laws.