Schwarzenegger Prepares to Do Battle in Calif - page 2

Is it only a game to him? For patients who lose their lives, students who fail to get a proper education unless they can afford private schools, people with pensions that have been handed over for... Read More

  1. by   MryRose
    After having sent him a letter stating my less than stellar opinion of hs actions against Nursing... this is his reply.

    Thank you for expressing your concern regarding the nurse-to-patient ratio law. As you know, our great State has a large population with dynamic health needs. Our State faces a shortage of nurses and an expanding patient workload. The Federal Health Resources and Services Agency (HRSA) has projected that California will need more than 42,000 nurses by 2010.

    California's nurse-to-patient ratio law, the first of its kind in the nation to require nurse-to-patient ratios in all hospital units, was enacted in 1999 and implemented on January 1, 2004. These ratios set minimum standards for nurse staffing in each unit of a hospital. My Administration is committed to the fundamental principle reflected in the ratios-establishing standards for safe patient care.

    Early experience has shown that California's adoption of minimum nurse staffing levels is a significant change in care and practice patterns. Nurses, other health care professionals and hospitals have all witnessed changes in patient care and hospital operations since ratios went into effect. While many of the reports of impacts of the regulations have been positive, some have raised concern regarding the possibility of unintended impacts on the health care delivery system.

    " Eleven hospitals have identified nurse-to-patient staffing ratios as a cause for the closure of their respective hospital, emergency department or psychiatric unit

    " Between 2003-2004, six emergency departments have closed in the greater Los Angeles area

    " Four hospitals have petitioned the California Department of Health Services (CDHS) to suspend the use of beds because of the inability to provide enough nurses to care for the patients

    As our State proceeds forward on health care policy, it is necessary to ensure patient safety and protect California's fragile health care system. The following emergency regulations were filed on November 4, 2004, to allow hospitals and care providers the flexibility necessary to best serve their patients:

    " Maintain until January 2008 the current limit of no more than six patients assigned to any one nurse for medical/surgical and mixed units. Previously, the maximum number of patients per nurse in those units was scheduled to drop to five in January 2005. Now, that change is scheduled for 2008

    " Provide hospital emergency departments with temporary staffing flexibility to respond to an unforeseeable influx of patients with immediate needs. Hospitals will continue to be required to return to the specified staffing ratio as soon as possible. In addition, the documentation requirements for emergency departments will be simplified

    " Clarify the requirement that the regulations be met "at all times" to include whenever the nurse is on the unit and available for patient care. Currently, a strict interpretation of the regulations requires that all patient assignments be given to another nurse during restroom breaks or phone calls

    It is important to move forward cautiously until the impact of these current ratios are fully understood and allow time to complete the two-year study the California Department of Health Services is conducting to evaluate the effect of the nurse-to-patient ratios.

    As Governor, it is my goal to create solutions that will best accommodate the health care needs of the people of California. I understand that nursing issues are important to you and appreciate your concern.

    Sincerely,



    Arnold Schwarzenegger

    He still doesn't get it..... How about reducing administrations pay and the profit margins a bit and PAY to have the extra staffing needed for SAFE PATIENT CARE!
    Last edit by MryRose on Apr 19, '05
  2. by   sharann
    I wonder who wrote the above letter from Arnold. I know he doesn't know how to use s
    uch BIG words. The letter was written by someone with above average writing skills. I have never felt such disgust or embarrassment regarding a political "leader" in my own state. I would love a recall election as well. What a shame.
  3. by   Lisbeth
    I was wondering what the average nurset ratios are in other states, and if the California nurses are experiencing department closures or other problems related to the ratios. It seems to me that the Governor should be focusing on increasing nursing training programs to address the shortage, not increase nursing workload. :icon_roll
  4. by   pickledpepperRN
    http://www.calnurses.org/?Action=Content&id=806

    April 19, 2005

    Assembly Committee Approves California Nurses Association Bill to Allot $45 Million for 3,000 Nursing Education Slots

    A California Nurses Association bill to create 3,000 additional nursing education slots in California community colleges over the next two years won bi-partisan approval today in the Assembly Higher Education Committee.

    AB 232, carried by Assembly members Juan Arambula (D-Fresno) and Jerome Horton (D-Inglewood) on behalf of CNA, passed on a 6-1 vote. It would earmark $45 million to state workforce investment boards to expand nursing education programs in the state.

    "This bill is an important step forward to assuring a continual supply of registered nurses in the future as we work to rebuild the nursing infrastructure in our state," said CNA President Deborah Burger, RN.

    AB 232, she noted, "complements our efforts to improve patient care standards in hospitals, especially with the RN staffing ratio law which has dramatically increased the number of nurses at the bedside in California."

    Safe staffing and expanded nursing education programs are essential elements for addressing future RN workforce needs, said Burger. "Ratios are critical to stopping the exodus of nurses out of the hospitals. Increased education funding is essential to assure there are sufficient RNs in the coming years as both the current nurse workforce and the patient population ages."

    Following passage of the CNA-sponsored ratio law in 1999, California has made genuine progress in mitigating a nursing shortage created in the 1990s by hospital layoffs, replacement of RN staff, and the departure of many RNs unwilling to work in unsafe conditions.

    California now exceeds by at least 15,000 projections of the demand for RNs in 2005 made by the U.S. Department of Health and Human Services, Health Resources and Services Administration (HRSA) in 2002.

    "Now we have the foundation to restore a stable RN workforce into the future at a time when the average age of RNs is nearing 50 and many are contemplating retirement," said Burger. CNA, she added, has sponsored programs for years to expand RN education funding, and worked on numerous RN education programs.
  5. by   Sheri257
    Quote from MryRose
    " Eleven hospitals have identified nurse-to-patient staffing ratios as a cause for the closure of their respective hospital, emergency department or psychiatric unit

    " Between 2003-2004, six emergency departments have closed in the greater Los Angeles area

    " Four hospitals have petitioned the California Department of Health Services (CDHS) to suspend the use of beds because of the inability to provide enough nurses to care for the patients

    It is important to move forward cautiously until the impact of these current ratios are fully understood and allow time to complete the two-year study the California Department of Health Services is conducting to evaluate the effect of the nurse-to-patient ratios.
    This is what drives me crazy. Notice how Schwarzenegger doesn't mention that the emergency room closures are mostly due to Illegal Immigrants. Even the California Hospital Association has admitted that.

    Why do nurse ratios have to suffer because of illegals? Why do all of these burdens have to be shouldered by nurses? If you give nurses more patients, they'll quit and make the shortage worse.

    They need to solve the illegal problem, not roll back ratios.

    The two year study is bogus too. The administration has announced they're now going for a permanent regulation so, they have no intention of "studying" the problem. They want a permanent rollback.

    :angryfire
    Last edit by Sheri257 on Apr 20, '05
  6. by   MryRose
    Quote from lizz
    This is what drives me crazy. Notice how Schwarzenegger doesn't mention that the emergency room closures are mostly due to Illegal Immigrants. Even the California Hospital Association has admitted that.

    Why do nurse ratios have to suffer because of illegals? Why do all of these burdens have to be shouldered by nurses? If you give nurses more patients, they'll quit and make the shortage worse.

    They need to solve the illegal problem, not roll back ratios.

    The two year study is bogus too. The administration has announced they're now going for a permanent regulation so, they have no intention of "studying" the problem. They want a permanent rollback.

    :angryfire
    I completely agree with you. He's using Nursing as an excuse for the problems he won't address because he needs the Latino vote for future elections. It's just a matter of what issue is "PC" at the time for his career.... after all he wants the Constitution changed to allow him to become President!

    I may beg my way into Canada if that happens!
  7. by   pickledpepperRN
    http://www.calnurse.org/?Action=Content&id=844

    Most nurses don't belong to unions, but they still fight for staffing ratios
    By Deanna Ostler, R.N.
    Irvine
    Orange County Register
    May 1, 2005

    Steven Greenhut's commentary was unsubstantiated, inflammatory and insulting to nurses.

    I have labored in a hospital setting my entire 15 years as a nurse. I have been supported by a union for only a few of those years and can attest that with or without a union my job description and level of dedication have never changed. The mandated nurse-to-patient staffing ratio law is the only perk I can recall that has ever gone in the favor of nurses.

    Greenhut implies that the nursing industry is union-driven, but he might be surprised to learn the number of non-union nursing jobs and the number of hospitals that have no representation. The California Nurses Association is available to the masses, but the number of members is small in comparison to the number of working nurses.

    People like Greenhut want the public to believe that nurses (maybe because they are primarily women) should just be willing to carry unrealistic workloads and just nurture the public back to health with some magical healing power. But we, like all others workers in this money-hungry, lawsuit-ready society, need a safety net. I have in years past been assigned 12 patients with only the help of a nurse's assistant. It was not safe for anyone. Understaffing nurses can only shortchange the public even more. Would Greenhut support the idea of sending 25 troops to the front line of a war with 15 guns because it is more within our means?

    Did Greenhut bother to mention that one reason so many hospitals close is that the corporate leaders running them aren't willing to spread their fair share around? Did he bother to check the bonus pay - not the salary - of the CEO of Tenet or any other hospital corporations?

    The truth is this problem is multifaceted. To blame unions or nurses or to side with the governor's first intuition is merely ignorant.

    There is a lack of funding for nursing schools, but that is a completely separate problem. It also takes more nurses to train all those lucky lotto winners in the clinical setting. As far as the shortage goes, Greenhut neglected to mention that many nurses are simply aging into retirement, and that the nursing profession itself just isn't as desirable as it once was. There are simply more choices and jobs with less liability (like commentary writing) that are so much more appealing.

    Greenhut's limited knowledge of the law is reflected when he suggests that the ratios are 5-1. In many units the workload is still higher: well-baby nursery, 8-1; obstetrics, 6-1. Specialized units and critical care are protected under Title 22 and allow lower ratios ... for now.

    Nurses are not the enemy here. We will continue to speak up to keep our ratios safe; why wouldn't we? We are protecting not only ourselves but also the patients we care for.
  8. by   Jessy_RN
    HE SHOULD JUST GIVE IT UP AND GO BACK TO ACTING. BUT THEN AGAIN HE CAN'T DO THAT EITHER :chuckle
  9. by   Judee Smudee
    This 12/1 patient ratio is on the way to being an industry standard. Over work and overtime is the reason so many nurses became activist. By Deanna Ostler, R.N.
    Irvine
    Orange County Register
    May 1, 2005



    I have in years past been assigned 12 patients with only the help of a nurse's assistant.
  10. by   Jessy_RN
    BRING HIM ON :chuckle

    :smiley_ab
  11. by   cardiacRN2006
    Quote from Judee Smudee
    This 12/1 patient ratio is on the way to being an industry standard. Over work and overtime is the reason so many nurses became activist. By Deanna Ostler, R.N.
    Irvine
    Orange County Register
    May 1, 2005



    I have in years past been assigned 12 patients with only the help of a nurse's assistant.
    I can't even imagine taking care of 12 pts! I guess it would be ok if we didn't have to give them any meds or do any assessments. Then it might be doable. I wonder if Ah-nold was hospitalized how he would feel with his nurse being hours late with his meds because she was on her 10th assessment of the day!
    I work at a hospital that is part of a 'chain' basically. After we all got hired they dropped the "we don't pay holiday pay" bomb. I never thought of asking that in the interview because WHO DOESN'T PAY FOR HOLIDAYS??? Anyway, we opened up another hospital in Cali a few years later and they found out that Cali RNs were not going to tolerate working holidays without holiday pay. So the rest of the 8 or so hospitals in the 'chain' had to change the policy and got the holiday pay. SO don't give up over there in CA. The rest of the country will follow your lead--they'll have to.
  12. by   pickledpepperRN
    http://www.mercurynews.com/mld/mercu...s/11747806.htm



    Posted on Fri, May. 27, 2005

    Judge sides with nurses on patient ratio

    TOM CHORNEAU
    Associated Press

    SACRAMENTO - In a setback to Gov. Arnold Schwarzenegger, a superior court judge issued a tentative ruling Thursday requiring hospitals to provide staffing ratios sought by nurses.

    The seemingly bureaucratic dispute between the Schwarzenegger administration and the state's largest nurses union has evolved into an ongoing public spectacle, with angry nurses dogging the governor at many of his appearances.

    In her tentative ruling, Sacramento County Superior Court Judge Judy Holzer Hersher shot down an emergency order issued by the administration that sought to delay implementation of new nurse-to-patient ratios. The administration said the mandate would exacerbate an already critical shortage of nurses in California.

    The requirement limits nursing coverage to no more than five patients at a time. Holzer Hersher said she could not find any legal authority for the governor to issue a delay.

    "(Department of Health Services) abused its discretion and failed to follow the procedures established by law in determining that the regulations were necessary for the immediate preservation of public health and safety," Holzer Hersher wrote...
  13. by   Jessy_RN

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