Texas Marchers back bill seeking mandatory staffing ratios - page 2

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  1. by   ZASHAGALKA
    Quote from lizz
    Just FYI Timothy but, Texas has about 180,000 nurses, not a million. A million nurses would be really high even for California, which has about 340,000 RN's.

    ftp://www.bne.state.tx.us/06-co-rn.pdf

    :typing
    I stand corrected. I thought about this as I was re-reading my comment before getting to yours. Had you not posted this, I would have corrected.

    Still, it doesn't detract from my point: 250 is a paltry number by comparison. To be precise, it represents 1/10th of 1%

    According to the TX BNE (board of nurse examiners), as of 9/06, Texas had 180,137 RNs and 77,117 LVNs.

    ~faith,
    Timothy.
    Last edit by ZASHAGALKA on Mar 31, '07
  2. by   Sheri257
    Quote from ZASHAGALKA
    Still, it doesn't detract from my point: 250 is a paltry number by comparison.

    ~faith,
    Timothy.
    Yeah ... to be honest, I still can't figure out why CNA is spending so much time in Texas because, I'm not sure how successful they're going to be either. Seems like a long shot.

    :typing
  3. by   ZASHAGALKA
    Quote from lizz
    Yeah ... to be honest, I still can't figure out why CNA is spending so much time in Texas because, I'm not sure how successful they're going to be either. Seems like a long shot.

    :typing
    I'm not against the idea, even if I have some reservations about it. Mainly, my reservations are not about the importance of the idea, but how to implement it. I think nurses are more powerful than we give ourselves due credit as holding.

    I would RATHER see a strong organization that demands ratios and holds the respect and command of individual members to bring it about instead of a law that is impractical. In reality, even WITH such a law, without unions to enforce the law, it would be all but moot.

    I suspect that is the point. However, despite CNA's calculation, a passage of this law would NOT directly lead to a rush to join unions in Texas.

    It just isn't the right environment. EVEN if it were, 'right to work' would not ensure the production of dues for any union. Another 'free rider' economics problem. . .

    ~faith,
    Timothy.
  4. by   pickledpepperRN
    My educated guess is that like in California the registered nurses in Texas are doung most of the work.
    The reason is that as nurses we thing patients in Texas deserve a nurse too.

    Under Pressure from NNOC Campaign, Some Hospitals Lower Ratios
    We are receiving reports that a few hospitals are “informally” (nothing official, nothing in writing) lowering staffing ratios in some selected units. For example,

    * University Hospital in San Antonio, 9th fl. Telemetry, day shift only, lowered to 1:4

    * Seton Medical Center in Austin, Telemetry/ Step-down, also lowered to 1:4

    * Baptist in San Antonio, ICUs, lowered to 1:2

    We applaud any lowering of staffing ratios as a vital step toward safe patient care and better conditions for RNs. But independent of hospital policy or lack of policy, it is always the obligation of RNs to police and enforce proper
    staffing and other safe practices. In order to meet their legal and moral obligations, RNs need their own strong independent organization and minimum staffing ratios established by
    state law.

    This is what the Texas BNE has to say about RNs' obligations - “…a nurse has the duty to the patient which cannot be superseded by hospital policy or physician's order.”

    http://www.calnurses.org/nnoc/texas/...tter022807.pdf
    http://www.calnurses.org/nnoc/texas/...tter031207.pdf
  5. by   Sheri257
    Quote from ZASHAGALKA
    I would RATHER see a strong organization that demands ratios and holds the respect and command of individual members to bring it about instead of a law that is impractical. In reality, even WITH such a law, without unions to enforce the law, it would be all but moot.

    I suspect that is the point. However, despite CNA's calculation, a passage of this law would NOT directly lead to a rush to join unions in Texas.

    It just isn't the right environment. EVEN if it were, 'right to work' would not ensure the production of dues for any union. Another 'free rider' economics problem. . .

    ~faith,
    Timothy.
    I see your point. And, given that California and Texas are two completely different environments ...

    I'm not sure what you mean by impractical. California hospitals seem to be doing ok with it. At least four hospitals in my area are actually expanding. Somehow, they made the finances work.

    As far as needing unions to enforce the law, I worked for two non-union facilties and compliance wasn't an issue that I saw, at least on the floors I worked on. I personally never saw a violation. Probably because they didn't want to risk losing Medicare funding, which can happen if they don't follow state laws.

    As far as CNA membership in Texas, I'm sure they're hoping a ratio law will help because it did in California. Before the ratio law, CNA was mostly strong in the northern part of the state. But, just in the last five years ... they're all over southern California.

    Five hospitals in my area alone went CNA just in the last five years. Who knows if the same things would happen in Texas but, I guess that's what they're counting on.

    :typing
    Last edit by Sheri257 on Mar 31, '07
  6. by   purplemania
    I fully support the TNA position. This bill was presented by a California union, not Texas nurses. We already have a whistleblower law, a staff-ratio law, a safe harbor law----. This bill calls for a double standard between hospital nurses and other nurses. It also calls for a repeal of our peer review law and the law that states every nurse is required to report an unsafe nurse. A lack of peer review is a step backwards - when the attys and others decide a nurses' fate without nurses being involved. Go back to CA! You screwed up that state's nursing status - keep away from Texas!
  7. by   ZASHAGALKA
    Quote from lizz
    I'm not sure what you mean by impractical. California hospitals seem to be doing ok with it.
    I didn't say it was impractical in California. I said it was impractical in a union-poor environment because there isn't an organized check against abuse or outright refusal to abide by the law.

    California has that union environment.

    Texas, does not. And will not, whether this bill passes, or not.

    ~faith,
    Timothy.
  8. by   lossforimagination
    Quote from purplemania
    I fully support the TNA position. This bill was presented by a California union, not Texas nurses. We already have a whistleblower law, a staff-ratio law, a safe harbor law----. This bill calls for a double standard between hospital nurses and other nurses. It also calls for a repeal of our peer review law and the law that states every nurse is required to report an unsafe nurse. A lack of peer review is a step backwards - when the attys and others decide a nurses' fate without nurses being involved. Go back to CA! You screwed up that state's nursing status - keep away from Texas!

    You must be joking that Texas has a staff-ratio law? I've been nursing in TX since 1992 and was not aware of any such thing. Please advise where I might find that written.
  9. by   RN34TX
    Quote from glasgow3
    When a so-called nurse"s association is on the same side of an issue as the hospital association, does that tell you anything?
    That's exactly what I thought after attending "Nurse Day at the Capitol" in Austin a few weeks ago which was organized by TNA.

    When meeting with our senators and representatives during Nurse day, we were instructed by TNA to not discuss the staffing ratio issue and were warned that some might ask us about our feelings on it and that we were to direct them to TNA's position statement on the issue.

    During the orientation session the night before, TNA proclaimed that they had already addressed the staffing ratio issue a long time ago and I was thinking....did I miss something here?

    If that were true, then why did my last med/surg job demand that I take on 7-8 patients, often with no nursing assistant support? And why are some Texas ICU nurses still reporting taking 3 patient assignments?

    I'd also like to add that TNA spent the majority of that "orientation" session introducing and glorifying it's various members and going on and on about their career histories and accomplishments.
    I didn't see one single TNA representative on that stage that could possibly be younger than 55 years of age and I'm being kind here.

    If nothing else to turn it around and get with the times, TNA is in desperate need of some new fresh younger blood.
  10. by   RN34TX
    Quote from purplemania
    I fully support the TNA position. This bill was presented by a California union, not Texas nurses. We already have a whistleblower law, a staff-ratio law, a safe harbor law----. This bill calls for a double standard between hospital nurses and other nurses. It also calls for a repeal of our peer review law and the law that states every nurse is required to report an unsafe nurse. A lack of peer review is a step backwards - when the attys and others decide a nurses' fate without nurses being involved. Go back to CA! You screwed up that state's nursing status - keep away from Texas!
    That's the same rhetoric TNA spouted at me when I attended Nurse Day in Austin when I questioned their position on the staffing ratio bill.....the fact that this current bill would only cover hospital nurses and left out long term care, home health, and other practice areas.

    Is that any reason to throw out the baby with the bath water? We have to start somewhere.

    The fact is that the majority of RN's are employed in inpatient hospital settings, so this bill would affect the largest group of RN's in the state.
    CA's law is evolving and changing as we speak and has been modified since it's first inception to include other areas and make ratios even lower than what the law originally called for.

    Texas could start with this current bill and then later introduce long term care and other staffing ratios. What is wrong with that?

    By the way, you said it before so I'll say it again, Texas has no such thing as a staff-ratio law in any way, shape, or form. Unless of course that law states that it's ok to give a med/surg nurse 8 patients and an ICU nurse 3 patients. That's some law....

    I just feel like too many Texans have an attitude that this is some "outsider agitation" and since it wasn't the product of a "native son" and is seen as something coming from CA and not TX, that it has no validity.
  11. by   cookielady,rn
    i think the 1:3 for tele and 1:4 for medsurg is a bit too conservative. I think one more on each would still be safe and still way less than what's expected now. I worked for UMC in Tucson where the ratio on all floors but ICU was 1:4, sometimes taking a 5th and it was fine if everyone worked together. We still had a secretary, pharmacists, aides, and supplies. Congratualtions to Texas for getting this. I hope soon all states will follow.
    It sickens me that any so called nurse's association would oppose a safety measure.
  12. by   gauge14iv
    Quote from cookielady,rn
    i think the 1:3 for tele and 1:4 for medsurg is a bit too conservative. I think one more on each would still be safe and still way less than what's expected now. I worked for UMC in Tucson where the ratio on all floors but ICU was 1:4, sometimes taking a 5th and it was fine if everyone worked together. We still had a secretary, pharmacists, aides, and supplies. Congratualtions to Texas for getting this. I hope soon all states will follow.
    It sickens me that any so called nurse's association would oppose a safety measure.
    Texas doesn't have it, it won't pass, and it isn't the thing itself the TNA opposes but the way the CNA worded it and is going about it. Please read all of the information about this. I do not agree with all of the points the TNA makes, but I agree even less with CNA. It's a "pick the lesser of two evils" situation at this point.

    Again - a good strong organization is what PROFESSIONAL educated nurses and their patients need. Not a blue collar union.
  13. by   glasgow3
    Quote from gauge14iv
    Texas doesn't have it, it won't pass, and it isn't the thing itself the TNA opposes but the way the CNA worded it and is going about it. Please read all of the information about this. I do not agree with all of the points the TNA makes, but I agree even less with CNA. It's a "pick the lesser of two evils" situation at this point.

    Again - a good strong organization is what PROFESSIONAL educated nurses and their patients need. Not a blue collar union.

    In my opinion, there is nothing wrong with good paying blue collar jobs; many college graduates owe their upper mobility to their hard working parents. They skimped and saved so that their children would have it "better" than they did. It is a shame that mindless, one sided trade agreements, greatly eroded labor law/ worker protections, and illegal immigration have combined to eliminate those blue collar jobs where one bread winner could raise a family and send their children to college.

    I should also point out that the membership of the CNA is composed of Registered Nurses; they are professional, educated nurses.

    According to Nurse Day attendees, TNA believes that they have adequately addressed the safe nurse-patient ratio issue-----this despite the fact that there is no legislated mandatory minimum and continued prevalence of clearly unacceptable staffing practices within Texas.

    We work in an industry which mandates a minimum number of inches the top of a linen cart must be from the ceiling; Is it an unreasonable expectation to require that a facility insure that a minimum number of RNs are present at a given level of care? I think not.

    Sadly, TNA is not merely impotent with respect to legislative advocacy----they actively oppose mandatory ratios.

    If I were TNA, I would be quite concerned. There is an audience for CNA's ideas: the previously ignored bedside nurses. One poster on this thread could not understand why CNA came to Texas. Still others describe CNA as outside agitators. But the way it works is some Texas nurses decided to advocate and organize and they INVITED CNA to help because of their track record.

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