Too few nurses for California to meet new hospital staffing law - page 2

san francisco chronicle, ca - mar 23, 2004 california's hospitals are on the front lines, delivering care 24 hours a day to every person who needs our help, whether or not they can afford to pay.... Read More

  1. by   pickledpepperRN
    BUKKO:
    I am so sorry you are having to do that. Thankfully you have help working with management. We have a great rep too. Our PPC started long ago and still they come up with something new.

    HELLLLLLO NURSE:
    Thank you.
    Seems in my experience most are doing better where the nurses work at it, some are doing great (I can think of about 1/2 of the units at my hospital) and some are extremely dangerous places to be a patient. My license is too important to me to risk there.
  2. by   newgrad2004
    I live in Northern Cali, and our hospitals are meeting those ratios, a CN or a Team leader doesnt take patients, and covers breaks. Down side is less NA's but with 4-5 pts it isnt so bad. NA takes vitals and we all help get our AM care, the NA or RN does it and everyone helps another. The ratios are good for Nurses so we have less errors and more time, but we do pick up the slack and do more care rather than relying totally on the NA's. Good pay and better ratio's!

    I love Cali!

    I should clarify the step down units are 4:1 and soon all other units will be mandated to be 5:1 RN ratio.
  3. by   heart queen
    On the step down unit two weekends ago, I had 5 patients. Three were swanned, all three on primacor and heparin, one with a CI of 1.3 and Q4 hr. numbers, the other two q6 hr. #'s. The other two patients were new Afib. :angryfire This was just about the worst I have seen at THIS facility.

    This is what can and DOES happen at a right to work state. In some fairness to management, they had been working many hours staffing as well, but someone never figured out that if you just stop filling the emply beds,
    it won't become unsafe.

    Would love to hear more from California nurses as to how this develops.
  4. by   JoJozay
    I'm going into nursing and I was wondering why there are less NA's now. Is this what the law mandates or do the hospitals hire less NA's since they need RN.s? Thanks.




    Quote from newgrad2004
    I live in Northern Cali, and our hospitals are meeting those ratios, a CN or a Team leader doesnt take patients, and covers breaks. Down side is less NA's but with 4-5 pts it isnt so bad. NA takes vitals and we all help get our AM care, the NA or RN does it and everyone helps another. The ratios are good for Nurses so we have less errors and more time, but we do pick up the slack and do more care rather than relying totally on the NA's. Good pay and better ratio's!

    I love Cali!

    I should clarify the step down units are 4:1 and soon all other units will be mandated to be 5:1 RN ratio.
  5. by   nursemaa
    Quote from heart queen
    someone never figured out that if you just stop filling the emply beds, it won't become unsafe.
    If you stop filling beds, what becomes of the patients in the ED (or direct admits) that need inpatient care? You could ship them to another hospital, but what happens when that one fills? Keep sending them further away? And what about the patients being stuck with a bill they can't afford to pay because the insurance company won't pay when they end up in an out-of-network facility? The answer is more nurses. We all know what should happen (administrations need to stand behind nursing), but we have to deal with the reality while pushing for the ideal. Legislation will be slow in coming because healthcare is business. I find it all very frustrating.....
  6. by   terri0318rn
    Yes, collegues, there is a shortage of nurses, but of "good nurses". Those of us who are "good" nurses seem to stick our necks out there. But, are we good employees? I have resigned to 2 positions because I was a good nurses.....skills and care were not in question. I seemed to be "spending too much time with my patients". Isn't nursing still about spending the time it takes to comfort family as well as the patient when the patient has an "end stage" disease or is a newly diagnosed oncology patient. I would not have become a nurse if it was all about passing pills! If we don't take a stand for these ratios, no matter where you work, the patients are definitely not getting the type of nurse we all took an oath to be.......anybody remember that oath? And how about malevolence, benefisence and malfeasance?
    Signed a "good" nurse
    Terri
  7. by   shodobe
    The hospital where I work and another one I work part time at are going through a round of "layoffs" because the hospitals are losing so much money. The biggest problem I can see is eventually the blame will fall on the backs of the RNs because the hospital will say they needed to hire more RNs because of the ratios. The moral is going down the toilet and no one knows who will be next. Some of the ancillary staff have recieved letters stating there is no guarantee for their jobs after a certain date. I can see other hospitals in the state following suit if this prevails. The rest will sit back and watch the SoCal CHW system do their dirty deeds and see if it can work for them. The doctors I work with in the OR are fighting like crazy to not let this happen, they know it will hurt the care of their patients and they don't want this to happen. Like I said before, other hospitals will try this because they all have the same mindset, do more with less! Mike
  8. by   ktwlpn
    Off-duty RNs will make themselves available on their off days to work beginning on Monday to ensure adequate staffing to meet the requirements of the new law>>>>>>>>>>>>>>>>>
  9. by   MellowOne
    Quote from heart queen
    This is what can and DOES happen at a right to work state. In some fairness to management, they had been working many hours staffing as well, but someone never figured out that if you just stop filling the emply beds, it won't become unsafe.
    So where do you tell the sick people who come through your doors to go so that you can stop filling beds? Just a question...

    Be well...

    The Mellow One
  10. by   donmurray
    Here's another question. Where is the point where taking one more patient compromises the care that can be given to all those you already have, by overstretching the resources available? The minimum staffing level is not an arbitrary number.
  11. by   PMHNP10
    I'm not interested in hearing excuses by hospitals, and claims that ratios are bad, etc, etc. The lines in Sacramento are too extensive to convince me that there aren't enough RNs in this country.
    Instead, what I'm interested in hearing about is hospitals not complying with the ratios and the consequences that follow. Are the nurses holding their admin accountable? And even if they are, can the governing bodies really do anything about hospital noncompliance to give admin a bit more encouragement--eg. a fine. While I agree, ratios aren't the perfect answer, they are certainly a start. Certainly better than how it was before ratios--8+ pts during the day.
    So are the ratios nothing more than words on some paper, or is there any functioning backbone to the ratios?
  12. by   Katerina
    it would help if other regulations such as the waiting period, after failing the nclex exam on the first try, would be less than three months
    or
    hiring new staff at cal board of nursing to speed up the rn licencing process. is this possible?


    Quote from brian
    [color=#6f6f6f]san francisco chronicle, ca - mar 23, 2004

    california's hospitals are on the front lines, delivering care 24 hours a day to every person who needs our help, whether or not they can afford to pay.


    new state regulations, however, are seriously testing the ability of hospitals across california to provide this care. although the requirement for hospitals to base their staffing on specific nurse-to-patient ratios was signed into law in 1999, the california department of health services (dhs) didn't finalize the numeric ratios or the regulations needed to implement them until september 2003. these new regulations, which took effect this past january, are now forcing hospitals throughout the state to close beds, deny patient transfers, increase ambulance diversions and require longer waits in the emergency room. the major reason for hospitals' inability to meet the nurse-to-patient ratio regulations: a dire shortage of nurses and dhs' interpretation that the ratios must be met "at all times." the california nurses association would have the public believe that there is no nursing shortage. the cna, a labor union for nurses, even goes on to claim that california has 30,000 more nurses than we had just three years ago, yet this is not supported by the facts. california ranks 49th among states in the number of nurses per capita, according to 2001 data by u.s. bureau of labor statistics. only nevada has fewer. the state economic development department says california will be short more than 30,000 rns by 2006. by 2010, the department adds, the shortage will more than triple -- to more than 109,000 rns...

    read more: http://www.sfgate.com/cgi-bin/articl...dgb95ogri1.dtl
  13. by   PMHNP10
    Quote from Katerina
    It would help if other regulations such as the waiting period, after failing the NCLEX exam on the first try, would be less than three months
    OR
    hiring new staff at Cal Board of Nursing to speed up the RN licencing process. Is this possible?
    I have heard that the first statement is being considered to being dropped down to 45 days. Whether or not it will happen is a whole different story.

    As for the second, I'm guessing the budget can't afford such a thing at this time.

close