Showdown between California hospitals and nurses goes to judge
By JIM WASSERMAN, Associated Press Writer
Posted: Friday May 14th, 2004, 6:35 PM
Last Updated: Friday May 14th, 2004, 6:35 PM
SACRAMENTO (AP) - With a statewide nursing shortage, hospitals and nurses battled in court Friday over new mandatory staffing levels that hospitals say are unrealistic and nurses say are necessary to protect patients.
Sacramento County Superior Court Judge Gail Ohanesian promised to rule quickly on a hospital industry challenge to new regulations requiring extra nurses to replace those who leave their station to transport a patient or take a break.
California Nurses Association Director Rose Ann DeMoro said outside court that there would be a "mass revolt" if the judge reverses rules that took effect in January.
The ruling is also expected to have an impact statewide and nationally, as the two sides battle over how many nurses are needed when they briefly leave their stations. A ruling supporting nurses would boost their campaign for more jobs in other states, while a nod favoring hospitals would help the industry contain costs.
The judge listened to 2 1/2 hours of arguments over the landmark law sponsored by the 57,000-member nurses association.
The Legislature passed the law in 1999 amid concerns over cost-cutting by hospitals and health maintenance organizations, but hospitals claim the state's regulations exceed the law by requiring additional nurses to cover for their colleagues.
"Our main concern is simply that nurses aren't available," said attorney Robert Leventhal, representing the California Healthcare Association's 400 hospital members.
The association sued the California Department of Health Services on Dec. 30, two days before the law took effect, arguing that the nation's second-worst nursing shortage makes compliance impossible. Hospital officials have argued the requirement could cause them to cancel surgeries, discharge patients earlier and turn away patients.
The court challenge is over a traditional hospital practice of assigning nurses to a specific number of patients at the beginning of a shift, and maintaining that nurse-to-patient ratio throughout the shift, even when nurses are on breaks. The new rules require staffing extra nurses on duty to keep up that ratio. No other state has such a requirement.
The new regulations require one nurse for every two patients in intensive care units, labor and delivery, and one nurse per patient in operating rooms and for trauma patients in emergency rooms. Next year it also requires one nurse to five patients in medical and surgery wards, up from one nurse to six patients now.
Attorneys for the state, the nurses union and the Service Employees International Union said the old rules threatened patient safety, leaving them in care of nurses agreeing to cover for them.
"The bottom line is, you can't be assisting someone, and let that person being assisted take a break or go to lunch," said Deputy Attorney General Janie Daigle, defending the state.
Daigle said the hospital industry is using its concerns about one part of the law as a back door to weaken its requirements for higher nurse-to-patient ratios.
Leventhal argued that new nurses briefly assigned to a patient are more likely to mix up medications and threaten the patient's safety.
"The concept makes no sense at all," he told the judge.