Fiestynurse, tell us about the california staffing legislation for tomorrow

massEDgirl · Apr 30, 2002

I am all for nurse patient ratios...and I thinks it is great how far CA has come...Here in MA we look closely at the goings on in the CNA.

I have been an ED nurse now for 8 years...I just don't quite understand their ratio for the ED.....1:3??...1:6??.....How can you set ratio's in the ED??......Beleive me!!!...Not that I would not want them!!

On a floor or ICU there are only so many beds per floor.....So you can kinda figure out how many nurses you would need if all beds were full....and figure out ratios from there.

Now the ED......how do you figure this out??

I work in a busy level II trauma center.....18 regular beds.....(2 of which are trauma rooms....4 of which could be used as trauma if need be).....In the regular section we have the room for another 12-14 hallway spots ...(which we use on a daily basis).....We have an 8 bed observation area which is supposed to be used for patients being HELD in the ED due to no beds on the floor.....(we HAVE used this are for regular ED patients......and we have a 5 bed prompt care area. Also our triage area has 2 beds if you need to lie someone down right away.

Now count the HUGE waiting area with countless chairs that have TONS of triaged patients in them waiting to come in to be seen...(which by the way you are VERY much responsible for)

How can you figure ratios out from this?? There is no controling the amount of patients in the ED...like you can control the amount of patients on the floor. ...You might be able to go on diversion to ambulance traffic ( a trauma center does not always have that luxury)....but the doors to the triage remain open 24/7...there is NO stopping the patient flow that walks in...20....50....100 patients a shift.

Wildtime....looking at the potential number of patients my ED could be looking at , at any one given time.......do you still feel a 6 pt to 1 nurse ratio in the ED is unsafe......He!!...there are some nights I would be happy to have a 10 patient to 1 nurse ratio!!

I think this legistration will eventually be great for the floor nurses....but in all reality I can't see them making it work for us ED nurses.

Gomer · Apr 30, 2002

The staffing ratio "law" was just a political thing. Gov. Davis is in bed with the unions and under his reign CA, wage and hour laws, and labor laws have gone backwards. If we do see the union's staffing ratios go into effect hospitals will just close beds due to the lack of nurses. Or, "richer" hospitals will be able to steal nurses from poorer hospitals, which will probably lead to closure of those hospitals (usually the ones that serve the poorer communities too).