CA staffing ratios evoke anger 'tween RNs & LVNs - page 2

Big news on the California nursing ratios front. As California prepares to carry out its first-in-the-nation law telling hospitals how many nurses they must have on hand for patients, a bitter... Read More

  1. by   -jt
    <not fighting for the word RN rather than nurse in the legislation>.

    Why do you automatically assume that the original bill written by the RNs did not include or specify the word REGISTERED with the word NURSE when the bill was first submitted to the legislature or that the RN union did not lobby all this time for it to remain with that specification? Did you ever think that despite the RNs efforts, the legislature could have changed the language themselves to appease certain other big-moneyed groups (like the hospital associations) and the Gov agreed to sign the draft with the language he wanted to sign?

    <it is VERY likely that this language was manufactured and inserted by the PACs who didn't want the bill in the first place and so created the loophole to benefit themselves. This problem isn't the union's doing, in other words.>


    And if thats what happened, the Gov played good politics, no? He appeared sympathetic to the plight of the RNs by being understanding of their issues, supportive, and willing to get staffing ratios on the books, he showed the public he cared about their safety by forcing hospitals to increase their staffing numbers - (the public probably sees no difference between the kind of nurse it is anyway), and then he gave the hospitals a way to manipulate it all easier by not specifying "RN" in the language of the staffing law - which he signed in the face of fierce lobbying by the hospital associations & other groups in his state.

    Probably was a compromise with those big business buddies there & he probably knew exactly what he was doing. And that was out of the unions & the RNs hands.

    Looks like he gave everybody a piece & then stepped back to let the Dept of Health figure out the rest... and let them deal with the fur flying. Perfect politics!

    But who created the mess? The state legislature that bowed to hospital assoc lobbying pressure and passed a revised bill for the Gov to sign that said "licensed nurses" instead of "Registered Nurses".
    Last edit by -jt on Nov 20, '02
  2. by   Jenny P
    Gomer, you are baiting others, just as -jt said.

    LNPs/LVNs are LICENSED NURSES. RNs are also LICENSED. The law was written to be about REGISTERED NURSE staffing; but was changed to LICENSED Nurses when it was passed. Now none of the major players is happy about the law.

    The CNA would be happy with the law as written IF it pertains to only RNs.

    The SEIU is in favor of LVN's being included in the staffing ratio becasue they support the fact that LVNs are nurses; BUT they also want the ratios lowered to 1:4.

    The California Hospital Association is in favor of LVNs being included in the ratio in order to save $$$$ too; BUT they want to delay and increase the ratios, AND claim that they'd have to hire an extra nurse to relieve breaks, etc.. (Poor babies, could we please hold off on implementing this law for another couple of years, too so we can figure out another loophole?)

    I got this information from the articles noted in the first posting here and read all 4 articles. Gomer, it sounds like you don't like unions. That's fine, just don't put your twist to the problems here. YOU DON'T KNOW what CNA or the SEIU fought for, nor have you read the actual law, correct? Maybe that would be a good place for you to start.

    This is a serious problem for all nurses (RNs AND LPNs/LVNs), and we should all be keeping tabs on this law and how it is implemented. Maybe a mass email writing campaign from nurses around the country would be in order here-- but I'm not in California, so I won't start it.
    Last edit by Jenny P on Nov 20, '02
  3. by   sanakruz
    I am a member of SEIU. I am an LVN. The hospitals have been fighting these mandated ratios for 6 years! We were so close..Godamn it! Ive been reading everything my union sent me on not knuckling under and accepting the Dept of Health Services offer of 1:6 and sticking to our guns for 1:4. I did not know CNA ( that started the process but couldnt get anywhere until the SEIU got involved; this powerful union represents alot more than nurses) would come in and cut their own throats at the eleventh hour because of their hatred of Kaiser! Im so upset by this im actually in tears! To bring in LVN VS RN **** you!!! this is a red ****ing herring!!!! Dirty politics once again!!!! Watch, it'll take years to resolve this and by then George Bush and the Homeland Security Dept will have busted all unions!!!!
  4. by   michelle95
    Not to denigrate L.P.N.'s, but when push comes to shove, I want an R.N. at my bedside.
    Well, hopefully, you won't have to be taken care of by me...I would probably kill you or something since I am too stupid to know how to do my job being only an LPN...


    I've known some pretty stupid RNs myself.

    Truthfully, a lot of the RNs that I work with are pretty lazy and don't want to do their jobs properly. Would you like me to lump you in that category?

    Don't generalize LPNs and we won't do that to you
    Last edit by michelle95 on Nov 21, '02
  5. by   -jt
    <Ive been reading everything my union sent me on not knuckling under and accepting the Dept of Health Services offer of 1:6 and sticking to our guns for 1:4.>

    What do you mean by the RNs cut their own throats? SEIUs ratio may sound good to you if youre just looking at the surface of what they tell you, but if you read between the lines & look at how it would work in practice, youd see that SEIUs ratio is not as good as the DHS ratio for RNs. The whole issue was about improving RN staffing, so why should RNs accept a ratio that is inferior to the one the DHS wants to give them?

    The intent was 1 RN to 6 pts. And that would have been fine to start. LPNs would still be on staff - just not assigned their own 6 pt load . SEIU is demanding that they be given full pt assignments, & wants that to be 4 pts instead of 6. In theory & on paper 1:4 sounds nice at first glance. But look a little closer......

    The DHS proposal of 1:6 - counting RNs only - is a BETTER ratio than SEIUs because in SEIUs 1:4 any-nurse proposal, the RN still would have at least 8 pts!

    Since SEIU & the hospitals are now also demanding that the nursing staff on the floors be 50% LPNS, SEIUs 1:4 proposal would mean that the ratio for RNs would really turn out to be at least 1:8 - 2 pts MORE than the DHS proposal!

    With SEIU's plan, the RN would have the responsibility of her own 4 pts PLUS the LPNs 4 pts - for a total of 8 pts.

    The DHS ratio gives the RNs responsibility for only 6 pts.

    With SEIU's plan, the ONLY ones who will actually have just 4 pts are the LPNs.

    How is SEIUs plan supposed to be an improvement for RNs? How is SEIUs proposal better for RNs than the DHS proposal when SEIUs requires RNs to care for more pts than the DHS proposal does???? Hmmm?

    Ironic how what was supposed to address the RN staffing crisis by mandating RN staffing ratios could end up benefitting only LPNs & hosiptals, while the RNs still get responsibility for too many pts at once.

    And isnt it strange how so many people can complain about & criticize the RNs for not wanting to accept this??
    Last edit by -jt on Nov 21, '02
  6. by   Gomer
    Let's see, where to begin....well, first, yes I have read the bill (all versions of it), and yes, I'm against unions (never worked in a hospital that had one and never will, although I've been in hospitals that unions tried to get into and failed). Second, the governor is in the pocket of all unions (and other pacs too). When the ratios were announced his picture graced CNA publications and website as if he were some sort of god. I find it hard to believe that at that time CNA didn't understanding the wording in the legislation. And even after the final ratio bill was presented CNA strongly backed him in our election 3-weeks ago.
    Third, yes, I agree LVN's are nurses and I've worked with some great ones. I'm not the one fighting LVN's, CNA is because LVN's can't join (and pay $$$$ to) CNA. SEIU supports the legislation because LVN's can join and pay $$$ to it.

    If you support and belong to a union, should live long and prosper. My only point was that this fight (RN vs LVN) really boils down to which union will control nursing unionization in California. CNA used to be the big cheese in this state, but SEIU has come on strong. Unions are not "sisterhoods" they are businesses who are supported and financed by dues. CNA may be in a fight for its life.
  7. by   -jt
    <that this fight (RN vs LVN) really boils down to which union will control nursing>

    Really? Is that what its about? Funny...... I thought it was about which staffing rato was best to deliver safe care to the pts....

    a ratio of 1 RN for 8 pts minimum with an LPN to help with 4.... (leaving the RN with responsibilty for all 8 plus whatever pt care the LPN isnt able to provide for the 4)......or a ratio of 1 RN for 6 pts only.
    Last edit by -jt on Nov 21, '02
  8. by   Babe
    Sorry to butt in here with a question but as a student things like this really leave me wondering if at my age ( 53) I should continue going to school, I'm being taught that it is the RN who is responsible for everything and everyone ! We are told that everyone including LPNs, work under our directions making us accountable for their actions. In the real world how does it work ? Really having second thoughts here and need some info!!!!
  9. by   LoisJean
    As California goes so goes the Nation. I suggest all LPN/LVNs hold on to their azzes, because the big blow is going to blow even harder. Cripes- the nursing shortage/crisis or whatever spin anyone wants to put on it, is just that because LPNs/LVNs ARE NOT counted as nurses in the mix of numbers. Somewhere along the line it was taken away from us--by bean counters. You RNs bring in big bucks to health care institutions--they charge for your services and pay you back in chump change. For the sake of those big bucks, someone took the autonomy and skills of the Licensed Nurse away--(never mind that it was you, the RN, who taught us and utilized us in those skills) -little by little by little until the very defination of an Licensed Nurse became muddied and murky nation wide. We were not allowed to use what we had been educated to do and were made to become the registered nurse's dependent, rather than her Assistant. And now you are complaining because you have to be responsible for us...!? Go figure. You are getting what you asked for.

    I vow to all that's holy right here and now that I will not ever, never, while I am still breathing, consider myself less worthy of rightful recognition as a NURSE because I am an LPN--and don't any of you try to tell me that worthiness is not the issue. It is. If there were any recognition at all of the prime role of the LPN as a viable member of the nursing community it would not be necessary to belabor this subject. It is PRIMARILY because of this denigeration of the LPN/LVN over the past few decades that I do not any longer grace the halls of any hospital or other institution as a nurse and believe me, that is your loss not mine. I work for myself and that is what keeps me very satisfied within my nursing role. I damn well know who I am and what I am and I am damn good! And as for you, Canada--well, sorry for your experience...but you are a litigeous person--short-sighted, narrow minded people usually are.

    No Peace on this one, Folks-
    Lois Jean
  10. by   -jt
    <I'm being taught that it is the RN who is responsible for everything and everyone ! We are told that everyone including LPNs, work under our directions making us accountable for their actions. In the real world how does it work ?>

    Thats exactly how it is. And thats why the RNs dont want the SEIUs any-nurse proposal that will leave them responsible for the LPNs 4 pts as well as their own 4 pts for a total of 8 pts for the RN.

    Before anyone gets nuts over the RN vs LPN debate, thats not even what this whole thing is about. The issue is the fact that RNs have had to be responsible for a dangerously high number of pts. Its unmanageable. End of story. It does not solve the problem to add more LPNs. That STILL would require the RN to be responsible for the care of too many pts - hers AND the LPNs. Asking for the RNs pt load numbers to be reduced by having enough RNs on staff is not a reflection on or denigration of the LPN. The focus of the issue is getting lost here.
    Last edit by -jt on Nov 21, '02
  11. by   sanakruz
    jt- You dont practice in CA I take it. Rns do not have to "cover" for lvns. The whole point is to get a MANDATED STAFFING RATIO IMPLEMENTED and to leave the LVN vs RN for another fight!! Trust me DHS is NO FRIEND TO NURSING
  12. by   -jt
    Actually I've had my California license for years, am there for part of every year and work in the UC system then. I dont know what you mean by RNs not having to "cover" for LPNs. The RN is legally responsible for the pts & the care they receive, even for the pts that the LPN is assigned to. And the RN must provide all the care for those pts that is not within the LPNs legal scope of practice. Thats not to say that the LPN is unworthy- just that the RN has double the assignment & responsibility. The issue is about manageable pt loads - not which kind of nurse is better.

    DHS may not be a friend of nursing (even with the NY RN they had at the helm as director), but the fact is their proposal gives RNs a ratio of at least 2 pts less than SEIUs. SEIUs plan only will give LPNS the 4 pt ratio. Since they are trying to also manddate that staff on the floor consist 50% of LPNs, the RNs pt load will be doubled that - 8 pts. DHS proposal of 1:6, if applied to RNs, is a better, more manageable ratio for RNs.

    Its not about kinds of nurses - its about numbers of pts the RN is to be responsible for & can safely provide for.

    It has to be settled before any ratios are implemented, because once the wrong ones get implemented, it will be near impossible to change them. The point is not to just get mandated ratios implemented. The point is to get the right ratios mandated & implemented.
    Last edit by -jt on Nov 21, '02
  13. by   sanakruz
    I agree its not about lvn vs rn. Its still dirty pool on CNAs part. As a result we are all stymied,all of us.