Calif. court upholds nurse-staffing law


    2:37 PM PDT Wednesday June 26, 2004
    Calif. court upholds nurse-staffing law

    A Sacramento Superior Court judge on Wednesday rejected arguments made by the California Healthcare Association that challenged the state's mandated nurse-to-patient staffing ratios.

    The CHA, a Sacramento lobbying group that represents nearly 500 hospitals, sued the state Department of Health Services Dec. 30 to stop it from enforcing the part of the new law that requires compliance during breaks and meals.

    The mandate, which went into effect Jan. 1, requires specific nurse to patient ratios to be maintained in hospitals at all times. The numeric ratios are specific to hospital departments. They range from 1 nurse per patient in trauma units to 1 nurse to 6 patients in a medical/surgery unit. Some ratios get tougher between now and full implementation of the law in 2008.
    The CHA challenged the mandate saying that hospitals should not have to comply with the law when staff takes meal or rest breaks.

    However, Judge Gail Ohanesian ruled Wednesday that CHA's interpretation of the law makes the ratios completely meaningless.

    In her ruling, Ohanesian closed the loopholes for CHA saying, "the hospital must reassign the nurse's patients to another nurse and the reassigned patients must not cause the relieving nurse's patients to exceed the applicable ratios set forth in the regulation."

    Rose Ann DeMoro, executive director of the California Nurses Association, called the ruling a victory for patients and nurses.

    "This is a searing indictment of the hospital industry's illegitimate attempt to deny patients safe care as required by the Legislature, the governor, and the Department of Health Services - and a huge victory for RNs and patients."
    DeMoro said the CNA, which sponsored the legislation, will make sure hospitals understand "there can be no confusion or compromise when it comes to this law and patient safety."

    2004 American City Business Journals Inc.
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    Joined: Mar '99; Posts: 13,361; Likes: 1,376


  3. by   Agnus
    Yes :hatparty:
  4. by   pickledpepperRN
    Quote from Agnus
    Yes :hatparty:

    May 26, 2004

    Court Rejects Hospital Suit to Reverse Safe Staffing Law
    'Big victory for RNs and patient safety,' says Calif. Nurses Assn.

    Sacramento Superior Court Judge Gail Ohanesian today upheld California's historic law mandating safe registered nurse staffing in hospitals.

    In a case watched closely across the nation, the judge issued a sweeping ruling against a lawsuit filed by the California hospital industry that the landmark RN-to-patient ratio law should not apply "at all times," an interpretation that, Ohanesian wrote, "would make the nurse-to-patient ratios meaningless."

    "This is a searing indictment of the hospital industry's illegitimate attempt to deny patients safe care as required by the legislature, the Governor, and the Department of Health Services - and a huge victory for RNs and patients". said Rose Ann DeMoro, executive director of the California Nurses Association which sponsored the law and was an intervenor in the case.

    "Once again California Nurses have shown their power by successfully mobilizing against this lawsuit. Our members should be very proud today," DeMoro added.

    In her ruling, Ohanesian rejected a series of arguments made by the California Healthcare Association (CHA), the hospital industry lobbying arm, that hospitals need not comply with the ratio law while RNs were on meal or rest breaks. On one argument after another, the judge wrote the CHA contentions were "without merit."

    Since the ratios went into effect in January, a sizeable majority of hospitals have been in compliance. Break coverage has been the leading violation, with "some hospital corporations and individual hospitals banking on a victory in court as their backdoor attempt to vacate the entire ratio law," DeMoro said.

    In emphatic language, the judge ruled "the hospital must reassign the nurse's patients to another nurse and the reassigned patients must not cause the relieving nurse's patients to exceed the applicable ratios set forth in the regulation."

    "This ruling slams the door shut and makes it clear beyond doubt that patients are entitled to safe care at all times," DeMoro said. "The industry should be embarrassed for their attempts to undermine the continuous standard requirement that placed in danger all safety regulations in hospitals. CHA wasted the time and resources of the state of California, infuriated RNs, CNA, and patients, and exposed the agenda of the hospitals they represent."

    In the 12-page decision, Ohanesian dismissed CHA arguments that the "at all times" provision was an "interpretation" not found in the law or the regulations to implement the law, and that the industry was unaware of the requirement. The "petitioner (CHA) was on notice at all times during the rule making process that under the regulation nurses who were away from their assigned floors would not be counted for purposes of compliance with minimum ratios," she wrote.

    Additionally, the judge reaffirmed provisions of California law that RNs are the foundation of nursing care and must not be assigned more patients than the specified ratios. Some hospitals have sought to use licensed vocational nurses, rather than RNs, to meet the ratio law.

    Effects of decision will be heard across California and the nation

    DeMoro said CNA will take the message of the ruling to RNs and hospitals across the state to assure that any hospitals continuing to violate the law "understand the unequivocal message - there can be no confusion or compromise when it comes to this law and patient safety."

    She noted that hospitals and nurses throughout the U.S. have been watching the outcome of this case since the suit was filed last December 30, just hours before the ratios became operative. "This ruling should boost the efforts of RNs in several dozen other states who are pursuing similar ratio laws," DeMoro said.

    California's law will continue to be the model for the nation, in providing genuine solutions for the current hospital care crisis and nursing shortage that affects many states.

    Numerous studies document that safe RN staffing reduces preventable patient deaths, accidents, infection rates, and permanent injuries.

    State data documents that the Safe Staffing Law is also helping to dramatically expand the number of RNs in California. Before the law's passage in 1999, the state was hemorrhaging RNs. But in the past three years alone, the number of actively licensed RNs in California has grown by more than 33,000, from 255,145 in January, 2001 to 288,491, as of April 30, 2004.

    CNA conducted a 10-year campaign to win enactment of the ratio law, which included the largest rallies of RNs in state history in the Capitol. On the day of the court hearing in Sacramento May 14, about 500 RNs rallied outside the Capitol and marched to the courthouse.
  5. by   Nitengale326
    AMEN And Congrats California Nurses! :hatparty: During our breaks my "maximum of 7 patients" becomes 14! No way, no how can I manage 14 post surgical patients safely. Virginia, I hope will soon see the light and jump on the wagon as well. Of course, I am not gonna hold my breath but a girl can dream can't she....
  6. by   Agnus
    Virginia will not "jump on the band wagon." It is up to the voters and more especially the nurses to make this happen.

    It was NURSES in California that made it happen. If you sit back and watch nothing will happen it is up to you in your state.

    That is the problem too many people sit and hope for things to happen. They hope someone else will lead. They hope other jump on a wagon. They dream as you say. Dreams are only worth while if you act on them.
  7. by   pickledpepperRN

    Health Care
    Nurses rally for ratios
    By Devanie Angel

    Registered Nurse Paula Helmick used to be afraid that if she took her lunch break someone would die.

    Then, in January 2004, new staffing ratio laws took effect, requiring hospitals like hers--Enloe Medical Center--to have a certain number of nurses in each unit at all times.

    "In the past, we'd just sit in the breezeway and eat our lunch," said Helmick, who works in the Intensive Care Unit. Or nurses would forgo their breaks altogether.
    But the law has also hamstrung hospitals, says the California Healthcare Association, which, disagreeing with the Department of Health Services' interpretation of the law, sued the state to challenge the requirement that hospitals reassign patients to a substitute nurse when the primary nurse becomes unavailable.

    "It really caught hospitals by surprise. We did not believe it was the intent of the Legislature," said Enloe spokesperson Ann Prater. She said the law creates logistical and financial problems that will cost Enloe $1 million a year.

    "Everyone agrees that the more nurses we can put at the bedsides, the better for our patients," Prater said. But she said with the cost and a nurse shortage--something the California Nurses Association disputes--it's difficult.

    About a dozen Enloe nurses joined colleagues from around the state in Sacramento May 14 to protest the hospital industry's attempt to block elements of the law. They rallied outside the courthouse during a judge's hearing.

    Charles Idelson, a CNA spokesman, said the industry's approach is "a classic bait-and-switch." If it succeeds in striking down the ratio rules, he said, it could open the gates to invalidate all other safety laws.

    Prater said a more reasonable interpretation of the law would be to allow flexibility to allow the ratios, which vary by unit, to be met "on average, during the course of the day."

    RN Kathy Lundquist said the new law has given her peace of mind since Enloe hired someone just to relieve nurses for breaks during the course of a shift. "I feel so relieved that I can go on my break and not worry about my patients," she said.

    Helmick said that getting together with other members of the CNA union served an additional purpose. "It's always a rejuvenating experience," she said. "You think that you're the only people having those kinds of problems. It's a great feeling to know you're not alone."

    The California Healthcare Association, of which Enloe is a member, called the rally a "publicity stunt" and "membership drive tactic."