Why can't the other 49 states get ratio laws?

Noryn · Nov 9, 2007

Contact your legislators and write to the papers. California is often the leader on issues. But the CNA really did a great job of organizing the nurses especially after the governor went against them. Ratio laws have been debated for years however most hospitals send their nurses in administration to fight these, saying "You just dont know the hardship and heartache you will cause especially in a rural area." So nurses in administration are one of our own worst enemies, along with the multi million or billion dollar hospital corporations.

But you are right on the money. In my state care is pathetic and an embarassment.

RN1989 · Nov 9, 2007

Because no one has been able to rally enough nurses in the other states to be able to effect change. Nurses are too scared and/or too apathetic to try to fix their own issues. They are unwilling to do the hard work required to lobby their legislators and the private wealthy citizens who could help effect that change. I've seen more teachers come to offer their support of nursing at rallies than I have seen actual nurses show up! Oh yeah, and let's not forget people like the ANA who let it be known that people without MSNs (or a BSN at the very least) should not be allowed to be nurses. Their stance on that just continues to divide nurses. There's a reason why several states have parted ways with the ANA. Of course all the real nitty gritty issues aren't common knowledge so most nurses don't even really know what the issues are in nursing and how to fix/fight them.

sharona97, BSN, RN · Nov 9, 2007

Petition your cause and bring it to the powers that be at your state level. My sister-in-law is currently fighting for a medical cause and she has proceeded in this way and now has TV coverage. "I'm a one man army" is what she wrote to me. Huge task, but some of us are made for implementing.......... Good Luck Bethin. Great cause.

rn undisclosed name · Nov 9, 2007

Well, I am in Illinois and effective January 1 there is a law for staffing by acuity. Big whoopy doo. In my eyes NOTHNG will change. There is supposed to be a committee for this that is supposed to include bedside nurses. Now, how often do they listen to the bedside nursing when it comes to staffing? Each hospital is responsible for implementing their own plan. I still believe this does a BIG nothing for staffing. So basically nothing will change and it will be back to the way it was. It is basically the governors way of saying he is doing something to address the staffing issue when in reality the hospital still maintains control and doesn't have to make changes to address this issue.

classicdame, MSN, EdD · Nov 9, 2007

First, a ratio law does not automatically fix the problem. That is why the other states have not followed CA. One patient can keep you extremely busy and 5 may not, depending on many factors. Also, nurse:patient fixed ratios may result in support staff not being available, since the hospital will have to pay higher wages to nurses. Texas law states that the ratio must be SAFE, and is dependent on skill mix and patient acuity. Therefore, the NURSE decides. There is safe harbor for when the nurse is over-ruled. Rarely does a rule work in every situation and patient safety is impt. More staff who are better educated is the answer, but not always achieveable budget-wise.

cjmjmom · Nov 9, 2007

I may be an optimist but I believe as time goes on and nurses learn to stand together, united, we will get ratios and safer staffing conditions! It takes time and LOTS AND LOTS of effort but it will be done! Our patients deserve the best we can give them...It is our duty as ADVOCATES!!! The most important thing is that WE, as nurses, STICK TOGETHER!! In Ohio, we are beginning our fight. It is slowly taking form but we have huge obstacles to overcome...namely the Ohio Hospital Association (OHA), the Ohio Nurse Executives (who are affiliates of the OHA) and the Ohio Nurses Association. (They are trying to get a lame bill passed that will change ABSOLUTELY NOTHING about staffing!) Notice that the obstacles are NOT bedside, front line nursing staff... Every state has these same players (and others with financial and professional stakes!). But bedside staff outnumber every single one of these obstacles and we must remain aware of this fact and not let them frighten us!! It is IMPERATIVE for front line staff to recognize we have the POWER to change ANY AND ALL hospitals and systems! If you are interested, go to the California Nurses Association website. Learn about them, pass on the information to others, contact them. I did several months ago and found other like minded Ohio RN's. Certainly glad I did...finally found nurses not only willing to talk about change but willing to make it happen!!

GYPSY1349 · Nov 9, 2007

One Word....UNION.

morte, LPN, LVN · Nov 9, 2007

First, a ratio law does not automatically fix the problem. That is why the other states have not followed CA. One patient can keep you extremely busy and 5 may not, depending on many factors. Also, nurse:patient fixed ratios may result in support staff not being available, since the hospital will have to pay higher wages to nurses. Texas law states that the ratio must be SAFE, and is dependent on skill mix and patient acuity. Therefore, the NURSE decides. There is safe harbor for when the nurse is over-ruled. Rarely does a rule work in every situation and patient safety is impt. More staff who are better educated is the answer, but not always achieveable budget-wise.

oh dear, and what section of management are ye employed by?!

safe harbor, as far as i have seen here on allnurses isnt worth the powder to blow it to, were ever you might like....if you file for it you had best have another job lined up........

allnurses Guide · Nov 9, 2007

First, a ratio law does not automatically fix the problem. That is why the other states have not followed CA. One patient can keep you extremely busy and 5 may not, depending on many factors. Also, nurse:patient fixed ratios may result in support staff not being available, since the hospital will have to pay higher wages to nurses. Texas law states that the ratio must be SAFE, and is dependent on skill mix and patient acuity. Therefore, the NURSE decides. There is safe harbor for when the nurse is over-ruled. Rarely does a rule work in every situation and patient safety is impt. More staff who are better educated is the answer, but not always achieveable budget-wise.

This did happen last summer at the rural hospital where I used to work. We lost our nurse advocate DON and a new CEO came in focused on financial issues. We lost all our CNA's and Ward Clerks. After butting heads against brick walls, I quit, because of patient safety issues.

And I'm in California - with the ratio law.

Many hospitals chose to cut staff after the ratio law passed.

It isn't a panacea.

steph

Rnandsoccermom · Nov 9, 2007

Well, I am in Illinois and effective January 1 there is a law for staffing by acuity. Big whoopy doo. In my eyes NOTHNG will change. There is supposed to be a committee for this that is supposed to include bedside nurses. Now, how often do they listen to the bedside nursing when it comes to staffing? Each hospital is responsible for implementing their own plan. I still believe this does a BIG nothing for staffing. So basically nothing will change and it will be back to the way it was. It is basically the governors way of saying he is doing something to address the staffing issue when in reality the hospital still maintains control and doesn't have to make changes to address this issue.

They got around that where I work by adjusting their "numbers" to make sure the nurses have 7-9 patients. When we are over in the "numbers" they complain, and want to send people home early. If we are under, they do absolutely nothing.

pickledpepperRN · Nov 19, 2007

Regarding decreasing nursing assistants, secretaries, and other caregivers it is NOT allowed.

Title 22 licenses hospitals. It requires that Hospitals must provide staffing in accordance with the nurse-to-patient ratios.

Staffing for care not requiring a licensed nurse is not included within these ratios and MUST be determined pursuant to the patient classification system.

The regulations: http://www.dhs.ca.gov/lnc/pubnotice/NTPR/R-37-01_Regulation_Text.pdf

Unfortunately there are not enough inspectors to ensure compliance so nurses, other hospital staff, patients, and visitors must report a hospital that does not obey the law.

You can look up the address here: http://www.dhs.ca.gov/lnc/org/default.htm

Have the information such as the name & address of the hospital, the unit, what was unsafe, assignments and room numbers, any harm to patients (med errors, late treatments, incomplete charting, and all the regular what? why? when? how? where? and who?

Did patients miss their bath?, was anyone injured because of insufficient staff?, were there complaints due to slow answering of call lights? What did staff do to improve it? Who did they tell? What did management say?

If the nurses get together to plan what to do and are unified in supporting each other for the sake of the patients a lot can be done.

Some of these administrators don't mind being criminals. They have to be forced by unified nurses, hospital workers, and the community to obey the law so patients get the care they need.

If everyone agrees you may want to document that you told management that the assignment is unsafe in your professional opinion. Keep a copy of the ADO attached to this post.

It takes courage but may safe your license.