National Nurses United

RAD_April 5/7/10 9:38 PM Page 16 Rose Ann DeMoro Executive Director, National Nurses United ALife-SavingLaw,UnderThreat Nurses fought for and won California's staffing ratios. Now we must defend them from corporate politicians. ore nurses, less death." The succinct headline in the Philadelphia Inquirer April 20 about the first major study on California's historic law summed up what nurses and patients have known for a long time. Minimum, specific, numeric RN-topatient ratios, augmented by a genuine patient acuity system, are the single most effective safeguard for hospital patients. It's why California's ratio law has become the national model for safer nursing care, a critical part of addressing the unfinished business of national healthcare reform, which includes establishing a single standard of quality care for all in hospitals. It's also why nurses and patients from coast to coast have a lot at stake in the critical California governor's race this fall. Lower mortality rates, understandably, are the calling-card achievement of the ratio law. But ratios, the study proves, also mean RNs have more time to spend with patients, more time to observe changes in their condition, more time for educating them and their families to promote better post-discharge care. And, by assuring nurses the ability to safely practice their profession, they reduce nurse burnout, keep nurses at the bedside, and promote recruitment of new RNs. The documentary evidence, provided in compelling detail by the eminent nurse researcher Linda Aiken and her University of Pennsylvania research team, dismantled reams of anti-ratio rhetoric from the hospital industry and its acolytes in academia and the American Nurses Association. Case closed— the law works. As we always said it would. There was only one major element missing in the study: agency. California's lifesaving ratios would never have become law, and survived wave after wave of healthcare industry assaults, without the California Nurses Association. It was CNA, with all the power, focus, " M 16 N AT I O N A L N U R S E creativity, and unity of our direct-care nurse leadership and staff, that wrote the law, mobilized thousands of nurses and patients to fight to enact it, produced unprecedented research to assure strong, specific ratios were adopted, defeated a hospital industry lawsuit and regulatory attacks, and stopped the most famous governor in the world when he tried to roll back the law. Further, it's CNA and other National Nurses United and National Nurses Organizing Committee affiliates who have led efforts to pass similar legislation in more than a dozen other states styled on the successful California experience. And it is the coming together of NNU that inspired the creation of a national ratios bill, S 1031, the most comprehensive legislation for nurses and patient advocacy in U.S. history. But all our efforts to pass and defend the law, and to build a powerful national model, should also serve as a sober reminder. Nurses and patients have powerful adversaries in the multi-billion-dollar hospital industry, with all its economic and political clout, and only the continued vigilance of our leaders and members, and support from the public, will protect the law and its life-saving benefits. It's a lifeline that can be very tenuous, as we were reminded when California Gov. Arnold Schwarzenegger issued his infamous emergency regulation in November 2004 at the bidding of the hospital industry as a first step to overturn the law. It took the most herculean effort CNA has ever mounted to save the law. For those who may not recall, Schwarzenegger issued his fiat two days after a Presidential election in which he was widely credited with helping re-elect George W. Bush and was at the apex of his popularity. Many of the supposed experts counseled us to accommodate and conciliate, not fight. But RNs knew how much was at stake and refused to be silent. We decided to target his fundraisers, drawing the links between his corporate contributors and his corporate, anti-patient, anti-nurse, anti-worker agenda. As we held protest after protest, others W W W. N A T I O N A L N U R S E S U N I T E D . O R G began to join us. Soon it was no longer just RNs, it was a mass movement. Schwarzenegger lost in court, he lost in the arena of public opinion, and then he lost at the polls with all four of his anti-union special election initiatives crashing to humiliating defeat. If we had not acted, the Terminator would have won—a prelude to eroding other patient-care and workplace protections. Today, we face a similar challenge. Billionaire CEO Meg Whitman, who some have characterized as "Arnold on steroids," threatens to buy the governor's office in California and ram through an even more amped-up corporate agenda. Whitman's avowed program includes "streamlining" regulations to create a more "business-friendly climate" in California, such as eliminating workplace standards that might interfere with accumulation of profits. So it should come as no surprise that Whitman says she wants to roll back University of California staffing to 2004 levels. That happens to be the very year when the ratios went into effect, and Schwarzenegger, in collusion with the California Hospital Association, sought to overturn them. We will need every ounce of that same people power and street heat again to protect California's law. Now that the evidence is in, we know that silence truly does mean death for hospital patients. From Arizona to Massachusetts, the hospital industry and its allies have contributed to the attacks on the California law which they, too, know serves every day as a living, effective model solution to the patient care crisis for nurses, patients, and legislators in other states and Washington as well. We will have to summon all the creativity, energy, and dedication of our national nurses movement to re-secure the law in California, and to extend its life-saving benefits to the rest of the nation. Rose Ann DeMoro is executive director of National Nurses United. APRIL 2010

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