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6 N A T I O N A L N U R S E 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 J U LY | A U G U S T | S E P T E M B E R 2 0 1 9 NATIONAL R egistered nurses at Tenet Healthcare hospitals in Arizona, California, and Florida held one- day strikes on Sept. 20, urging management to invest in nursing staff to ensure optimal patient care at their facili- ties. The strikes in Arizona were the first ever held by registered nurses in that state, and the Florida strikes mark a first for hospital-based RNs in that state. Nurses at 12 Tenet facilities are urging management to invest in nursing staff. This will improve the recruitment and retention of experienced RNs, and ensure optimal patient care, say nurses. More than 360,000 people hold active RN licenses in the states of Arizona, Cali- fornia, and Florida yet are not working as nurses, according to the National Nursing Database, the Bureau of Labor Statistics, the Arizona State Board of Nursing and California Board of Registered Nursing. Some of these people are retired or unem- ployed while others are choosing not to work in the field. "We believe that more nurses in these states with active RN licenses would return to work at the hospital bedside if there were staffing and other working conditions that supported their providing optimal care to patients," said Janice Ames, one of more than 5,500 RNs who work at the Tenet hospitals that went out on strike. "I grew up in this community, this is my home. Our community deserves the best patient care possible and that starts with Tenet investing in its nurses," said Nicolette Afan, an RN in the progressive care unit of Desert Regional Medical Center in Palm Springs, Calif. Arizona nurses at Tenet-affiliated St. Joseph's Hospital and St. Mary's Hospital in Tucson participated in the one-day strike. The 1,000 RNs who work at both hospitals are members of National Nurses Organizing Committee. According to well-established research, there is a clear link between RN staffing levels and good patient outcomes. For exam- ple, research shows that every patient over four assigned to one nurse in a medical- surgical unit could increase mortality by 7 percent per patient. The staffing grid at St. Mary's Hospital allows for up to six patients per nurse in the medical-surgical units. Research suggests that a safe patient load per nurse in a progres- sive care unit, which is one step down in acuity from the ICU, is one nurse for every three patients. At St. Joseph's, the staffing grid allows for up to eight patients in the progressive care unit. The staffing grid at St. Joseph's also allows for three infant patients per nurse in the neona- tal intensive care unit when it is widely accepted that a ratio of one nurse for every two infants at most is best and, often, optimal care requires that a nurse focus on one infant patient assign- ment only. "Our patients are more likely to get opti- mal care when the hospital prioritizes investing in the nursing staff," said Jessica Rose, an RN in the surgery unit at St. Mary's Hospital. "This will strengthen recruitment and retention of experienced nurses and make it possible to bring staffing into align- ment with what research shows is optimal for patient care." California nurses walked out at eight Tenet hospitals: Hi-Desert Medical Center in Joshua Tree, Los Alamitos Medical Center in Los Alamitos, Doctors Medical Center of Modesto in Modesto, Desert Tenet nurses strike in three states NEWS BRIEFS