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E rin bennett couldn't believe what she was reading when she clicked on that email July 27. "I was absolutely outraged [to learn] from our labor rep that my hospital applied for a staffing ratios wavier," recalled Bennett, an RN in the medical-surgical unit at Sutter Lakeside Hospital in Lakeport, Calif., located nearly 120 miles north of San Francisco. "Our hospital has never had to go into surge capacity for caring for Covid patients. At the time, we had a max of four Covid patients and we were low census." California is the only state with a nurse-to-patient ratios law, which sets a maximum number of patients that can be safely assigned to one nurse in acute-care hospitals. Due to the pandemic, the California Department of Public Health (CDPH) allowed hospi- tals to apply for a waiver of the staffing ratios if there was a surge in patients or a staffing shortage. In early July, the CDPH issued an All Facilities Letter (AFL) that allowed waivers until March 2021. Of course, California Nurses Association nurses have been on high alert to hospitals using the pandemic as an excuse to circumvent the ratios law, which the hospital industry has always opposed and consis- tently tried to undermine. So RNs have mobilized and fought back to ensure that hospitals do not make crisis standards permanent. Bennett immediately called her coworkers to see if they got the email, too. Meanwhile, their labor rep sent a request for information to human resources and the chief nursing executive, asking many questions about what qualified them to apply for a waiver and giving them a week to respond. "We immediately pushed back and had a day wearing safe staffing stickers," said Bennett. "The respiratory and physical therapists were wearing stickers. Even patients wanted to have stickers, especially after they understand that safe staffing is why you have safe outcomes. We informed patients that California has some of the best hospital out- comes because we have safe staffing ratios. Safe staffing saves your life." By Tuesday, Aug. 4, the nurses won. The hospital withdrew its waiver application. Bennett says management never answered any questions about why the hospital applied. "They tried to sneak the waiver in and they got caught." Meanwhile, nurses at other facilities were also making their voices heard in July. At John Muir Medical Center in Concord, about 30 miles east of San Francisco, nurses were "in a unique situation," said Kate Thurston-Mobeen, an RN in the telemetry unit. "Throughout the pan- demic, we were in contract negotiations, so more was at stake. We made a decision in late June, early July to make ourselves heard through a [public] action. We held an action on July 8 to make them listen." Around mid-July, Thurston-Mobeen said their labor rep told them that the hospital had applied for a waiver. The next day the nurses met with their rep and Thurston-Mobeen went to every unit and handed out flyers and stickers. "We met with nurses the whole morning," said Thurston-Mobeen, who is on the professional practice committee and a member of the bargaining team. "When we got confirmation on July 17 at 7:30 a.m. that the waiver was filed, we started to email and text blast membership." 20 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 2 0 Nurses successfully fight back pandemic plays to circumvent safe staffing ratios. B Y C H U L E E N A N S V E T V I L A S