National Nurses United

CALIFORNIA S ince the beginning of the Covid- 19 pandemic, nurses have been urging hospitals to prepare for a surge, especially during flu season. But instead of preparing, hospitals contin- ued their just-in-time operations and created a crisis in staffing. On Dec. 11, the California Department of Public Health (CDPH) handed hospitals a gift: permis- sion to violate the state's RN-to-patient safe staffing law. Under "expedited waivers," hospitals can, upon mere submission of the form, increase the workload in intensive care units to 1:3, in step-down to 1:4, in ERs and telemetry to 1:6, and in medical- surgical to 1:7. California Nurses Association (CNA) RNs immediately spoke out to denounce CDPH's dangerous decision, holding more than 25 actions and an online press confer- ence in mid-December. "To roll back the protections Californi- ans fought for years to achieve and defend is a disaster on top of the calamity that is the worst pandemic in a century," said Zenei Triunfo-Cortez, RN and a president of CNA and National Nurses United (NNU). CNA sponsored and lobbied for A.B. 394, the landmark legislation passed in 1999 that put into place minimum nurse-to-patient staffing ratios at acute- care hospitals in California. Nurses know that this is a manufactured crisis. Hospitals could have been training nurses for a surge over the past several months, but instead they laid off nurses, cancelled shifts, and refused to hire more nurses. "My hospital is using Covid as an excuse," said Tinny Abogado, an RN in the step-down unit at Kaiser Permanente Los Angeles Medical Center and a CNA/NNOC board member. Abogado and nurses from across the state shared their stories and experiences during the Dec. 16 press confer- ence. "They saw the opportunity to get around ratios, and are taking it. They have only themselves to blame for any lack of staff and for how exhausted and over- worked we are. Everyone knew Covid was going to resurge in winter and they had almost a year to prepare. They have not done what it takes to build a strong staff pool, but instead done what is best for their bottom line." John Pasha, RN at Good Samaritan Hos- pital in San Jose, an HCA-owned facility, agreed that HCA, too, manufactured its cri- sis. "Our hospital is using a bait-and-switch scheme and willful neglect that's put our community in jeopardy by refusing to hire full-time nurses, by failing to utilize per diem nurses fully, and by failing to attract or retain travel nurses." "HCA can certainly afford to pay compet- itive wages and to honor its contracts," said Pasha, who noted that HCA raked in $2.7 billion in profits for the first nine months of the year. Acuity is having a major impact on a nurse's workload. "Before the pandemic, I took care of four patients at most," said Ner- issa Black, an RN in the telemetry unit at Henry Mayo Newhall Hospital in Valencia, Calif. "During this pandemic, that number has remained the same, but my patients are now much sicker than before. Many of my patients are waiting until their illness or injury is unbearable, before seeking care. They are coming to the hospital sicker and sicker, requiring more care and interven- tions." "With things already stretched to the limit, my employer now wants to assign six very sick patients to nurses like me," contin- ued Black, who noted that her employer laid off 100 staff, including 35 RNs, in June. "Six patients would mean I would only have ten minutes per hour to spend on each patient, including my time spent putting on personal protective equipment!" Mawata Kamara, an ER nurse at San Leandro Hospital in San Leandro, Calif. emphasized that safe staffing is not just about how many patients a nurse has to care for. "The ratios are actually just the bare minimum," said Kamara. "Each patient's acuity is actually what determines how many patients a nurse should get." Rachelle Harig, an RN at Adventist Health and Rideout in Marysville, Calif., also noted that caring for more patients with no help increases the risk of making mis- takes. "This higher ratio doesn't help patients!" exclaimed Harig. "Instead, this policy focuses on unsafe ways for the hospi- tal to make a buck, not what is best for the patients or the nurses." "We are all struggling to manage patients that we have right now," said Kamara. "We know that safe staffing saves lives. Remov- ing safety standards will only increase the suffering and the death count for patients, nurses, and other health care workers." —Chuleenan Svetvilas Protecting safe staffing standards during Covid Nurses fight hospital industry's use of pandemic to attack ratios O C T O B E R | N O V E M B E R | D E C E M B E R 2 0 2 0 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 N A T I O N A L N U R S E 5

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