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20 » RNs in Motion 20 » RNs in Motion 13-YEAR FIGHT TO WIN CALIFORNIA'S STAFFING RATIOS 1993 First ratios legislation, A.B. 1445. 1996 Proposition 216: ballot initiative, cosponsored by CNA. Ratios were a core component of this HMO reform. More than three million Californians vote for Prop. 216. 1998 Staffing ratios bill, A.B. 695, wins approval in the legislature for the first time. California Gov. Pete Wilson vetoes A.B. 695 after extensive lobbying by the hospital industry. 1999 A.B. 394 introduced by then-Assemblymember Sheila Kuehl. CNA gathers more than 14,000 letters in support and commissions public opinion poll showing 80 percent public support for the bill. A.B. 394 passed by legislature after CNA mobilizes 1,500 RNs for a rally on the steps of the Capitol on same day the Senate votes on the bill. Gov. Gray Davis signs the bill, making California the first in the nation to require RN staffing ratios. 2001 CNA mobilizes more than 2,000 RNs for a rally in Sacramento demanding adoption of CNA's proposed ratios. The hospital industry proposes 1:10 for medical- surgical, telemetry, and oncology units. 2002 Gov. Davis and the Department of Health Services (DHS) announce specific unit ratios. Hospital industry's proposed ratios are soundly rejected. 2003 The hospital industry continues its failed campaign to defeat the ratios with an 11th-hour lawsuit filed in Sacramento Superior Court seeking exemption from compliance during all breaks and mealtimes. 2004 January — RN staffing ratios become law in all California acute-care hospitals. Statewide campaign to monitor and enforce the ratios is launched. CNA mobilizes 500 RNs in a courthouse rally to protest hospital lobby lawsuit. Superior Court soundly rejects lawsuit and issues sweeping ruling upholding the law that ratios must be adhered to at all times. November — California Gov. Arnold Schwarzenegger issues emergency regulation suspending portions of ratios law in medical-surgical units and emergency departments. CNA begins immediate protest campaign that includes radio and TV ads, nurses' letters to the editor, and extensive media coverage from around the world. December — More than 2,500 RNs rally on the Capitol steps in Sacramento, Calif. in major protest against ratios suspension. Capitol steps covered by a sea of red CNA signs with slogans like "Patients Are Our Special Interest" and "Protect Our Patients, Let the Ratio Law Stand!" About 300 RNs protest Gov. Schwarzenegger at his Conference on Women in Long Beach, Calif. Inside, RNs display a banner reading, "Hands Off Patient Ratios." Schwarzenegger retorts "Pay no attention. They're just the special interests who don't like me because I am always kicking their butt," a remark that gains national notoriety. Associated Press reports on CNA challenge: "Picking a fight with nurses is another matter, ranking up there with bad-mouthing mom and apple pie. A national Gallup poll showed that Americans for the third year in a row rated nurses as 'the most ethical and honest professionals' in the country." 20 » RNs in Motion RN Safe Staffing Ratios PATIENT ADVOCACY— OUR GUIDING PRINCIPLE