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LET TER FROM THE COUNCIL OF PRESIDENTS i t 's h a r d t o b e l i e v e that 2009 marks the fifth birthday of ratios taking effect in California, and 10 years since the law was passed. So much has changed since the days before ratios, when many RNs out on the floors were responsible for 10 or even more patients and going home every night wondering if they had hurt, instead of healed, someone. Enforceable ratios have made nursing safe again and brought RNs back to the bedside. The California Board of Registered Nursing has tracked an influx of some 100,000 newly active RNs into California since passage of the ratio laws in 1999. In this issue, we interview RNs about the differences they've observed in their practice before and after this groundbreaking, first-in-the-nation law. What's scary is that it's still the same, crazy, slammed work environment in all the other 49 states out there. Registered nurses across the United States, particularly the South, report that with their staggering patient loads, they're running themselves ragged just trying to make sure no one dies on their watch. Forgive us for being so blunt, but we all know it's the truth. That's why CNA/NNOC is sponsoring ratio legislation in an unprecedented number of states this year, from Arizona to Texas to Pennsylvania. Our friends at the Massachusetts Nurses Association, with whom we've joined forces in the new UAN-NNOC group, have introduced ratio legislation for that state, too. Of course our goal is to have nationwide ratios in effect for all hospitals at all times. Patients—and we'll all be patients someday—deserve no less. We as nurses deserve no less. REGISTERED NURSE,™ (ISSN 1932-8966) The Journal of Patient Advocacy, March 2009 Volume 105/2 is published by the California Nurses Association/National Nurses Organizing Committee, 2000 Franklin Street, Oakland, CA 94612-2908. It provides news of organizational activities and reports on developments of concern to all registered nurses across the nation. It also carries general coverage and commentary on matters of nursing practice, community and public health, and healthcare policy. It is published monthly except for combined issues in January and February, and July and August. Periodicals postage paid at Oakland, California. POSTMASTER: send address changes to Registered Nurse, 2000 ™ Franklin Street, Oakland, CA 94612-2908. To send a media release or announcement, fax (510) 6630629. Registered Nurse™ is carried on the CNA/NNOC website at www.calnurses.org. You know what hasn't changed since ratios? The depths the hospital industry will stoop to repeal, block, or undermine these standards. To win ratios in California, we had to try multiple times and the hospitals fought us tooth and nail every inch of the way. Once we got them, they've lobbied the governor, the Legislature, and the courts to suspend them, weaken them, or adopt "creative" interpretations of what they mean. We've had to fight them on those fronts, too. It's the same story with ratio legislation in every state. The hospital industry is coming out in full force and resorting to every trick in its playbook to prevent states from establishing real patient safety standards. The most common one is counter proposing that hospitals adopt unenforceable staffing plans and form committees to talk about staffing. Nurses are tired of talking. We want action. We want ratios, and we want them now. Deborah Burger, RN | Geri Jenkins, RN Malinda Markowitz, RN | Zenei Triunfo-Cortez, RN CNA/NNOC Council of Presidents For permission to reprint articles, write to Editorial Office. To subscribe, send $40 ($45 foreign) to Subscription Department. California Nurses Association/National Nurses Organizing Committee also produces California Nurse, which it will ™ continue to publish periodically. PLEASE CONTACT US WITH YOUR STORY IDEAS They can be about practice or management trends you've observed, or simply something new you've encountered in the profession. They can be about one nurse, unit, or hospital, or about the wider landscape of healthcare policy from an RN's perspective. They can be humorous, or a matter of life and death. If you're a writer and would like to contribute an article, please let us know. Our contact information is in the masthead. executive editor Rose Ann DeMoro editor Lucia Hwang graphic design Jonathan Wieder communications director Charles Idelson contributors Hedy Dumpel, RN, JD Donna Smith photography Jaclyn Higgs Lauren Reid