National Nurses United

NewsBriefs NURSES ARE ROARING FOR RATIOS na/nnoc is on a coast-to-coast campaign to win patient protection legislation in every state, starting with those in which we have a base of members: Arizona, Texas, Illinois, Ohio, and Maine. The patient protection legislation includes several key components, including minimum, numeri- C cal, mandatory RN-to-patient staffing ratios; whistle-blower protection for RNs; and clearly establishing the RN's professional duty and right to act as patient advocate above all other interests. Unfortunately, hospital associations in each state, often collaborating with state chapters of the American Nurses Association, are proposing watered- down, fake staffing proposals that usually require no more than that a hospital post its staffing numbers and policies. With a strong foothold in California, CNA/NNOC member RNs are working hard to make sure real mandatory ratio laws ¶get passed and that patients across the country receive the same high standards of care. CALIFORNIA AFTER A DECADE-PLUS FIGHT to win staffing ratios with multiple attempts at legislation, CNA/NNOC in 1999 shepherded through a law which took effect in 2004. Almost immediately, the hospital industry began attacking the minimum staffing numbers, arguing that they didn't apply at all times, such as during meals and breaks, and convincing Gov. Arnold Schwarzenegger to issue an emergency order to suspend ratios for certain units. CNA/NNOC nurse activists next spent more than a year defending ratios by protesting Schwarzenegger everywhere he showed his face. Ultimately, Schwarzenegger and the hospital industry lost in the courts as well as the court of public opinion and backed off their assault on ratios. So far, the California ratios are a huge success. Some 80,000 new registered nurses have received licensure since 2004, as student and returning nurses enter the workforce and nurses from other states flock to Cali- fornia, confident that they'll be able to safely take care of their patients. RNs across the state report being able to spend more time caring for patients, whether it's reviewing patient charts or teaching their patients how to care for their conditions. Workloads are more manageable and staff turnover is dropping. "I work in a medical unit where a majority of our patients are diabetic and require lots of teaching and monitoring," said Mary Bailey, an RN at Long Beach Memorial Medical Center in Long Beach, Calif. "Our night shift RNs used to have nine to 12 patients before the ratios were in effect. We could never keep a core nursing staff on nights. As a result of the ratio law we don't have more than five patients which gives us the time we need to do patient teaching and has dramatically improved patient outcomes and nurse retention. Our hospital has added 500 new RN positions and we rarely use registry or travelers." ARIZONA ARIZONA RN ANN DICHOV vividly summarizes how it feels for nurses to be overloaded by patient assignments without the protection of mandated nurseto-patient ratios: "You feel like a MAC truck has hit you." RNs in her state are determined to change all that with the passage of ratio legislation modeled after California's groundbreaking law. The Arizona Patient Protection Act, HB 2041, was introduced in January by state Rep. Tom Prezelski at the request of CNA/NNOC and would not only create ratios but strengthen the rights of RNs to report unsafe staffing and to 6 REGISTERED NURSE act as patient advocates. Nurses from across Arizona and the rest of the country marched on the state capitol in Phoenix Feb. 14 to rally support for the bill and pay visits to legislators to urge them to vote yes. (See page 4 in this issue for more details.) Already, the Arizona Hospital and Healthcare Association has launched a scare campaign against the bill, issuing flyers erroneously arguing that ratios ignore acuity and will worsen the state's nursing shortage. RNs like Dichov know better; Dichov used to work in California under ratios before moving to Arizona W W W. C A L N U R S E S . O R G in June 2007 and understands how important it is to have a baseline number of RNs to patients that units never fall below. In fact, the California experience shows that vacancy rates have declined dramatically to less than 5 percent since ratios were implemented. "Even one nurse to four patients is [sometimes not good enough]," said Dichov. "On a typical shift, you'll have at least one admission, discharge, or transfer. It's so much work. This bill is a very important piece of capping the number of patients a nurse can have." MARCH 2008

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