Issue link: https://nnumagazine.uberflip.com/i/971007
4 California's historic first-in-the-nation safe staffing ratios, sponsored by the California Nurses Association, took 13 years to win and have been in effect since January 2004 despite continued efforts of the hospital industry to overturn the law. The bill was enacted in 1999 following an extensive grassroots campaign by RNs with broad support from patients and the general public that included thousands of letters, calls, and a massive CNA rally on the steps of the state Capitol in Sacra- mento on the day of the final legislative vote. A concurrent public opinion poll found that by 77 to 13 percent, Californians believed it is "a good idea to have a certain safe number of trained registered nurses per patient to protect the quality of care" and 69 percent they "would expect" the governor to sign the bill. Shortly after, Gov. Gray Davis signed the bill into law. Hospital executives lobbied to defeat the law, tried to persuade state health officials to adopt unsafely high ratios, filed a lawsuit to try to block enforcement of the ratios at all times, encouraged hospital managers to evade the letter and spirit of the law, and recruited compliant allies to propose measures to overturn it. All those efforts have failed. Safe RN ratios have improved quality of care and nurse recruitment and retention in California hospitals. Staffing continued to improve with a 1:3 ratio (from 1:4) in step-down units and 1:4 (from 1:5) in telemetry and specialty units implemented in January 2008. RN Ratios 101 California's Safe Staffing Ratio Law — It's more than just the numbers