Hospital unfazed by nursing decision
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Jeff Benson
Hoag Hospital officials say a delay in a proposed statewide staffing
increase for nurses won’t affect the city’s central healthcare
provider.
Gov. Arnold Schwarzenegger delayed the increase last week,
temporarily thwarting a requirement for a higher nurse-to-patient
ratio in hospital medical and surgical units.
While Hoag downplayed the importance of the decision, state
nursing officials were angered that Schwarzenegger’s administration
cited as its reason a heavy financial burden that the increase would
have put on medical centers. California Nursing Assn. President
Deborah Burger said the state’s nursing union plans to protest the
decision on the steps of the state capitol building Dec. 1.
The Office of Administrative Law has seven more days to reject or
accept the governor’s emergency regulation.
“As I’ve been telling many people, I’m furious [Schwarzenegger]
has taken such a cavalier attitude toward the safety of the citizens
in California,” Burger said. “We’re not going to tolerate betraying
the public’s trust by taking emergency regulations and cooperating
with the healthcare industry.”
Without Schwarzenegger’s delay, hospitals would have been required
to have one nurse for every five patients, beginning Jan. 1. But the
new emergency regulation announced by health director Sandra Shewry
on Thursday suspends the change until 2008 and holds the ratio at one
nurse for every six patients.
The current ratio is part of a 1999 law sponsored by the
California Nurses Assn., which requires separate nursing ratios for
various hospital departments. For the surgical department, it’s one
nurse for every six patients, and for the emergency department, it’s
one for every four.
The decision to keep the same ratios will not affect the staff at
Hoag Hospital, because it had already raised its nurse staffing level
to meet January’s anticipated mandated increase, said Rick Martin,
Hoag’s chief nursing officer and vice president of Patient Care
Services.
The hospital does not anticipate cutting back the number of nurses
on staff because it wants to maintain the staffing level up to and
through the 2008 increase, he added.
Hoag Hospital administrators had already budgeted and planned
their staffing levels for 2005, Martin said, and didn’t feel a
reduction was necessary before they’d be forced to increase staffing
in 2008.
“We had already budgeted and planned for that so we could meet the
requirements for 2005,” Martin said. “We’re already ready for it. The
challenge is for the other hospitals that can’t meet the ratios. For
[Schwarzenegger], pulling back on it, it gives them an opportunity to
gather their staffs for when the ratios go up at a later time.”
Burger applauded Hoag’s decision to keep its nursing staff levels
up when it isn’t legally required to do so.
“I think it’s an excellent thing,” she said. “They’re not stupid.
The research has proven that every time you add a nurse to your
staff, you improve outcomes in heart-related illnesses, you decrease
hemorrhaging and cases of pneumonia, and you improve the ability of
the patient to get out alive. It’s all because of the education we
provide in patient care.”
California ranks 49th in the nation in registered nurses per
population, Martin said, adding that the problem can be boiled down
to a severe shortage of nursing programs in California and a lack of
funding to support existing programs.
“It’s difficult when you only have 50% of what you need as a
state,” he said. “In the next 10 years, we’re going to need 125,000
[registered nurses]. But at the current levels, we’ll only produce
40,000 in the next 10 years.”
Smaller clinics don’t follow the same nurse-to-patient ratios that
the larger hospitals do, but they could still be affected secondhand,
California Nursing Assn. spokesman Chuck Idelson said.
“If the care standards are reduced in emergency rooms, more people
will show up in clinics with emergency problems,” he said. “Our
entire healthcare system is like a fragile ecosystem. If you affect
one part, you affect all parts of it.”
* JEFF BENSON covers education and may be reached at (714)
966-4617 or by e-mail at [email protected].
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