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Hospital unfazed by nursing decision

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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