Re "HMOs Don't Squeeze Only Doctors," Commentary, July 19: Jean Chaisson's commentary supporting mandated nurse-to-patient staffing levels in hospitals, while passionate and heartfelt, leads the reader to the wrong conclusion. The Institute of Medicine (at the request of the U.S. Congress), California Department of Health Services and others have come to the same conclusion: Nurse-staffing ratios are inefficient, inflexible and can result in poor care.
There is no documented trend showing deterioration of care in California's hospitals. There have not been cutbacks in the number of professional nurses who provide inpatient hospital care. In fact, a study by the California Strategic Planning Committee for Nursing found that the average number of nursing personnel hours per patient day in California is rising.