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Commentary

New Nurse-Patient Ratios Will Ensure Better Care

January 31, 2002|ROSE ANN DeMORO | Rose Ann DeMoro is executive director of the California Nurses Assn., a union and professional association that represents 44,000 nurses.

Release of California's proposed new nurse-to-patient ratios is welcome news for those who have experienced long waits for care in understaffed hospitals and emergency rooms.

The new ER ratios will have an especially dramatic impact at a time when emergency rooms are closing and patients are enduring long waits for access to medical services while unstaffed beds sit empty.

California's regulations are the first in the nation, but they won't be the last as policymakers grapple with a seemingly intractable shortage of nurses.

The problem is the direct result of 10 years of reckless, market-driven practices by a hospital industry pressured by health maintenance organizations, pharmaceutical companies and other industry giants in pursuit of profits at the expense of patient care.

After years of losing jobs to unlicensed staff, many frustrated registered nurses simply voted with their feet and refused to work in hospitals that they felt endangered patients' and their own well-being.

Hospitals have tried a variety of gimmicks such as huge signing bonuses to attract nurses.

But nurses will not remain in unsafe hospitals.

The shortage problem is not just that nurses are getting older. A National Institutes of Health study last May found that one-third of nurses younger than 30 said that they plan to leave their jobs in the coming year because of poor conditions.

Although the total number of RNs continues to grow, fewer work in hospitals, with many now choosing to work in medical offices, insurance companies, home health agencies or schools.

Only a comprehensive approach can stop the exodus of nurses from hospitals.

Ratios are an essential first step in this effort to repair patient care standards and persuade nurses that hospitals are again a safe place for their patients and themselves.

All other approaches can succeed only after safe ratios are imposed.

Safe ratios will help stop the hemorrhaging of the current nurse work force.

Through collective bargaining, the California Nurses Assn. has won other workplace changes, giving nurses a greater voice in patient-care decisions and banning dangerous practices such as mandatory overtime.

Gov. Gray Davis deserves praise for his bold actions and support for nurses and patients. But the state should not bear the financial burden alone.

The health care industry that created this crisis through shortsighted cost-cutting should provide a dollar-for-dollar match for programs to retrain other staff and help pay for training registered nurses.

The hospitals, which bitterly opposed the safe staffing regulations that Davis proposed, should embrace them immediately to restore safe patient care conditions.

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