Davis Submits Regulations To Establish Minimum Nurse-to-Patient Ratios to Administrative Law Office

Gov. Gray Davis (D) on Sunday submitted to the Office of Administrative Law first-in-the-nation proposed regulations that would establish minimum the nurse-to-patient ratios in each hospital in the state, the Los Angeles Times reports. Under the proposed rules, the ratios would "vary according to the level of care required by each type of patient." The nurse-to-patient ratios would range from 1-to-1 in trauma units to 1-to-6 in medical-surgical units, where the ratio would decrease to one-to-five after the first year (Ellis/Warren, Los Angeles Times, 9/30). Under current state law, California only requires minimum nurse-to-patient ratios for five hospital departments that include intensive and critical care and neonatal intensive care units (California Healthline, 1/23). The new regulations, first proposed in January, would take effect on Jan. 1, 2004. The Department of Health Services based the rules on information collected in unannounced visits to 80 acute care hospitals and 10 state-operated hospitals that began in May 2001. The department will hold public hearings on the proposed regulations in Los Angeles on Nov. 15, San Francisco on Nov. 19 and Fresno on Dec. 4 (Office of the Governor release, 9/29). The California Nurses Association and the Service Employees International Union said that the regulations will "help ease" the state's nursing shortage. However, the California Healthcare Association, which represents hospitals in the state, said that the rules could have "unintended consequences," the Times reports. Jan Emerson, vice president of the CHA, said, "Whatever the ratios are determined to be, hospitals will comply. But to do that, we may have to shut down beds, we may have to shut down entire units; emergency room patients may have to wait longer for care." She added, "It's going to take us years to dig out of that shortage and nursing ratios aren't going to create more nurses magically overnight."

Davis this weekend also signed into law a bill (AB 2314) that would expedite the education of nursing students at community colleges and state universities, the Times reports (Los Angeles Times, 9/30). The new law, sponsored by Assembly member Helen Thomson (D-Davis), will establish a "more efficient and accessible education process and allow nursing students to complete their education faster" (Office of the Governor release, 9/29). The bill also requires the California State University system to standardize nursing prerequisites at each campus (California Healthline, 9/3). Davis said, "These moves make California a national leader in nursing and patient care. They address the quality of patient care and help meet the nursing workforce needs of the 21st century" (Office of the Governor release, 9/29). In addition to the legislation, Davis approved $21 million in grants as the first part of a $52 million campaign to train more than 5,000 nurses over the next three years (Los Angeles Times, 9/30).