Editorials Weigh In on State’s New Nurse Staffing Ratios

The new minimum nurse-to-patient ratios unveiled by Gov. Gray Davis (D) on Tuesday "put California in the forefront of efforts to protect hospital patients from dangerously low levels of staffing" and "should assure patients they will receive top-quality care," according to a San Jose Mercury News editorial. The Mercury News writes that there is "plenty of evidence that current staffing levels, [which] often leave one nurse in charge of 10 seriously ill patients, are inadequate." The editorial notes that the ratios will force hospitals to spend more on hiring nurses but says that the state "should be able to absorb the increase [in costs] in return for adequate care," adding that hospitals "will save some money as they pay less for overtime and for expensive registry nurses hired by the day." The Mercury News concludes, "California's efforts in this field are being closely watched by other states. Although implementation is still 18 months away, the day is coming when patients can regain some confidence that when they enter a hospital, they'll be taken care of by nurses who aren't trying to watch too many patients and who aren't working exhausting overtime schedules" (San Jose Mercury News, 1/24).

While Davis' announcement of the ratios "seemed like major news," the new standards "may end up more of a symbolic victory for the nurses union, and a defeat for the hospital industry, than anything of enormous substance," according to a Sacramento Bee editorial. According to Joanne Spetz, a researcher at the University of California-San Francisco, 80% of California hospitals already comply with the new standard of one nurse per six patients on general medical floors. The standard eventually will be reduced to one nurse per five patients. The Bee writes that a "typical Sacramento-area hospital could meet the standard by hiring as few as four additional nurses." The editorial also notes that Davis did not initially specify which types of nurses will be included in the new ratios, but the Department of Health Services later said that both registered nurses and licensed vocational nurses will meet its definition. "Allowing hospitals to count LVNs as nurses means many of them already comply with this staffing standard," the Bee writes. The editorial concludes that the ratios also may "distract policy makers from other problems, such as a growing shortage of nurses and the failure of the state to train enough new ones. These issues may not attract the news cameras, but solving them would truly change the world of nursing ... for the better" (Sacramento Bee, 1/25).