Nurse-to-Patient Ratio Rules Cause Emergency Rooms To Divert Ambulances, Survey Says
Nearly half of hospital emergency rooms have diverted ambulances because they have not been in compliance with staffing regulations established by new nurse-to-patient ratio rules that took effect Jan. 1, according to an informal survey by the California Healthcare Association, the San Jose Mercury News reports. The survey of 150 hospitals also found that about 90% of hospitals said they have been out of compliance with the new staffing rules at some point (Feder Ostrov, San Jose Mercury News, 1/27). Under the new staffing rules, nurses will not have to care for more than eight patients at a time. The rules also call for one nurse per five patients in medical-surgical units by 2005, as well as one nurse per four patients in specialty care and telemetry units and one nurse per three patients in step-down units by 2008. In addition, the regulations state that licensed vocational nurses can comprise no more than 50% of the licensed nurses assigned to patient care and that only registered nurses can care for critical trauma patients. The rules also require at least one registered nurse to serve as a triage nurse in ERs (California Healthline, 1/15). The Mercury News reports that ERs in Santa Clara County diverted ambulances for a total of 243 hours between Jan. 3 and Jan. 16, "more than double" the amount of time that ERs diverted ambulances during the same two-week period a year earlier. According to the Santa Clara County Emergency Medical Services Authority, hospitals attributed more than 40% of the 2004 period's diversion hours to the new nurse-to-patient ratio rules.
CHA spokesperson Jan Emerson said that ER doctors and nurses must "either provide the care and be in violation of the law, or they make the very difficult decision of turning patients away and not violating the law." Chuck Idelson, a California Nurses Association spokesperson, said, "A large part of this is political. There've been diversions for years due to inadequate staffing" (San Jose Mercury News, 1/27).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.