Nurse-to-Patient Ratios Will Cost Hospitals $900 Million Per Year, Department of Health Services Says
Hospitals statewide will collectively need to hire 5,000 additional nurses at an annual cost of about $900 million in order to meet regulations scheduled to take effect Jan. 1 that set new nurse-to-patient ratios, according to the Department of Health Services, the Silicon Valley/San Jose Business Journal reports (May, Silicon Valley/San Jose Business Journal, 10/24). Under the new rules -- the first such regulations in the nation -- nurses will not have to care for more than eight patients at a time. The rules, the result of a law that Davis signed in 1999, 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 emergency departments. In addition, the regulations will require hospitals to document nurse assignments to individual patients by licensure category for each day and each shift; hospitals must retain the documentation for at least one year (California Healthline, 9/30).
Hospitals already are having difficulty filling nursing positions, and DHS estimates a shortage of about 30,000 nurses by 2006, according to the Journal. Hospital officials have expressed concern about the cost of hiring more nurses and the difficulty in recruiting from local colleges and universities because many nursing programs have been eliminated in budget cuts. In addition, hospital officials are concerned about being able to increase the number of nurses as quickly as patient numbers increase, which might lead to more denials of emergency department patients. Further, the new law might deter hospitals from transferring patients to different departments because of capacity limitations. The nurse-to-patient ratios are based on departments, not on patient care, according to the Journal. "The challenge we all have is, 'Where are we going to get these nurses?'" Christine Delucas, vice president of acute care services at Mills-Peninsula Health Services, said (Silicon Valley/San Jose Business Journal, 10/24). NPR's "Morning Edition" on Wednesday reported on the nurse-to-patient ratio rules and the "creative efforts" of hospitals to recruit nurses. The segment includes comments from Tenet Healthcare spokesperson David Langness and Pulse Healthcare Staffing Vice President Dan Walters (Neighmond, "Morning Edition," NPR, 10/29). The full segment is available online in RealPlayer.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.