Sacramento County Judge Hears Arguments on Mandatory Nursing Staff Levels
Sacramento County Superior Court Judge Gail Ohanesian on Friday heard arguments in a hospital industry challenge to new nursing staff regulations that require extra nurses to replace those who leave their stations to transport patients or to take breaks, the AP/Contra Costa Times reports. Traditionally, hospitals set a nurse-to-patient ratio at the beginning of a shift and maintain it throughout the shift, including during nurses' breaks. The new regulations make that practice a legal requirement (Wasserman, AP/Contra Costa Times, 5/15). The new rules also state that nurses do not have to care for more than eight patients at a time. The regulations 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 law states 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 (California Healthline, 5/11).
The California Healthcare Association, which has 400 hospital members, filed a lawsuit against the Department of Health Services on Dec. 30 -- two days before the nursing staff regulations were to be implemented. The association said the regulation requiring extra nurses during breaks "exceed[s] the law," the AP/Times reports. Robert Leventhal, an attorney for the association, said the "concept makes no sense at all," partly because nurses briefly assigned to patients are more likely to make medication errors or otherwise compromise patient safety. Further, association officials said complying with the ratios is "impossible" because the state has the nation's second-worst nursing shortage, according to the AP/Times. To sustain staffing levels in accordance with the new ratios, hospitals might have to cancel surgeries, discharge patients earlier and turn away patients, hospital officials said. Deputy Attorney General Janie Daigle, who represents the state in the case, said the hospital industry is focusing on one part of the law to protest the new ratios altogether. Officials from the California Nurses Association, which sponsored the law, say the ratios and requirements are necessary to protect patients. Ohanesian "promised to rule quickly" on the case, the AP/Times reports (AP/Contra Costa Times, 5/15).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.