State Delays Release of Minimum Nurse Staffing Ratios; Regulations ‘May Not Be Ready for Several Months’

Mandatory hospital nurse-to-patient staffing ratios intended to take effect Jan. 1 will not be implemented on time, as state officials have not yet finished developing the new rules, the Los Angeles Times reports. According to state Department of Health Services spokesperson Lea Brooks, the regulations may not be ready for several months. "It's a very complex, very time-consuming process and we're still analyzing the data we gathered," Brooks said. While staffing requirements previously existed for some hospital areas such as intensive care units, 1999 legislation made California the first state to require mandatory nurse-to-patient ratios in all hospital units. The regulations were intended to take effect in January 2001, but the Times reports that the state "lack[ed] an agreed-upon 'magic number'" for the staffing ratios and delayed implementation for a year. According to Brooks, the state is analyzing proposals from nursing and hospital associations, as well as studies of staffing ratios and information gleaned during "unannounced visits" to 80 acute-care hospitals.

The Times reports that nurses' unions support a ratio as high as one nurse to three patients, saying it would "ease excessive workloads, improve patient care and make the job more attractive" during an ongoing national nursing shortage. Hospital associations favor a ratio as high as one nurse to 10 patients, saying "there aren't enough nurses available for blanket increases" and that "there is no proof that more nurses equal better care." Jan Emerson, a spokesperson for the California Healthcare Association, which represents hospitals, said the group is "philosophically opposed" to staffing ratio regulations, but would wait until they were announced to comment. Jill Furillo, director of government relations for the California Nurses Association, said, "I understand that (the state) is working really hard on them. We need them, but we also want to make sure that whatever they do, they do it right." According to Brooks, a public-comment period of 45 days will follow the state's announcement of the new regulations (Briscoe, Los Angeles Times, 12/30).