The California Nurses Association promised to fight California Gov. Arnold Schwarzenegger's proposal to relax a 10-month-old law that limits the ratio of hospital patients per nurse.
"We're furious," said Deborah Burger, president of the nurses' union, who criticized the proposal, arguing it would erode California's landmark nurse-patient ratio law and threaten patients' safety.
The union will file its objections during a public comment period and has scheduled a Dec. 1 rally to protest the move.
The proposal, filed with the state Office of Administrative Law by the Department of Health Services, would let emergency rooms temporarily relax ratios during an unexpected flood of patients. It also seeks a three-year delay on the tightening of nurse-patient ratios for medical-surgical patients, set to drop from 1-to-6 to 1-to-5 in January 2005.
Brenda Klutz, the health services department's deputy director for licensing and certification, defended the proposal and praised the ratios. "We believe they've been absolutely good for patient care," she said. "We're not eliminating the ratios. We're not doing anything to jeopardize the ratios."
The health services department needs time to study the consequences of nurse-patient ratios, which have been cited as a cause for ambulance diversions and escalating nurse wages, she said. Nursing homes and home healthcare agencies have complained that it is increasingly difficult to compete with hospitals in an already tight labor market, she said. "The nursing shortage is very real here," she added.
The governor's proposal also clarifies a requirement that hospitals adhere to nurse-patient ratios "at all times." Nurses must be physically located on a unit to count toward the ratio, she said.
The Office of Administrative Law has 10 days to accept or reject the proposal. If approved, the changes go into effect for 120 days, during which time the office will schedule a public comment period. The health services department may ask the administrative law office to extend its approval every 120 days for up to a year, as it seeks permanent approval from the office for the changes.
Jan Emerson, a spokeswoman for the California Healthcare Association, praised the changes and said they give hospitals "common-sense flexibility" to react to the tight labor market or a sudden increase in emergency room patients. California hospitals have reported diverting ambulances to avoid violating the ratios, she said. "It's going to protect patients' access to healthcare services," she said.