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Schwarzenegger Attempts to Halt Scheduled Decrease in Nurse - Patient Ratios

  • December 9, 2004

California Governor Arnold Schwarzenegger has sought to delay the scheduled reduction of mandatory nurse-to-patient ratios for combined medical/surgical hospital units. State Health Director Shewry has requested an "emergency regulation" to maintain the current mandated ratio of one nurse for every six patients. The reduction from six to five patients for every nurse is currently scheduled to take effect Jan. 1, 2005.

If the emergency regulation is accepted, it will remain in effect for 120 days after its filing date with the secretary of state. During that time, the administration may use normal procedures to get a new regulation in place, or it may seek to readopt the emergency regulation.

If the emergency rule is approved, the California Department of Health Services will hold a public hearing in January and may have a new regulation within a year's time, according to Brenda Klutz, the agency's director of licensing and certification. Ms. Klutz was quoted in an article in the BNA Daily Labor Report on Nov. 8, 2004. "During the ten months that nurse-to-patient ratios have been in effect, they have been cited as a cause for the closure of two hospitals and the closure or reduction in capacity of several hospital emergency rooms and other patient care units," CDHS said in its "finding of emergency" statement. Klutz told BNA, "We cannot verify, but neither can we refute" anecdotal evidence that the competition for nurses in California is so severe that "it is nearly impossible" for non-hospital health care facilities to hire enough staff.

The nurse-to-patient ratio law mandates staffing ratios in a number of different medical units, including critical units, operating rooms, and emergency rooms. It went into effect Jan. 1, 2004. The proposed emergency rule would implement the following changes:

  1. the current one-to-six nurse-to-patient ratio in medical and surgical units would remain in effect until Jan. 1, 2008;
  2. hospital emergency departments could temporarily divert from mandated staffing ratios during an unexpected and unpredictable influx of patients;
  3. nurses' duties would need to be reassigned for restroom or telephone breaks (current regulations require duties be reassigned during meal breaks or other employer-mandated work breaks).


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