Safe Staffing Law Needs Sharper Teeth

May 2012

UNAC/UHCP Nurses fought for nurse-to-patient ratios and our state's landmark Safe Staffing Law, which have been shown to save lives. But these laws need tighter enforcement. During Nurses Week State Secretary-Treasurer Barbara Blake, RN, writing in the North County Times, called for passage of Senate Bill 1246 to save even more lives. Read it here.

A man has a heart attack and his wife calls 911. The ambulance, lights flashing, screams into the ER just in time for doctors to save his life.
Once he's stabilized, he should be sent to intensive care, where he'll receive close monitoring by a nurse who, by California law since 1975, can be assigned only two patients at a time.

Anyone who might ever be a patient in a California hospital can be thankful to our state's nurses who fought for these first nurse-to-patient ratios and our landmark 2003 Safe Staffing law, which implemented ratios in every unit of every acute care hospital in California. These laws have been shown to save lives.

But unfortunately for our heart attack victim, the ambulances don't stop coming. Next up: a gunshot victim. Once doctors dig the bullet out and stop the bleeding, she, too, needs close monitoring in the ICU. But the hospital didn't expect such a busy night, so it didn't schedule enough ICU nurses to cover our heart patient and gunshot victim.

Do they call in another nurse? To follow California's Safe Staffing law and give critical patients the best chance at recovery, that's exactly what they must do. Instead, they quietly move our heart patient to what's called a "step-down unit" ---- DOU, or "definitive observation" ---- where the state allows three patients to each nurse, and where his new nurse's attention will be further divided.

How is this possible? How can the hospital get around specific nurse-to-patient minimums by deciding on its own where to send a patient ---- essentially cherry-picking which staffing rule to abide by?

Without tougher oversight to give our Safe Staffing law more teeth, the pressures of running a hospital can lead administrators to fudge the rules and cut corners, jeopardizing patients.

That's why United Nurses Associations of California are again stepping up to advocate for our patients by toughening the law. We are patients' advocates ---- by calling, and by the legal requirements of our licensing. As bedside nurses, our first duty is always to our patients ---- not to our hospitals' budget or profitability projections. We are the ones who monitor every change in a patient's condition: taking vital signs, administering medicine, assessing recovery moment by moment, and relaying this crucial information to doctors and hospital administrators.

To shore up our Safe Staffing law, we've sponsored the amendments in Senate Bill 1246, authored by California State Senator Ed Hernandez, a doctor of optometry and chairman of the Senate Health Committee.