State-Mandated Nurse Staffing Levels Delayed Again
HEALTHCARE
by Vita Reed
The New Year for California hospitals was supposed to bring state-mandated nurse staffing guidelines. But it looks like that’s one more resolution deferred.
State regulators said at the end of December that they had not finished nurse-to-patient ratio regulations that were scheduled to take effect Jan. 1. A California Department of Health Services spokeswoman, in published reports, noted that the process was complex and time-consuming and that regulators still had to analyze data they gathered.
Gov. Gray Davis signed the nurse-staffing bill around four years ago, making California the first state with minimum staffing levels for hospital units encoded into law.
But staffing ratios have been a point of hostile debate between hospital industry groups, such as the California Healthcare Association, and nurses unions like the California Nurses Association.
Industry representatives have suggested ratios of one nurse for every 10 patients, contending that California is still in the throes of a nursing shortage, among other things. By contrast, the California Nurses Association would like to see ratios as high as one nurse for every three patients, arguing that more nurses would improve patient care and make the nursing profession more attractive.
The latest delay, however, prompted a relatively mild reaction from both sides. The hospital association said that it would refrain from taking a position until the new rules actually come out, while the nurses union was diplomatic, stressing its desire to see the ratios done correctly.
Nurse staffing rules were supposed to take effect about a year ago, but officials postponed implementation because the parties couldn’t agree on ratios. When the state finally does impose the new nursing rules, hospital officials will be putting out more money to comply. The San Francisco-based Public Policy Institute of California, a not-for-profit research group, reported in August that each hospital in California could spend $200,000 to $2.3 million to comply with the staffing law.
Institute economist Joanne Spetz found that at least half of the hospitals in California and perhaps as many as 95% would be affected by new minimum staffing ratios under three separate scenarios. She found that the healthcare association’s proposal would come in at the low end, at around $200,000 per hospital, while a proposal backed by the Service Employees International Union and others would cost more than $1.3 million, while the nurses union’s proposal could cost hospitals upward of $2.3 million a year.
There are still some who question whether mandatory nursing ratios enhance patient safety. Last summer, the federal Agency for Healthcare Research and Quality reported that mandatory nursing ratios didn’t even make a list of top 11 patient safety practices that the agency looked at and that more research was needed.
In a separate nursing matter, the American Association of Colleges of Nursing released survey results showing that enrollments in entry-level baccalaureate programs in nursing increased this past fall, ending a six-year period of declines.
The association based its responses from 548 nursing schools with bachelor’s and graduate-degree nursing programs. It found that total enrollment for fall 2001 in such programs was 106,557. In 1995, the year when the association said total enrollments started to dip, the number was 127,683 for all baccalaureate nursing programs.
Survey data showed that enrollment in entry-level baccalaureate nursing programs up 3.7% from fall 2000. In terms of regions, the association reported that Western nursing school enrollment, including California, went up 3.4%. By comparison, enrollment in Midwest and North Atlantic schools both increased 3.5% and Southern nursing school enrollment went up 4%.
Association officials, however, said that the enrollment numbers would still fall short of what is needed,figures from the U.S. Bureau of Labor Statistics show that the country will need 1 million new nurses by 2010.
St. Joseph’s New Chief of Staff
Dr. William Collins is the new chief of staff at St. Joseph Hospital-Orange. Collins was most recently vice chief of staff at the 469-bed hospital, one of three local facilities owned by St. Joseph Health System, Orange.
Collins has been associated with St. Joseph-Orange for more than 27 years. He received his bachelor’s degree from Holy Cross College in Worcester, Mass., and his doctorate of medicine from Indiana University School of Medicine. His background also includes four years in the U.S. Army Medical Corps.
The doctor is board certified in both internal medicine and gastroenterology. He’s been an assistant clinical professor of medicine at University of California, Irvine, since 1974.
Bits and Pieces:
Hoag Memorial Hospital Presbyterian, Newport Beach, said it earned five-star ratings from Health Grades Inc., a Lakewood, Colo.-based healthcare information company that issues a yearly hospital “report card.” The data, collected from 1998 to 2000, gave the 409-bed hospital high marks for cardiac care, orthopedics, obstetrics, neuroscience and pulmonary/respiratory care.
