As a new state law requiring hospitals to hire more nurses per
patient took effect on New Year’s Day, reaction in the
medical community was deeply divided over the implementation of the
new legislation.
On Jan.1, while nurses across California celebrated the
opportunity to provide more attentive health care, some hospitals
lamented that they lacked the human and financial resources to
satisfy the new requirements.
But for the UCLA Medical Center, it was business as usual as the
hospital adjusted to the new requirements with relative ease.
“(UCLA Medical Center) will meet the staffing
ratios,” said Heidi Crooks, director of operations and
patient care services for UCLA Medical Center. “We have
already met them for some time.”
Crooks credited UCLA’s prestigious reputation with helping
to attract nurses in times when resources and personnel are scarce.
U.S. News and World Report consistently rates UCLA Medical Center
among the top hospitals in the nation.
“We have the name UCLA, which is attractive (to
prospective nurses),” Crooks said. “If they want to
work in an academic institution, this is the place to
work.”
Other Los Angeles hospitals are finding the nurse-patient ratios
to be much more difficult, ratios ranging from one nurse for every
two patients in intensive care units to one nurse for every six
patients in psychiatric and surgical wards.
Martin Luther King/Drew Hospital in Willowbrook, a public
hospital serving a predominantly poor and minority population, is
not meeting the state-mandated ratios.
“We’re working on it like everybody else,”
King/Drew Hospital Nursing Recruiter Carolyn Tailor said.
“There are not that many nurses. The shortage of nurses is
affecting the state as a whole.”
Santa Teresita Hospital, located in Duarte, closed its emergency
room and acute-care facilities on Jan. 9 due to an insufficient
number of nurses.
The plight of Santa Teresita reflects the difficulty of
implementing the nursing ratios. Many hospitals say they do not
have the capability of meeting the requirements; with the new
legislation their very existence is now at risk.
Hospital officials statewide have waged a four-year campaign to
delay or revise the implementation of the ratios.
“We think that this is going to be, at least in the short
term, a train wreck,” said James Barber, president and chief
executive of the Hospital Association of Southern California.
Officials cite the shortage of available nurses, as well as the
substantial additional costs connected with the new regulations, as
reasons the new legislation must be reevaluated.
The California Department of Health Services estimated that the
implementation of the new ratios will cost hospitals roughly $480
million a year.
Yet hospital officials say the greatest challenge is not
acquiring the financial resources to pay a larger staff, but simply
finding nurses to hire.
“The issue isn’t whether or not we want to hire more
nurses,” said Hospital Association of Southern California
executive vice-president Jim Lott, in a debate held Dec. 4.
“The issue is that we simply can’t find
them.”
Despite the hospital industry’s concerns, Gov. Arnold
Schwarzenegger did not take any action to delay or revise the
legislation before it took effect on Jan. 1.
Tailor was skeptical of hospitals claiming to already be
compliant with the newly imposed ratios.
“There are some facilities that say they will be meeting
the ratios, but if you talk to the actual nurses at the hospital,
it is a different story,” Tailor said.
Nurses at UCLA, though, expressed satisfaction with the
facility’s response to their demand for more reasonable
nurse-patient ratios.
Amelia Morva has been a nurse at UCLA Medical Center since 1994.
She said there has been a dramatic improvement in the number of
patients allotted to each nurse during her time at the
hospital.
“A long time ago, practices were unsafe,” Morva
said. “We were too busy ““ we didn’t even have
time to think. But there have been lots of improvements (in recent
years).”
Morva said UCLA Medical Center began a concerted effort to
better nurses’ working conditions in 1999, when the bill to
establish ratios was originally introduced and passed by the state
Assembly.
Anticipating the near-certainty of the proposed legislation
becoming law, UCLA began a long transition to meet the ratios prior
to formal implementation by the state.
Morva said UCLA’s early response enabled the facility to
easily adjust to the new ratios while neighboring hospitals, such
as Santa Teresita Hospital, face extreme difficulties.
Nearly two weeks after the new ratios took effect, Morva and
many other nurses remain elated about the new policies and the
effect they are having on their performance, despite the stress
most hospital officials feel.
“With the new ratios, nurses can give the best
service,” Morva said. “Now (we) are able to provide the
care the patient needs.”