Quality Concerns Drove Nurses to Action

Your story (“2 Plans to Regulate HMOs Move Toward State Ballot,” April 23) on the initiatives aimed at controlling HMO abuses misrepresents the movement as a union effort, the implication being that they are job-protection actions.

I can speak only for the proposition backed by the California Nurses Assn., “a labor union.” Really? The California Nurses Assn. has many responsibilities and functions, and whereas they do indeed represent some nurses in labor negotiations, the vast majority of nurses in California are represented by no one.

To place this initiative on the ballot, the CNA mailed short forms, good for three signatures only, to registered nurses of California. Activists picked up other, 10-signature, long forms to obtain even more signatures. No paid signature gatherers, just concerned nurses.

The RNs of California were energized to place this measure on the ballot because they have seen firsthand the changes in staffing that threaten the safety, even the lives, of our patients. Nursing today is a sophisticated profession requiring a broad scientific foundation as well as specialized education and training in modern diagnostic, monitoring and intervention techniques.

When minimally trained “unlicensed assistive personnel” are charged with observing and interpreting life-threatening changes in the patient’s condition; when there are not enough RNs to assess patients in the emergency department and to pour massive interventions into life-saving treatments such as rapid identification and treatment of acute heart attack; when, now that you must require professional nursing in order to obtain authorization for admission to the hospital, you are less likely to get it than in any time in my almost 50 years as a registered nurse--these are causes for alarm.

The initiative covers much more than this, and the controls it attempts are badly needed. As a retiree, my motives as I circulated the petitions were not protection of nursing jobs; they were protection of nursing care.

PATRICIA A. FYLER

Brea