Nurse-to-patient ratios proposed by the state Department of Health
Services will allow nurses to focus on fewer patients, but local
nurses and union representatives say the changes won’t take place
The proposed ratios, the first state-mandated standards of their
kind in the nation, would set caps for the number of patients one
nurse can handle in a variety of different areas. For example, a
nurse in a medical surgical unit could only handle up to six patients
at a time.
While many of the caps will go into effect Jan. 1, 2004, some will
not begin until 2008. Representatives of Service Employees
International Union, the largest nurses’ union in the country, say
the changes need to be implemented sooner.
“We can’t let patients wait until 2008 to have safe care,”
spokeswoman Livia Gershon said.
Nora Santos, a registered nurse at Providence St. Joseph Medical
Center, said lower ratios are needed in part because patients are
requiring more care. With so many medical procedures done on an
outpatient basis, Santos, a 14-year nursing veteran, said those who
are checked into the hospital need more attention.
“Patients are sicker now,” she said. “They used to be walking and
talking, but now when they come to the hospital, they are very
Santos works in the telemetry unit, where patients are on heart
monitors. She handles about five to six patients at a time; that
number would be limited to five as of Jan. 1. However, the ratio
won’t be reduced to 1-to-4 until 2008.
State officials are accepting public comment on the proposed
ratios through July 17, and union officials have encouraged their
members to send postcards demanding the caps come sooner, and in some
cases be reduced even further.
The union is also backing a bill in the state assembly that would
fine hospitals that violate the standards $50 per bed per day, and
would allow unannounced inspections of facilities, Gershon said.
“In addition to putting in these new standards, it’s important to
make sure they’re enforced,” she said.
If the DHS does not adjust its proposed ratios, Gershon said union
officials might attempt to achieve the goal through the collective
bargaining process with individual hospitals.
St. Joseph spokesman Dan Boyle said the hospital will comply with
the new standards, but since bargaining sessions have not begun, he
would not speculate whether or not the hospital would dip below the
The hospital already meets or exceeds existing recommended ratios,
and Boyle said it would not be difficult to move into compliance with
the new standards.
“It’s not a die-hard standard right now, but we’re very close to
those ratios,” he said.