Public Comment

Hospitals: Moving Backwards, Medically Speaking

Harry Brill
Friday May 08, 2020 - 12:29:00 PM

On behalf of the state’s hospital patients, California limits the number of patients that a nurse can treat at one time. Generally speaking, one nurse can serve no more than five patients. In intensive care units the maximum for one nurse is two patients (sometimes three). The purpose is to insure that patients receive quality care.

But when these ratios are violated the mortality rate increases appreciably. For example, if the number of patients taken of by a nurse increases from four to six, the mortality rate would climb by 14 percent.

The law benefits nurses as well as patients. Nurses who are not overworked are less likely to burn out and experience physical and emotional exhaustion. And they are much less likely to be injured. In fact, since the nurse-patient legilation was passed nurse injuries have declined 30 percent. Of course, better working conditions improve the quality of care for patients.

Unfortunately, however, Governor Newsom has issued an executive order that is very bad news for the California public. The governor has surrendered to the hospital industry. For a long while the hospitals have been pressuring Newsom to relax standards. The coronavirus issue has given him the excuse to do so. 

Among the major concessions he made is to allow the same number of patients to be cared for by fewer nurses. That is always bad news. In fact, it is dangerous. In addition, Newsom’s executive order gives the Department of Public Health Director power to waive licensing and staffing requirements for hospitals. This means that many of the well trained Registered Nurses (RN) will be replaced by less qualified, lower wage nurses. 

Yet Newsom justified his executive order by claiming that the hospitals would be in a position to recruit “Thousands and thousands more health workers needed to fight coronavirus.” But his decision to allow the hospitals far more leaway, which includes reducing the number of nurses that are avaiable to patients, Is exactly what the Californa Nurse Association (CNA) defeated many years ago. As a result of that victory, the number of hospital nurses increased by 15 percent. But now we are more likely to witness a reduction in nursing staff, which risks increasing the patient mortality rate. 

Governor Newsom claims that his mandate will be effective until the end of June. But significantly, this time limit is not at all included in the actual executive order. That’s very worrisome. 

That too many hospitals seem to be more profit than health oriented is suggested by their resistance to providing staff with safety masks. Incredibly, many hospitals have discouraged both medical doctors and nurses from wearing masks. According to Associated Press (April 17, 2020) “Ten California nurses suspended for refusing to work without N95 masks”. The N95 is among the masks that offer the best protection.  

But the hospitals can certainly afford to provide staff with adequate health protection. The hospital industry is very profitable and executives are well paid. In one good year, for example, the CEO of Sutters Health earned over 6 million dollars. As a result of Newsom’s executive order, profits will increase at the expense of patients and the professional staff.  

Clearly, the CNA must do all it can to prevent the governor’s executive order from being carried out. At the very least the governor must be held to his promise to end the program in June. And the CNA along with other progressive organizations must inform and mobilize the public to protect the interests of hospital patients as well as the nurses and medical doctors who serve them.