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Contemporary Issues In Nursing Essay

1659 words - 7 pages

In today's world of nursing, there are efforts to improve patient care at hospitals. Severalstates across America are considering implementing nursing ratio laws. This ratio law wouldrequire hospitals to have strict nurse-to-patient ratios enforced at all times. Only California hasimplemented nursing ratios so far and it has been the subject of mixed reviews.Steps the legislation went throughThroughout the 1990's, health care labor unions in California tried to implement nursestaffing laws through legislation and ballot initiatives. The California Nurses Association (CNA)campaigned for several years to constitute a mandated nurse-to-patient ratio system in California.The first endeavor was in 1993 when Assembly Bill (AB) 1445 was introduced into theAssembly. Unfortunately, the bill did not succeed. The nurse-to-patient ratios were also a part ofProposition 216, the health care reform initiative introduced by CNA in 1996. Governor PeteWilson vetoed another version of the ratio bill, AB 695, which was passed by the legislature in1997 (Institute for Health, 2001). The CNA organized a rally of nurses and patients throughoutCalifornia to win enactment of AB 394. More than 10,000 letters, post cards and phone callswere made to the governor in support of the bill. Registered nurses (RN) and senior citizens bythe thousands assembled on the Capitol Steps in support of the bill in September, 1999 (Dumpel,H. 2003).Description of issue and recently enacted legislationAB 394 was passed and signed by Governor Gray Davis in 1999. This bill "directs theCalifornia Department of Health Services to establish minimum, specific, and numerical licensednurse-to-patient ratios by licensed nurse classification and by hospital unit" in acute carehospitals. Although it passed in 1999, it was not implemented until January 1, 2004 due to thefact that the California Department of Health Services could not base deductive evidence onwhich to base the actual ratios (Coffman, J., et al, 2002). The implementation was frozen as anemergency by California Governor Schwarzenegger due to the severe nursing shortage and highcosts. California courts upheld the Governor and enforced tougher standards (Anonymous,2007).Under the legislation enacted, acute care hospitals in California need to have a minimumof one licensed nurse for every two patients in intensive care units, one nurse for every operatingroom patient and one nurse for every five patients on a medical surgical floor. The legislationcalls for half of the licensed personnel working in intensive and coronary care units to belicensed as an RN. The consequence of the nurse ratio law on quality and access to patientcare is still a subject of debate in California (Coffman, J., et al, 2002).Impact of nursing practiceThe CNA claims that "ratios have been successful in creating safer workingenvironments in hospitals". The CNA believes that having the ratio laws in effect will attractRNs that have left the field. Data obtained from the...

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