The Spark

“The emancipation of the working class will only be achieved by the working class itself.” — Karl Marx

Los Angeles:
Nurses enforce nurse-to-patient ratios

Dec 20, 2004

Since September, nurses in two county-run hospitals in Los Angeles have been refusing to accept more patients than the limit set by California's nurse-to-patient ratio law. The nurses, who are represented by SEIU Local 660, have been able to force the hospitals to call in additional nurses.

This law was passed in California after a 10-year campaign by the California Nurses Association. But since the ratios went into effect on January 1, 2004, most hospitals in the state have simply ignored them, and the authorities have looked the other way. In fact, state officials have made it clear that they don't have the slightest intention to enforce the law. Just last month, Governor Arnold Schwarzenegger, granting hospitals their wish, postponed the next phase of the law for two years.

The law regulates the maximum number of patients that can be assigned to a Registered Nurse (RN) at any time. That number varies depending on the department and medical procedure. For general emergency room cases, for example, four patients may be assigned to each RN, whereas only one patient per RN is allowed for trauma cases. Nowhere are more than six patients per RN allowed.

Of course, it makes sense to have as many nurses and other medical staff at hand as possible. The more patients a nurse has to attend to, the less time he or she can spend caring for each patient, which, in turn, increases the risk of injury or death for the patient. There are ample statistics to support this obvious fact. For example, the Joint Commission on Accreditation of Hospital Organizations, which inspects hospitals, reported in 2002 that one-fourth of all "sentinel events," that is, unexpected patient deaths or injuries, were caused by inadequate staffing. In U.S. hospitals, at least 100,000 people die each year due to avoidable medical errors. Many, if not most, of these errors result from stress and fatigue, in turn caused by short-staffing.

But the hospital officials who cut down on staffing (and break the nurse-to-patient law) say that they don't have enough money to hire more nurses. That, of course, is a fat lie – just look at the billions of dollars hospital chains have been spending to buy other big chains. In California, hospitals reported a total of almost 12 billion dollars profit from 2001 through 2003. And some of the hospitals breaking the law are among the most profitable.

The nurses had no choice but to take matters into their own hands – not only in their own interest but also in the interests of their patients. Their actions set an example for the rest of us: law or no law, safe and decent working conditions will be assured only when workers themselves are ready to take action.