Hospitals Across America Lead A Profit-Driven Fight Against More Labor Protections For Nurses

Nurses are fighting to improve hospital standards and patient care by pushing for mandated minimum staffing levels for nurses in hospitals. The logic — which has been reflected in reality — goes that, with more nurses per patient, the better and more personal level of care Americans will receive. But as nurses’ unions take their push for legislation establishing these standards nationwide, they’ve come up against a formidable foe: hospital administrators who are balking at the price tag.

As proponents of nation-wide minimum nurse staffing laws — led by state nurses’ associations — point out, hospitals tend to bury nurses with massive patient loads in a penny-pinching effort to save costs. Beyond adding to nurses’ stresses, this lowers the quality of care that patients receive and increases the chances of a medical error occurring. And the example of California, the only state to currently impose a minimum nurse-to-patient ratio, suggests that a wide-scale effort to adopt such laws could greatly ease nurses’ burdens and offer patients some medical peace of mind:

“Hospitals right now are run like businesses and they’re focused on the short-term bottom line,” said Jeff Breslin, president of the Michigan Nurses Association, a union backing a minimum staffing bill in the Michigan legislature. If the bill becomes law, he said, “it doesn’t matter what part of the state you’re in, you can be assured you’re going to have adequate nursing care whatever place you’re going into.” […]

Today, only California requires all of its hospitals to maintain a minimum nurse-to-patient ratio. If a hospital sees a surge of patients due to something unexpected, like a car crash or an outbreak, it still must meet the minimum ratio. The only time a hospital can go under the minimum ratio is during what the statute calls a “healthcare emergency.”

Jolee Cochran, a registered oncology nurse who has been working at Cedars-Sinai Medical Center in Los Angeles for 26 years, said the law has made her job more manageable. Before, she said, it wasn’t uncommon for a nurse to be responsible for seven patients at a time. Now, it would be a violation of the law for her to have more than five patients under her care.

Cochran said patients in her hospital are much sicker than they used to be and require much more complex care. “I can’t imagine having more than five patients with one nurse, with the type of patients we have now,” she said.

While staffing law opponents argue that the measures would force additional costs onto hospitals and dispute how much such laws actually improve patients’ health, the fact is that the case for minimum staffing levels comes down to simple math — particularly with the advent of health care reform. As more and more Americans gain access to insurance under Obamacare, non-physician medical workers will have to take on an increasing number of responsibilities in order to meet increased demand. Nurses will be major foot soldiers in that effort — and if they are forced to do more procedures on top of having unsustainable patient loads, it could end up being a public health disaster.

That is likely also the reason that hospitals are so adamantly opposed to staffing requirements. With the expected influx of patients into the American health care system in the coming decade, some might not want to hire even more nurses to meet mandated ratios. Yet again, the example of California might serve as a template. “We don’t fight this issue now,” said Jan Emerson-Shea, vice president of the California Hospital Association. “It’s the law of the state. … It’s over. It’s done.” Unfortunately, hospitals in the other 49 states have had far more success in blocking such legislation from becoming reality.