Nurse

The Pittsburg Post-Gazette has a story about a new nurses union contract at The Medical Center, Beaver, that takes a step away from mandated nursing ratios.

Ratios that were established at the hospital in 2003 have helped to
improve patient safety and boost the job satisfaction of nurses, while
coinciding with financial success for the medical center, said Neal
Bisno, secretary-treasurer of SEIU District 1199P, the union that
represents the nurses.

But hospital officials say the ratios set in the contract -- which they
describe as "ratio ranges" -- are different than those proposed by
legislators in Massachusetts, as well as those enacted in California in
2004. The experience at The Medical Center, hospital officials contend,
exemplifies the broader criticism that the industry makes about
legislative efforts: One size doesn't fit all.

"No one will dispute that having more nurses will improve care," said
Paula Bussard, senior vice president for policy and regulatory services
at the Hospital & Healthsystem Association of Pennsylvania. "The
question becomes: Is it something you should set in law or regulation?"

The story goes on to provide a good history of legislated nursing ratios in California and current debate over possible mandated ratios in the Massachusetts legislature.

California passed a law in 1999 that created nurse staffing standards,
and 14 other states including Pennsylvania have similar legislation
pending, said David Schildmeier, spokesman for the Massachusetts Nurses
Association, a union group. Mr. Schildmeier said the contract adopted
at The Medical Center -- which calls for no more than five patients per
nurse in medical-surgical units during two shifts -- is relatively
uncommon in setting ratios.

No one in health care is for legislated nursing ratios besides the unions. The AHA, HIMSS and others have (or are about to) come out with positions opposing mandated ratios.