Nurses demonstrate in favor of bill to limit patient counts

By Daniel Raven
Tucson Citizen
February 15, 2008

Dozens of nurses demonstrating on the Capitol lawn Thursday said Arizona can improve patient care by limiting the number of hospital patients a nurse is assigned to care for.

Chanting and carrying signs, the nurses urged lawmakers to approve HB 2141, introduced by Rep. Tom Prezelski, D-Tucson, which would mandate a patient-to-nurse ratio of two to one in intensive care, three to one in pediatric units and four to one in emergency departments.

"It's pretty scary out there," said Lindy Abts, a registered nurse who works at a number of Phoenix-area hospitals. "It's not unusual for us to have six patients to one nurse."

Kirk Herbert, a registered nurse at Yavapai Regional Medical Center, said he left a Phoenix hospital because he was solely responsible for the care of 25 patients at night.

"Frequently a patient would have a life-threatening complication, and because I had to attend to them there was no other nurse there to take care of the other 24 patients."

The march was organized by the National Nurses Organizing Committee, a union started by the California Nurses Association. That organization has successfully sponsored nurse-to-patient legislation in California and is pushing for similar measures in Texas, Maine, Massachusetts and other states.

Prezelski's bill calls for hospitals to post required patient-to-nurse ratios and would establish fines and allow for the suspension or revocation of operating licenses for facilities that fail to abide by the ratios.

"Hospitals as an industry are increasingly concerned about profits," Prezelski said. "They've put issues of profits ahead of patient safety and the safety of the people who do the work in the hospitals."

Prezelski said there are guidelines for staffing levels in other industries where lives are at risk, such as railroad work and mining, but hospitals resist such standards for the sake of revenue.

The bill has yet to be scheduled for committee action.

Adda Alexander, a registered nurse and executive vice president of the Arizona Hospital and Healthcare Association, said standards don't equal safety and each patient should be evaluated on a case-by-case basis.

"Basing it on ratios is done under the assumption that all things are equal hospital to hospital and nursing unit to nursing unit," Alexander said. "That's just not true."

Alexander also objected to claims that the facilities she represents care only about money. She said Arizona hospitals have contributed $53 million in the past two years to the developing healthcare professionals, an investment that includes scholarships and donations to universities and community colleges.

Joyce Benjamin, a registered nurse and executive director of the Arizona Nurses Association, said hospitals aren't alone in opposing the bill.

"It's not that we're necessarily against ratios, but we don't feel like it should be set by legislation or governmental officials," Benjamin said.

Benjamin said her organization polled its members and board of directors and concluded that most Arizona nurses would prefer to decide how they attend to patients on a case-by-case basis.

Abts, the Phoenix hospital nurse who joined the demonstration, said Arizona needs staffing standards to make for happier nurses and healthier patients.

"No nurse wants to leave at the end of the day feeling like they didn't take the best care they could of their patients because they were stretched so thin," Abts said.