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December 14, 2020 – The California Nurses Association/ National Nurses United today warned that a campaign by the hospital industry to exploit the pandemic as a pretext for rolling back safe staffing standards in California puts the lives of patients, registered nurses and other health care workers at risk.
During the pandemic, California hospitals have been bombarding state health officials for individual, temporary waivers in adherence to California’s landmark safe staffing law, which requires minimum levels of registered nurse staffing for various hospital units.
Hospitals exploited that process to demand more reductions in safety measures and now, have been authorized to request “expedited waivers” to require already overburdened nurses to unsafely care for more patients at a time in intensive care units and throughout the hospital setting.
“This scheme will not ease the Covid-19 crisis facing California hospitals today, it will make it far worse,” warned CNA/NNU President Zenei Cortez, RN. “It will surely lead to more hospital acquired infections, and more nurse, other healthcare worker and patient deaths.”
More than 59,000 California health care workers have been infected with Covid-19, and 228 have already died, as of Sunday, according to the California Department of Public Health. “Slashing safety standards will only increase the suffering and the death count,” Cortez warned.
Since February, noted CNA/NNU Executive Director Bonnie Castillo, RN, “nurses have been working under enormous strain, putting their lives and safety in jeopardy, without enough personal protection equipment, and without sufficient hospital engineering controls to reduce the spread of infection that have turned hospitals into Covid-19 hot zones.”
“Larger patient assignments sharply cut the time nurses can provide individualized patient care, properly monitor a patient’s condition, and increase the likelihood of mistakes, as studies have documented for years,” said Cortez. “In a pandemic, that’s an open invitation to increase the risk of spreading the virus to other patients and other staff.”
“And now, the hospital executives want to double down at a time when nurses have no more to give. We simply can’t afford to lose more nurses, and more patients,” Castillo said.
Current conditions have already led to acute moral distress among nurses as described in a new NNU white paper, “Deadly Shame: Redressing the Devaluation of Registered Nurse Labor Through Pandemic Equity,” which details the consequences of the crisis standard of care for nurses on the front lines.
“It is the same industry that wants to further erode life-saving protections by pushing the state for an expedited waiver above the hundreds of individual ratio waivers already approved,” said CNA Legislative Director Stephanie Roberson. “Expedited waivers will create further stress, and fatigue for nurses who have been putting their health, safety and lives on the line for months.”
“It has been the malfeasance of the hospital industry, and its goals of higher profits that have led directly to the current crises in capacity and staff,” said Castillo. “They have had years to prepare for this pandemic and ignored the risk.”
Since 2000, there have been at least 50 hospital closures in California, including hospital and emergency rooms closures in Los Angeles, Long Beach, the Bay Area, and in rural communities, along with cuts in “less profitable” patient services.
In recent interviews, Carmela Coyle, president/CEO of the California Hospital Association, the industry trade lobby, defended the profit-focused goals due to “a lot of pressure on making health care more affordable” and questioning “should we invest in additional capacity” that will “add to the cost of the health care system” even though “just-in-time does not work during a pandemic.”
Yet, Castillo noted, “it was exactly ‘just-in-time’ practices sold by management consultants, that slashed preparedness in staffing, supplies, and other safety protocols. They treat safe staffing and needed supplies as a drag on budget goals and profit margins, rather than the prerequisite for a humane, fully prepared patient-oriented health care system.”
“Even in the midst of this pandemic and current surge,” notes Castillo, “we have seen hospitals not cancelling elective surgeries, making temporary or permanent closures of hospital units, not filling RN vacancies, sending scheduled nurses home, and even laying off nurses.”
California’s multi-billion hospital industry fought for years to block the state’s landmark safe staffing law, and then tried to overturn it, even though studies have shown the California law has resulted in up to 14 percent fewer patient deaths than in comparable hospitals, assured nurses more time to spend with patients, and kept nurses at the bedside far longer.
“We know that for the hospital industry, they hope to use ‘expedited waivers’ as a permanent standard, a first step to permanently overturn a law that has made California the safest state in the country for patients and a model for the world. Nurses will do whatever it takes to defend the law, which protects our patients and our nurses,” Castillo said.