California Nurses Declare Victory In Battle Over How Many Patients They Must Handle In COVID Era

Nurses are cheering California’s decision to end emergency waivers to hospitals and nursing homes, which have allowed the institutions to require nurses to care for more patients than state law allows at any one time.

Hundreds of nursing homes and more than 100 hospitals received the waivers since the program began in December, when surging cases of COVID-19 led to a severe nursing shortage up and down the state. Nurses staged protests when the waivers were announced, saying exceeding the cap on nurse-to-patient ratios put patients in danger.

Now, state public health officials say the nursing shortage is over, and the emergency waivers are no longer needed.

Hospitalizations for COVID-19 are falling across the state, after a difficult holiday surge. Across California, the number of people in the hospital with COVID dropped by 27% during the second half of January, to 1,531 from 2,107. By contrast, hospitalizations more than tripled from November to December.

“Staffing resources are more readily available, with thousands of health care workers ready to deploy to individual facilities on an as-needed basis,” a state public health spokesperson told The Chronicle Tuesday. As a result, “the goal is to get those needed staff to the facilities rather than (issue) waivers.”

State law limits intensive care unit nurses to two patients. The waiver allowed a third. In regular hospital units, nurses can care for up to five patients. The waiver let hospitals raise that to seven. Telemetry nurses, who provide cardiac monitoring, can care for four patients. With a waiver, that could rise to six.

The waivers were to expire March 1, but the state will end them on Friday.

“The California Department of Public Health will no longer accept any new expedited staffing waivers,” the state said in a message to hospitals on Monday that did not say why. “All existing approved staffing waivers will expire on February 8, 2021 unless CDPH determines on an individual waiver basis that there is an unprecedented circumstance.”

The California Nurses Association, which had said the waivers allowed hospitals to avoid hiring more nurses, greeted the news with delight.

The end of the waivers “is an incredible victory for patients and nurses, because we know that safe staffing saves lives,” said Zenei Triunfo-Cortez, president of the state nurses association and National Nurses United.

The state’s decision to allow the emergency waivers in December was the second time during the pandemic began that hospitals were allowed to temporarily exceed those patient-to-nurse ratios.

Gov. Gavin Newsom lifted the caps entirely from March through June, prompting statewide protests from nurses.


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