Information contained in this publication is intended for informational purposes only and does not constitute legal advice or opinion, nor is it a substitute for the professional judgment of an attorney.
Organized labor for years has used the nurse-to-patient ratio issue as a rallying cry for legislation. Those efforts were reinvigorated by a recent federal study crediting lower nurse to patient staffing for improved patient outcomes and reduced societal costs. Last month, union representatives rallied at the U.S. Capitol to support strengthened nurse to patient ratios and other healthcare workplace legislation. Eighteen states currently are considering changes to their nurse ratio requirements.
Unions also are using the minimum staffing issue as leverage in their collective bargaining negotiations. Twenty-five thousand nurses in California and Minnesota, all represented by the National Nurses United (NNU), have threatened to conduct a one-day strike on June 10 absent agreement on the issue.
In California, nurses have made plans for strikes at five University of California hospitals in San Francisco, Davis, Los Angeles, Irvine and San Diego and at three Los Angeles County hospitals. NNU claims that the hospitals are not complying with California's 2004 law governing minimum staffing. The University of California contends that the hospitals are in full compliance with California law, which is what their collective bargaining agreements require, and that the union has never established otherwise. The union meanwhile seeks to have more specific language on the staffing ratios included in the hospitals' collective bargaining agreements and additional language regarding break relief. Inclusion in the agreements would arguably improve the union’s ability to monitor, enforce and seek monetary remedies for alleged understaffing of nurses and could insulate the standards from being relaxed as a result of changes in the political landscape.
For the time being, strikes by the University of California hospital nurses have been blocked by a temporary restraining order issued by San Francisco Superior Court Judge Peter Busch. Judge Busch decided on June 8 that the order was needed because a strike could jeopardize patient safety. A hearing has been scheduled beginning on June 18 regarding the Public Employment Relations Board's and the hospitals' request for an injunction to prevent the strike. The union has not yet announced how it will respond to Judge Busch's ruling.
In Minnesota, 12,000 nurses at Twin Cities hospital systems plan to walk out on June 10 if their demands for California-style minimum nurse-patient ratios are not implemented. Linda Hamilton, President of the Minnesota Nurses Association, justified the walkout based on the union's emotional and incendiary claims that "Twin Cities' hospitals are dangerously understaffed, and our patients are needlessly suffering and sometimes even dying as a result."
Twin Cities representatives respond that current staffing levels actually are superior to those proposed by the union. The hospitals reportedly have lined up 2800 replacement nurses to maintain hospital operations during the walk out.
This entry was written by Frederick C. Miner.