Proposed staffing ratios at California Pacific Medical Center would assign six patients to each nurse in the emergency room rather than four. (Ellie Doyen/Special to S.F. Examiner)

Proposed staffing ratios at California Pacific Medical Center would assign six patients to each nurse in the emergency room rather than four. (Ellie Doyen/Special to S.F. Examiner)

CPMC nurses fight back against new staffing ratios

Hospitals say increased patient load needed to cope with surge in pandemic admissions

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Many of California’s hospitals are overloaded with patients as the recent COVID-19 surge infects hundreds of thousands of people across the state. In an attempt to resolve staffing issues, Gov. Gavin Newsom is offering hospitals a temporary expedited waiver to the state-mandated nurse-to-patients staffing ratios, effectively overturning a 16-year-old regulatory requirement to make it easier for hospitals to handle the rise in admissions. The expedited waiver process expires on March 21, 2021.

Thus far, more than 150 hospitals have applied for the waivers to increase capacity, including Sutter California Pacific Medical Center in San Francisco.

But many CPMC nurses say these new ratios put patients in danger. Across the state, these nurses have been rallying with their union, the California Nurses Association, stating that patients will suffer if nurses are forced to care for higher numbers per shift. Opposition to the new waivers has taken place in Roseville, Marysville and Los Angeles as well as San Francisco.

Jane Sandoval, a nurse at the Emergency Department at CPMC’s Bernal Campus, says that the waiver would assign nurses six patients at a time in the emergency room instead of four, which would give her an average of only 10 minutes an hour with each one.

“All of them would be put at risk by having only mere moments of my care,” she said.

A nurse for more than three decades, she remembers a time before the staffing limits were introduced in 2004.

“Nurses like me know the difference between the days when we were overloaded with way too many patients to take care of safely, and the days after, when our employers couldn’t just cut corners on staffing to save money,” she said.

Sandoval was one of several San Francisco-based Sutter nurses to speak out at a press conference Wednesday in opposition to new nurse-to-patient ratios instituted by the hospital.

Madeline Zamora, a labor and delivery nurse at CPMC’s Van Ness Campus, notes that CPMC has been voted the No. 1 place to have a baby in the Bay Area, but worries that standing won’t last under the new ratios.

“We cannot increase the number of babies per nurse, which this waiver will do,” she says. “We are involved in two patients: the unborn child and the mother. If we have more than one, two, three or more, I will not be able to care appropriately for them.”

Zamora and Sandoval join a chorus of nurses voicing their opposition to the new ratios, and say they were not included in the decision making process. “Instead of working with nurses to prepare, to plan, and to make sure they had the staffing in place before a massive wave hit, hospitals want the state and all Californians to bail them out from the crisis they themselves have created,” said Zenei Cortez, president of California Nurses Association and National Nurses United.

The San Francisco Examiner reached out to Sutter for comment, but was directed to the California Hospital Association. David Simon, the association’s vice president of communications, said that the unprecedented pandemic dominating the state requires moves like this one.

“We are in the middle of a crisis that is multiples worse than it has been in the last 10 months,” he told the Examiner. “Unlike other crises in the past — like wildfires or earthquakes — no additional resources are available. The number of trained and available ICU nurses is running rapidly thin, and there is no cavalry in the offing we can draw upon.”

Simon reaffirmed that the expedited waiver process is temporary. “We are not attempting to undo in any permanent way nurse-staffing ratios,” he said.

As protests around the nurse-to-patient staffing ratios continue around the state, Simon said that they’re “unconscionable and irresponsible at a time when people’s lives are on the line.”

“We are on this boat and it’s sinking and everyone is grabbing a boat and trying to save it,” Simon said. “You have one union that instead of grabbing a bucket they’re saying ‘if we can’t use the standard issue bucket we can’t bail at all.’”

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