Iowa lawmakers are getting conflicting reports on whether the state should establish nurse-to-patient ratios for Iowa hospitals. During a statehouse hearing on Tuesday, health care professionals from California testified both in favor and against such a move.
Beth Capell, a lobbyist for the nation’s largest health care union, says the nursing ratios California adopted a year-and-a-half ago were badly needed.
“I came here today to tell you that in California we have ratios because ratios save lives,” Capell testified. “I hope that you never hear the kind of examples that I heard time and again in California of patients who died because of lack of adequate staffing.” Capell says in many medical/surgical units, nurses in California were caring for as many as a dozen patients at a time before the lower nurse-to-patient ratios were put into state law.
But California Hospital Association vice president Dorel Harms says nursing ratios in her state have been a disaster. The ratios are one nurse for every four “ordinary” patients, one nurse for every two “critical” care patients and just one nurse for every patient in a “trauma” situation. Harms says what’s happening is hospitals are denying admission to patients coming into the hospital if they don’t have enough nurses in the emergency room. “That has resulted in patients in the back of ambulances driving around with their ambulance folks looking for hospitals where they can be admitted,” Harms says.
The Iowa Hospital Association also opposes nursing ratios, arguing it Iowa hospitals are in the midst of a nursing shortage and would find it difficult to meet the kinds of nurse-to-patient standards now enforced in California.
State Representative Linda Upmeyer, a nurse practitioner agrees. Upmeyer, who is a Republican from Garner, says most Iowa hospitals have better nurse-to-patient ratios than the proposed mandate of one-to-five. “I think in many cases we’re doing better than the standard and I don’t want to lose that,” Upmeyer says.
But Angela Trenkamp, a nurse at University Hospitals in Iowa City, disagrees. She backs the idea of minimum nurse-to-patient ratios to make the job of being a nurse more manageable. “There have been many times that I’ve gone home thinking ‘I could have done this. I could have done that, should have done this, should have done that,’ and didn’t have time,” she says. Trenkamp believes many of her colleagues in the nursing profession feel the same way, but are reluctant to speak out for fear of retribution from hospital management. Trenkamp and state Senator Joel Bolkcom spoke at a news conference yesterday, calling for a state law that would protect nurses who become “whistleblowers” about their working conditions.