NEW STAFFING LAW HELPS, NURSES SAY.

Byline: Evan Pondel Staff Writer

The California Nurses Association said Thursday that nurse-to-patient staff ratios have improved at hospitals throughout the state, though hospital officials themselves say they've seen no change.

Since Jan. 1, California hospitals have been scrambling to meet the new state requirements for fewer admitted patients for every nurse. Though the law encountered resistance from hospital operators who continue to grapple with rising health care costs, the California Nurses Association says ratios are improving. A CNA report says more than half of the 111 hospitals it surveyed in California are ``generally in compliance with the requirements of the law.''

``This information shows we are making progress. It also disputes the hysteria and destabilization that is being promoted elsewhere,'' said Chuck Idelson, a union spokesman.

The CNA surveyed its members by gathering anecdotal information about each hospital's nurse-staffing situation. Many of the nurses revealed scenarios that vastly differed from the grim realities depicted before the ratio laws went into effect.

Myrna Valmeo, a registered nurse at Glendale Memorial Hospital, said not only does she see the difference in ratios, she feels the difference. ``I'm happier now, and so are the other nurses around here,'' Valmeo said. ``Because of the nurse staffing ratios, the quality of care has greatly improved.''

That sentiment isn't echoed by the California Healthcare Association, a Sacramento-based organization that represents the interests of hospital operators. The group has been collecting questionnaires from about 300 hospitals since Jan. 1. The most recent data available reveal that 86 percent of the hospitals surveyed are not in full compliance with the law.

``This is not a sustainable situation, and we think that number is going to increase,'' said Jan Emerson, vice president of external affairs for the CHA. ``This speaks to the rigidity of the law.''

Karen McDaniel, a labor and delivery nurse at Tarzana Hospital, has noticed some changes, although she said there is still ample room for improvement. ``I truly believe the ratios are better in some areas. But the basic premise is that work needs to be done,'' she said.

For example, some nurses are expected to oversee and substitute for other nurses under the new ratio laws. That means greater workloads for some. ``But I will say I have been able to take lunch in the last two weeks for the first time,'' said McDaniel, who has worked at Tarzana Hospital for 30 years.

Many nurses have welcomed the nurse-patient ratios as a method to improve care and help manage the number of hours required to do the job. But if hospitals are not in compliance with the new laws, some facilities might stand a chance of losing their accreditation. The loophole: There isn't an independent governing body that is enforcing the new ratio laws.

``And it always seems irresponsible for the government to pass a regulation and then not be able to enforce the regulation,'' said Miriam Piven Cotler, a professor of health sciences at California State University, Northridge. ``I'm not an apologist for a hospital, but these ratio laws come at a tough time for everyone. We have gone from a situation of excess capacity to have to close emergency departments.''

The Department of Health Services has surfaced as the most authoritative in terms of enforcing the ratios. However, budget constraints continue to thwart most state agencies, and Cotler said the Joint Commission on Accreditation of Healthcare Organizations might be the only viable alternative. Instead of the CNA or the CHA conducting studies, Cotler also said it might be in society's best interest if an independent entity conducts a study on staff ratios.

``Instead of tokenism, using the money spent on some of these surveys could be allocated to train more nurses,'' she said. ``Or the universities could get involved in the surveys. There just isn't any grant money.''

Evan Pondel, [phone]

evan.pondel(at)dailynews.com