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Sunday, August 19, 2018  

The Wave of the FuturePublished 5/13/2005

I feel a strong wind blowing! I see change on the horizon. There is a storm coming that will change nursing, as we now know it. I predict it will have all the force of a tsunami! In the not-so-distant future safe staffing ratios are going to change. The Wave of the Future is 4:1 patient ratio and better, safer more reliable care for everyone.

The California Nurses Association (CNA) is fighting the battle now against an enemy of great strength. The Governor of California is finding out the hard way that nurses won’t just lie down and quit. Safe staffing legislation was passed in California in 1999. Then a new Governor was elected and he immediately attempted to over rule the legislation. Nurses have been ridiculed and labeled as "special interests" and referred to as "set dressing" but that did not stop them. The CNA is continuing to take the battle to the enemy.

The CNA is actively taking the issues to the Governor. They are making their voice heard in the political circles and announcing to the public that nurses will stand and fight. The Governor has picked this fight without good reason or sound reasoning. He attempted to issue an emergency order to delay safe staffing ratios to reduce from 1:6 to 1:5 in November. A Superior Court Judge ruled that the Governor’s attempt to block safe staffing ratios was overstepping his authority. The CNA took the battle right back to the Governor, filing a lawsuit stating that the administration’s move to block safe ratios fell short of the legal requirements to issue an emergency regulation. The California Healthcare Association argued that the new ratios would cause shortages and subsequently cause hospital closures. The Judge declared that those grounds did not have merit and that the administration was not empowered to suspend ratios.

The CNA is fighting for every nurse in the state of California. They represent a 60,000 member base and are determined not to let the Government make frivolous changes to legislation that was so hard won. The lawsuit accuses the governor and the DHS of compromising patient protections and unlawfully abusing executive authority to overturn a legislative mandate. The CNA maintains that safer staffing levels have alleviated the shortage by bringing 30,000 RNs to the state and luring burned-out and retired nurses to return due to better working conditions.

I understand that unions are very frightening to employers and that they make it more difficult to directly interact on a person to person basis. Unions are unfortunately necessary in some states to gain and maintain the force needed to make employers see the big-picture. Nurses work very hard in an unconventional way. We are on our feet most of the day. We perform many tasks that are quite routine and some that are not. We are expected to be able to use our critical thinking skills to better serve those in our care. We are expected to be subservient to those in our care as if we are waiters or waitresses but at the same time it is our responsibility to actually provide for the best interest of our patients. We have to be flexible and stern. We have to be reliable and understanding, yet we are decisive and accountable. We are working in controversial environment almost 50% of the time. Patients either do not understand or do not know what is going on and they need education. We are educators and must teach things that involve very serious decisions that will be made based on the understanding of the teaching we perform. We are often involved in the death of our patients and the healing process that follows. We provide comfort and solace to loved ones that have lost the most important person in their life. We swing on a giant emotional pendulum from sternly serious to light-hearted or from great joy to immense sorrow. We are nurses and we care.

In my point of view nursing is a vocation that can not be entered into lightly but is also a profession that can not be ruled by simple oversight of the uninitiated. To be able to understand the entire nursing process one must live through it either as a nurse or in the care of a nurse. Sitting upon the Governor’s seat and making decisions based on what money makers would like or in the interest of "kicking their butts" is never going to fly.

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