Since the coronavirus pandemic's first peak last summer, California hospitals have been utilizing waivers to relieve them of having to comply with the state's mandate for safe nurse-to-patient staffing ratios as part of its Health and Safety codes. This was in response to the surge of patients needing hospitalization after becoming infected with COVID-19.
However, the California Department of Public Health announced on Monday that not only would it stop accepting applications for waivers as of this week, but that all waivers already approved would expire on Feb. 8.
Registered Nurse Dotty Nygard, who has been leading efforts for safe staffing for California nurses in Tracy, expressed relief when she learned that waivers would be expiring next week.
"Yes! It was a great victory to see our Ratio Law respected. California is the only state that has fought and won nurse to patient ratios that has shown to improve patient outcomes, and save lives. Nurses across our state spoke up, held rallies and refused to allow the hospital industry to lower standards that govern safe staffing," she said in an email to Tracy Press.
"Nurses will always advocate on behalf of their patients for access to quality, safe and affordable care. Please continue safe practices and talk to your doctor about the benefit or risk with vaccinations — we all need to do our part to maintain a healthy community."
The expiration of waivers as a relief to many California nurses who have been rallying for months for the reversal of waivers, citing unsafe, strained and inefficient working conditions. According to data collected through collaborated efforts between Kaiser Health News and The Guardian nearly 3,400 confirmed deaths of healthcare workers during the pandemic.
A press release from the California Nurses Association and National Nurses United stated that that hospital employers had been using COVID-19 as an "excuse" to begin applying for safe staffing waivers, which designates how many nurses per number of patients should be staffed and attending at hospitals and other healthcare facilities. For example, the state's safe staffing ratios indicate that at least one nurse should be available for every two critical care patients on the floor. Waivers for this process allowed hospitals to operate in understaffed conditions.
"Nurses have been protesting all waivers of safe staffing standards, arguing that patients need more, not less, care during COVID and that the state was actually rewarding hospitals for manufacturing staffing problems by canceling traveling nurse contracts, failing to fill open RN positions, still doing elective surgeries, laying off and furloughing nurses, and more," the statement said.
A proclamation sent out by CDPH stated that while all waivers are set to expire on Monday, it would still evaluate hospitals on a case-by-case basis to see if a waiver is needed for unprecedented circumstances.
"Hospitals must maintain efforts to meet required staffing levels at all times. If CDPH has any indication that hospital have not maintained efforts to increase staffing, CDPH will investigate and require hospitals to provide documentation of their efforts. Additionally, CDPH may do unannounced audits to assess these efforts," reads an excerpt from the proclamation.
According to a representative from Sutter Health, Sutter Tracy Community Hospital — which is currently running at 125% adult ICU capacity — will not be affected by this new expiration date, as it never applied for any waivers to safe-staffing ratios.
San Joaquin GeneralHospital in French Camp — which is currently running at 181% adult ICU capacity — said that its staff is prepped for when the expiration officially takes place.
"SJGH is working with its own RN staff and contracted registries to provide adequate coverage for optimal patient care and to meet state staffing ratios. The hospital has been able to meet those ratios at nearly all the time but occasionally cannot due to staff absences or significant spikes in patent volume," said Jolena Voorhis, Deputy San Joaquin County Administrator.
"SJGH continues to recruit RNs to fill vacancies and this week has hired new graduates who are being pre-accepted over the next several months in their specific areas. The hospital has also an agreement with the State of California to provide RNs on a short term basis to meet increased patient volume."
• Contact Brianna Guillory at firstname.lastname@example.org or 209-830-4229.