Nurse-to-Patient Ratios During the COVID-19 Crisis

As registered nurses, it’s our responsibility to protect our patients and our licenses by following California’s Title 22 regulations.

Right now this isn’t easy because Governor Newsom has issued an Executive Order AFL-20-26.

Pursuant to the Governor’s declaration of a state of emergency related to COVID-19, the Director of the California Department of Public Health (CDPH) has waived the licensing requirements of Chapter 2 of Division 2 of the Health and Safety Code (HSC) and accompanying regulations with respect to any hospital or health facility identified in HSC section 1250. CDPH is temporarily waiving licensing requirements and suspending regulatory enforcement of all licensing requirements (this includes, Title 22, nurse-to-patient staffing ratios) for hospitals with a few exceptions. As a result of this temporary waiver, hospitals do not need to submit individual program flexibility requests. This waiver is valid until June 30, 2020 and may be extended based on any updated Executive Orders or guidance from CMS or the CDC.

We are still recommending that nursing staff file Patient Safety Reporting Forms (ADO) when asked to take a patient assignment that violates the ratio law or unsafe assignment and submit them to your union steward or representative.  Our employers are still required to comply with adverse event and unusual occurrence reporting requirements and report any substantial staffing or supply shortages that jeopardizes patient care/safety or disrupts operations.

As nurses, we know that if it wasn’t “charted” it didn’t happen, so continue to file complaints.  Don’t give our employers the excuse that nothing “bad” happened while we were out of ratio, so maybe we don’t even need them. We also know that when needed we step up and get the job done!  So using your professional judgement, report any near misses or other patient safety concerns during this time of crisis.  Because our patients’ lives matter no matter what.

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