The Facts About Nurse Staffing

Current Contract Guidelines

Since 2000, Saint Vincent has had one of the only nursing union contracts in the state that has specified staffing guidelines, including:
  • 1 telemetry unit with 1:4 nurse to patient guidelines
  • Mixture of 1:4 and 1:5 nurse to patient guidelines in med/surg units, depending on patient census
  • Requirement of a resource nurse on each floor to be a coordinator, with limitations on when they can take care of patients
  • Very limited ability to float nurses to another unit even if their unit has low patient census
The guidelines in the contract are already well within industry standards

MNA Staffing Proposal

The union is proposing staffing guidelines that mirror the 2018 ballot initiative which was voted down by 70% of voters. These requests include:
  • Ratios that more stringent than CA state mandated ratios which are 1:4 on telemetry and 1:5 on med/surg units; for example:
    • 1:3.3 med/surg floors if the resource nurse takes an assignment
  • Additional 21 full-time nurses in critical care without more patients and when the ratio is already 1 nurse to 2 patients
  • Increase from 71 to 157 full-time employees in a fully functional ER without more patients. This 2.2 times the current staffing
  • Minimum of 4 nursery nurses 24/7 even if there is only 1 baby in the nursery

Current Staffing

Saint Vincent underwent a thorough process to review each unit’s staffing since Jan 2019. The methodology and analysis was validated by an independent third party.

This table shows the number of patients per working nurse by unit during two different timeframes. The ‘excludes resource nurse’ calculation conservatively assumes they did not care for any patients.
 Telemetry Med-Surg Units
Timeframe Nurse Caring for Patients 36 North 24 North 34 North 35 North 21 South 22 South 23 South 33 South Avg Med-Surg
Jan 2019 to Feb 2020 All Nurses 3.4 4.0 3.7 3.6 3.8 3.6 4.0 3.9 3.8
Exludes Resource Nurse 3.7 4.5 4.3 4.1 4.4 4.3 4.6 4.4 4.4
Jul 2020 to Jan 2021 All Nurses 3.8 4.4 4.0 3.9 4.0 3.7 3.9 4.2 4.0
Excludes Resource Nurse 4.2 5.1 4.6 4.5 4.7 4.4 4.4 4.9 4.7

Hospital Staffing Proposal

We are committed to supporting our nurses and providing high quality care. We reviewed our patient acuity and proposed three staffing improvements to the MNA to support our operations:
  • Add 5 additional critical care nurse roles
  • Increase from 1 to 3 of 8 units with 1:4 staffing guidelines
  • Add COVID staffing guidelines in med/surg units and the progressive care unit
We believe that a staffing ratio policy debate would be best addressed through a state-wide process to ensure consistency across all hospitals.