Health facilities: direct care nurses.

Under existing law, the Board of Registered Nursing in the Department of Consumer Affairs regulates the licensing of registered nurses. Existing law requires the State Department of Public Health to license and regulate health facilities, including hospitals, and establish minimum hospital nurse-to-patient ratios by licensed nurse classification and by hospital unit. Under existing law, specified hospitals are required to adopt written policies and procedures for training and orientation of nursing staff. These provisions prohibit a registered nurse from being assigned to a nursing unit or clinical area until that nurse has received the specified orientation and demonstrated sufficient competency. A violation of these health facility provisions is a crime. This bill would require each direct care registered nurse to receive and complete an orientation to the hospital and patient care unit in which he or she will be working and to have demonstrated competency, as specified. It would preclude a nurse who has not completed this orientation and had validation of competency from being assigned direct patient care. This bill would specify that, until the nurse completes orientation and has validation of competency, he or she would not be counted as staff in computing the nurse-to-patient ratio. This bill would exempt a state inpatient mental health hospital, a state developmental center, a state veterans' home, or a state correctional institution from those provisions of the bill requiring specified observation of the nurse. By creating a new crime, this bill would impose a state-mandated local program. The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement. This bill would provide that no reimbursement is required by this act for a specified reason.