Return of an Endangered Species — Nurses

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How many nurses does it take to change an IV? It depends on whom you ask. Over the weekend, California governor Gray Davis signed a law requiring hospitals to maintain a certain level of licensed nurses (including registered nurses and nurse practitioners) at all times. Governor Davis's move delighted critics of managed care, who contend that the system's cost-cutting measures — such as the use of cheaper (and less qualified) nurses' aides — have compromised quality of care for patients. Hospitals have until 2002 to phase in the new minimums, with each hospital's needs being determined by the state Department of Health Services.

Critics of the California measure wonder where the new nurses will come from — and who will pay for them. Since so many hospitals have turned to less expensive workers to perform some of the nurses' tasks, demand for qualified nurses has decreased and supply has dwindled. It's not just a matter of finding qualified people to hire: Some hospital officials question whether Davis's move compromises the autonomy of each facility. "Hospital administrators don't want the government dictating the number of nurses they hire," says TIME senior writer Adam Cohen. But the biggest challenge is money: The added expense of hiring licensed nurses will conflict with the budgetary restraints of managed care systems. As this story unfolds, one thing is certain, says Cohen. "The rest of the country will be watching this play out. California is an incubator for social issues, and they're often on the cutting edge of policy reform."