District hospitals might soon face minimum nurse-to-patient thresholds, but the facilities are vowing an aggressive fight to defeat the strategy nurses contend will improve patient care.
"We're going to set a priority, and that priority is going to be patient care over profit," said Ward 1 Councilman Jim Graham, one of nine D.C. lawmakers who said they would support the measure when it is introduced Tuesday.
Under the plan, which must still make it through the legislative process but already has enough support to pass, hospitals would have four years to implement stringent nurse-to-patient ratios.
The precise ratios would fluctuate by specialty, but the proposal includes a mandate of one nurse for every two patients in critical care units and one nurse for every trauma patient in the emergency room.
Nurses said the changes are vital to protecting patients.
"Patient safety is regularly threatened because hospital corporations refuse to ensure there are enough registered nurses working," said Bonnie Linen-Carroll, a Washington Hospital Center nurse. "It is an absolute disgrace."
The labor union National Nurses United also pointed to a 2012 survey of D.C. nurses that found 57 percent thought "staffing is inadequate always or almost always."
But the DC Hospital Association, which represents 10 Washington hospitals, said the proposal was misguided.
"This makes no sense. No state in the entire country has taken this approach except for California and that was 10 years ago and no one else is even thinking about it," said Bob Malson, the association's president. "You're going to force the hospitals to hire people where they're not needed."
Both sides said research supports their views.
"The science and the academics and the people who actually do all of this stuff all the time will make the case," Malson said.
Hours earlier, the proposal's backers cited a study that said "outcomes are better for nurses and patients" in facilities that used the requirements codified in California.
Malson, who predicted lawmakers would ultimately spurn the proposal, wouldn't say whether his members might mount a legal challenge against the ratios.
But D.C. Council Chairman Phil Mendelson said he was ready for a confrontation.
"This bill is common sense," Mendelson said. "This bill is today's version of the eight-hour day, something that we will see business resist, but on the other hand makes good sense and will lead to quality care."