In February, about 175 nurses rallied in Tallahassee, complaining that they often have too many patients to properly look after them all. Clad in red scrubs and coats, the nurses asked for a law creating specific nurse-patient ratios at health care facilities throughout the state.
The bill died in committee, but nurses have kept up the fight — in a different way. In recent weeks, nurses at six Florida hospitals have voted to unionize, hoping to achieve better ratios and other improvements through the collective bargaining process.
Largo Medical Center, Community Hospital in New Port Richey and Oak Hill Hospital in Brooksville are among hospitals whose nurses have voted since mid November to affiliate with the National Nurses Organizing Committee-Florida, which is part of the 160,000-member National Nurses United.
The others are Fawcett Memorial in Port Charlotte, Central Florida Regional in Sanford and Osceola Regional in Kissimmee.
Though all six are part of the same for-profit chain, the Hospital Corporation of America, nurses say their issues are the same as at many hospitals across the country.
"It's about safe staffing levels, being able to spend more time with our patients," said Julie Scott, a registered nurse at Largo Medical Center.
Florida does not mandate nurse-to-patient ratios. The bill, which last year was called the Florida Hospital Patient Protection Act, would have set ratios based on patients' condition. In the intensive care unit, for example, there would be no more than two patients per nurse; in emergency rooms, the ratio would be one nurse for every four patients.
About 2,100 nurses work at the six hospitals. In the coming weeks, the nurses are expected to hold membership drives at the hospitals and form bargaining teams.
Debra McKell, a spokeswoman for HCA's West Florida division, released a statement that said "while we do not believe having a union is necessary for us to communicate with our employees over work issues, we respect our employees' rights to make this decision."
"Our hospitals will continue in their efforts to provide the best possible care to our patients and to be the best possible work environment for all our employees," the statement read.
National Nurses United is one of a handful of unions representing nurses in Florida. Others include the Service Employees International Union, which represents nurses at St. Petersburg General and Northside Hospital in St. Petersburg, and the Teamsters, which represents nurses at Regional Medical Center Bayonet Point in Hudson.
Ed Bruno, the southern states regional director for the National Nurses Organizing Committee, estimates fewer than 10 percent of Florida's approximately 200,000 nurses are union members.
But the number is expected to increase. National momentum for unionizing among nurses is growing, bolstered in part by union successes in California, which now has statewide nurse-patient ratios.
Another reason is the continued failure to set ratios here. Though lawmakers are expected to introduce the bill again in the coming session, passage seems even less likely with new Republican governor Rick Scott — who happens to be a former HCA executive — and a Legislature that is more pro-business. The bills were sponsored by a pair of Democrats — Rep. Oscar Braynon of Miami Gardens and Sen. Tony Hill of Jacksonville.
"It will be tougher," said Braynon, who has introduced bills to set nurse-to-patient ratios for the past three years. He said hospitals have opposed the effort, mostly because of what it would cost them. At the same time, Braynon said, support from nurses is growing. And he thinks having the nurses unionize at individual hospitals will help efforts.
Dee Dee Marsh at Oak Hill Hospital said the patient-to-nurse ratio on the telemetry floor where she works is about six-to-one. On other floors where she has worked as a floater, it has been as high as eight-to-one. She said while her supervisor works hard to keep ratios manageable, it can be difficult without a set policy.
"Sometimes it's too busy. You don't have enough time that's needed to advocate for your patient, to provide the best care for your patients," she said.
Richard Martin can be reached at email@example.com or (727) 893-8330.