Asm. Jerry Hill‘s (D-San Mateo County) AB 574 is relatively simple: it further limits smoking in hospitals.

This bill prohibits smoking in all areas of acute care hospitals, including the general hospital campus, buildings, parking areas, plazas, and sidewalks. Establishes a patient-specific exemption to the smoking prohibition established by this bill if authorized by a treating physician. (Assembly committee analysis 5/6/09)

The one stumbling block to this bill seems to have been removed when Hill agreed to allow an exception for a treating doctor’s letter. So, if this bill gets signed, be prepared to take a little hike if you want to smoke a cigarette near a hospital.

The logic behind this apparently comes from a “teachable moment” philosophy, meaning that when you are in a hospital, a place of sickness, perhaps you should consider what you are doing to yourself. Or perhaps that the smokers themselves should consider that the cigarettes are putting them in the hospital. Perhaps the hike to smoke the cigarette will impress upon the patient just how crazy this whole smoking thing is.

At any rate, as I mentioned above, this one looks set to cruise through the Legislature.  Given that there is no organized opposition to the bill, other than the Republicans who are against it just because, you would think Arnold would sign it.  However, this is Arnold we’re talking about, so you never know.

Amidst the consternation over the Governor’s veto of Sheila Keuhl’s universal healthcare bill, SB 840, many California political observers may fail to notice the death of a less famous but equally important healthcare bill in the State Senate last week.

AB 2754 would have compelled California hospitals to draft staffing plans for non-nurse caregivers.  Right now, nurse staffing at hospitals is governed by minimum nurse-to-patient ratios set by the Department of Health Services.  That’s a good thing for patient care.

Non-nurse caregivers, however, including housekeepers, unit clerks, nursing assistants, respiratory therapists and many others, are covered by no such regulations.  Without such rules, hospitals are free to continue to cut staff, just so long as the employees being cut are not registered nurses.  Then, with ancillary staff cut to the bone, it’s up to the nurses to pick up the slack.  That means more nurse labor hours spent answering phones, watching monitors, flipping beds and taking out trash, and less nurse hours attending directly to patients.  The effect is to make the nurse-to-patient ratios meaningless and to allow spending the night at the hospital to become a riskier and riskier undertaking with each passing year.

AB 2754 was a modest first step toward fixing the problem and putting hospital staffing levels in line with patient care needs rather than just the bottom line.

Senate Democrats could have carried the bill, but failed to muster the nerve to resist the pressures of the hospital lobby.  For the record, Ducheny, Florez and Machado voted against keeping you and your loved ones safe when you’re sick.  Lowenthal, Murray, Scott and Speier chose not to cast a vote in this critical decision.