Hi {{first_name|nurse,}}
If you have ever walked onto an acute psych unit and felt your body go, “Okay… eyes up,” you get it.
Psych is not a “lighter” assignment. It is nonstop assessment. It is meds, behavior changes, safety checks, de-escalation, and that quiet moment where you catch the subtle shift that tells you something is about to go sideways.
Right now, California nurses are pushing back against a state proposal that would let acute psychiatric hospitals count staffing ratios with as little as 50% Registered Nurses, with the other half made up of LVNs or psychiatric technicians.
What’s happening
The proposal would allow psych facilities to replace up to half of the RN positions used to meet staffing ratios with LVNs or psych techs.
Nurses argue this:
devalues the RN license
puts patients at risk by shrinking the number of staff qualified to do full assessments and manage meds safely
Why this hits hard (real shift talk)
This is not an LVN-vs-RN argument. And it is not a knock on psych techs. Strong units need the whole team.
This is about what changes when RN presence gets cut in half while acuity stays the same.
If you have ever handled rapid med changes, detox risk, escalating agitation, restraint/seclusion decisions, or a patient whose condition flips fast… you already know RN clinical judgment is not “extra.” It is part of what keeps people alive and safe.
The part nurses are worried about
When hospitals get “flexibility,” nurses often get the same expectation with fewer qualified hands.
And the risk does not disappear. It just gets passed down the line to the people still at bedside.
What you can do this week
If this news makes your stomach drop, you do not need to turn into an activist overnight to care about it.
Start small:
If you want to read the original statement, it comes from National Nurses United.
If you want to do something that actually helps without draining you, pick one of these:
Have one honest conversation at work. Ask a coworker who’s done psych (or floats) what feels safest on your unit and what doesn’t. Sometimes the first step is just naming what your gut already knows.
Check in on the nurses who carry psych shifts. A simple “How are you holding up?” goes a long way, especially for teams that deal with constant intensity and still get treated like an afterthought.
Share one real moment that explains the RN role. Not a debate. Just a true story: a subtle change you caught, a medication issue you noticed, a safety call you had to make. People who don’t work psych often don’t realize how fast things can change.
Protect your own capacity. If you are already stretched thin, your “something” can be reading the headline and staying informed. That still counts.
Final thoughts
This proposal matters for one big reason: psych care is medical care. It is not a holding area. It is not “just behavior.” People in acute psychiatric hospitals can be dealing with suicide risk, withdrawal, serious medication side effects, trauma responses, and complex co-existing conditions that look nothing like a simple checklist.
And on the hardest shifts, the RN role is the difference between “we noticed early” and “we noticed late.”
If California sets the tone that it is acceptable to meet staffing rules with half the RN presence, it can become a blueprint that spreads. That is why nurses are pushing back now, before it turns into the new normal.
If you are exhausted, you do not have to carry this alone. Talk about it with your coworkers. Share what you are seeing. Pay attention to what happens next. Psych nurses deserve real staffing, and patients deserve teams built for acuity—not budgets.
Talk soon,
Jason
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