Over the past several weeks principals of the Massachusetts Nurses Association and the Massachusetts Hospital Association negotiated with leaders of the House of Representatives to work towards a compromise bill to improve patient care in hospitals.

The highlights of the compromise bill legislative leaders developed include:

Patient safety protections

• Directs the Massachusetts Department of Public Health to set an optimum target RN-to patient assignment and to set safe limits on how many patients a registered nurse can be assigned at one time in acute care hospitals.
• The staffing levels would be based on scientific research on nurse staffing and patient outcomes and expert testimony for each specialty area.
• Creates standardized criteria to adjust the nurses’ patient assignment in order to better meet patient care needs.
• Prohibits the dangerous practice of mandatory overtime.
• Assures that hospitals cannot delegate to unlicensed personnel duties which demand nursing expertise.

Ensures a continued strong pipeline of nurses into the profession

• Creates programs to increase nurse faculty in our schools of nursing.
• Creates nurse recruitment initiatives to increase the supply of nurses, including nursing scholarships and mentorship programs.
• Provides for refresher programs to assist nurses in returning to practice at the hospital bedside.

Strong hospital and patient protections

• Provides ample time for hospitals to meet the new staffing standards and limits: with implementation in teaching hospitals in 2008 and in all community hospitals in 2010.
• Allows hospitals that can prove a financial inability to comply with the law to delay implementation.
• Requires prominent posting of the daily RN staffing standards on each unit.
• Calls upon DPH to monitor compliance, investigate non-compliance and to enforce compliance through a variety of actions including fines.