Safe RN Staffing Legislation Fact Sheet and Historical Timeline
1990
- Hospitals begin cutting nursing staff and replacing registered nurses with unlicensed personnel (no scientific data available to address questions raised by nurses on the safety implications to patients – industry assures no adverse impact to patient care).
1992
- MNA holds town meetings throughout the state open to nurses and consumers. All report health care changes as a result of managed care, deregulation and re-engineering causing patients to suffer.
1994
- MNA Statewide Safe Care Campaign is formed.
- Hospitals merge to compete, leveraging higher reimbursement rates from insurers – further nursing staff is cut.
- Blue Ribbon Commission with nursing and consumer input fashions a number of legislative health policy initiatives to rectify the rapidly deteriorating conditions in health care. (RN/Health professions ID requirement, Whistle blower legislation, moratorium on for-profits, hospital service closure oversight process, health data collection/disclosure requirements, RN-to-patient minimum staffing).
1995
- Hospital industry claims nurses are exaggerating claims of poor care, no need for legislation.
- First State House rally for RN-to-patient minimum staffing.
- MNA files minimum safe RN staffing legislation.
1996
- Hospitals administrative budgets increase to 46% while nursing staff is cut 27%
- Safe Staffing bill filed for 1997/98 session.
1998
- Boston Business Journal story: 495% increase in the number of patient complaints.
- American Hospital Association survey: 35% of patients report substandard care.
1999
- Safe Staffing bill filed for 1999/2000 session.
- Legislature passes “whistle blower protection” law to protect health care workers that speak out on patient safety and care.
2000
- Safe Staffing bill filed for 2001/02 session.
- Hospital RNs leaving the bedside in record numbers citing staff/workload and mandatory overtime – untenable working conditions for those who remain.
- Legislature’s Special Commission on Nursing recommends passing safe RN staffing legislation.
- The Joint Commission: inadequate staffing levels have been a factor in nearly 25% of the most serious life-threatening events.
2002
- New England Journal of Medicine report: ‘strong and consistent’ link between nurse staffing levels and patient outcomes.
- Safe Staffing bill filed for 2002/03 session.
- State House rally features delivery of more than 80,000 signatures of Massachusetts residents gathered in just 10 days in support of safe RN staffing legislation.
- Independent survey of Massachusetts residents reveal 82% in favor of passing minimum RN-to-patient staffing – feel current situation critical.
- With increasing data in support of bedside nurses claims of deteriorating patient care, hospitals cite an inability to recruit nurses as the reason to oppose minimum staffing.
2003
- Safe Staffing bill favorably released by the Joint Committee on Health Care.
- Journal of Health Care Finance: increasing nurse staffing levels is cost neutral-no impact to the bottom line.
- Institute of Medicine report: “nurse staffing levels affect patient outcomes and safety.”
- Massachusetts Department of Public Health report: 76% increase in reporting hospital injuries & errors.
- Coalition to Protect Massachusetts Patients formed – 70 health care advocacy and consumer groups endorse Safe RN Staffing bill.
2004
- Independent survey of part-time nurses in Massachusetts finds that among nurses who have left the bedside – a whopping pool of 22,000 in the state – over 65% say they would strongly consider returning to the beside if the minimum RN-to-patient staffing bill passed.
- Over 1,000 registered nurses and patient advocates rally at the State House imploring lawmakers to bring relief to patients and families assuring safe nursing care in Massachusetts hospitals – pass Safe RN Staffing H. 1282.
2006
- Coalition to Protect Massachusetts Patients grows to 100 groups.
- Negotiations with House leadership, MNA, MHA produce a compromise RN staffing bill.
- Compromise Bill passes House 133-20. Senate fails to take up bill before end of session.
2008
- RN Safe Staffing bill passes House 120-34.
- State Senate voted 23-13 in support of a drastically amended version of the Patient Safety Act (S. 2816).
- Legislative session ends in stalemate on Safe Staffing bill.
2009
- RN Safe Staffing bill filed in new legislative session and released from Committee on Public Health and Committee on Health Care Financing.
2010
- MA Legislative session ends without vote on Safe Staffing bill in either House or Senate.
- Two years after full implementation of California RN Staffing Law, peer review studies show dramatically improving recruitment and retention of nurses and significant improvements in quality of patient care.
2012
- A ban on mandatory overtime, originally a component of our safe staffing legislation, is passed into law by the legislature and goes into effect on November 5th, 2012
- The MA Legislative session ends without a vote on the full Safe Staffing bill in either the House or Senate.
