By Colleen Quinn
STATE HOUSE NEWS SERVICE
STATE HOUSE, BOSTON, JAN. 25, 2010…..Nurses from around the state, joined by a slew of legislators, urged passage of a nurse staffing law, saying they have battled too long for a bill they say would save patients’ lives.
Close to 100 nurses packed a hearing room Wednesday before the Joint Committee on Health Care Financing to plead for the staffing bill: a hearing that has become a perennial event during the last decade when the bill has failed each session to become law. Similar bills have passed in the House of Representatives, but have never made it to the governor’s desk.
Nurses want hospitals to limit the number of patients they care for at any one time. In the past, hospital administrators argued it would hinder their ability to staff hospital units, and would hamper them during hard economic times that have many hospitals struggling to stay open.
More than a dozen lawmakers lined up before the committee to express their support, calling it long-overdue, while members of the Massachusetts Nurses Association told stories of being unable to care for the number of patients they are assigned each shift.
“We continue to have a disturbing crisis in Massachusetts. Registered nurses are being forced to care for too many patients at one time,” said Donna Kelly Williams, president of the Massachusetts Nurses Association.
One bill (S 539), filed by Sen. Richard Moore, would establish a nursing advisory board to propose recommendations on patient safety and hospital staffing, as well as require hospitals to create staffing plans and limit the amount of lengthy shifts nurses are allowed to work. Another bill (S 543) filed by Sen. Marc Pacheco (D-Taunton) would collect nurse staffing and patient data, making it available to the public. It also includes provisions on forced overtime and hospital staffing plans.
Lynn Nicholas, the president and CEO of the Massachusetts Hospital Association, said her organization was in favor of Moore’s bill, saying it still gives hospitals flexibility in determining ratios in nurse staffing.
“We do believe a reasonable compromise is Senate 539. The reason for that is it doesn’t set hard and fast limits to be applied at all times and all circumstances because decisions about staffing should be made by the patient care team on a flexible basis, based on patients’ acuity, caregiver competencies, and a team approach,” she told the News Service after the hearing.
Contrary to what nurses contend, Nicholas said that recent data shows nurse staffing has risen over the past few years. One of the reasons the association favors Moore’s bill is because it calls for transparency around staffing plans, she added.
“We believe that we should be looking at outcomes, quality and patient safety data, and not anecdotal stories to make these important decisions,” Nicholas said.
Rep. Denise Garlick, a freshman representative from Needham, said she first testified on the issue in 2000. She is a registered nurse, who now sits on the committee considering the bill.
Creating nurse staffing legislation is imperative now as lawmakers contemplate health care payment reform, Garlick said. Many hospitals, bracing for changes initiated by payment reform, are already reducing nursing staff to cut costs, several nurses told committee members.
“When hospitals are asked to cut costs, the first place they go to is labor. The biggest chunk of labor is nurses,” Garlick said. “We are going to see the kinds of impacts that no one should have to endure. Now, more than ever, it is imperative that we talk about this patient safety act as we are talking about the health care payment reform.”
California has already passed similar legislation, setting limits on the number of patients a nurse cares for at one time. DeAnn McEwen, a registered nurse in California, came to Boston to tell Massachusetts lawmakers how the law is working on the West Coast.
“The hospital industry fought it there too with all the excuses,” she said. “I am here to tell you it has been a great success.”
In California, they have reduced medical errors stemming from nurse shortages, improved the quality of care, and attracted new people to the profession, McEwen said.
Laurie Budnick, an oncology nurse in Massachusetts, described patient care as resembling an assembly line - a situation she said is dangerous to those in chemotherapy, who are more susceptible to infection.
Marlena Pellegrino, a nurse at St. Vincent’s Hospital in Worcester, said she and other nurses at her hospital call administrators on a daily basis to let them know they are understaffed on a shift.
“We get patented responses on the phone: efficiency, streamlining and budgetary needs,” she said. “I am on the other end of the phone thinking¸ but what about the patients? I am working in a hospital. They are talking numbers and we are talking about the human lives in front of us.”
Tim Sullivan, legislative and communications director for the AFL-CIO, told a story about his cousin who was a nurse in Massachusetts, but moved out of state after she considered leaving the profession because she burned out at age 28. She heard about the law in California, and instead of leaving nursing, she moved.
“She said it is like night and day. She feels like a better nurse in California,” Sullivan said. “The system in California is better. It is not just better for the nurses; it is better for the patients and their families.”
Sullivan, like many others who testified, pointed out repeated appeals of nurses for staffing legislation.
“I have only been around since 2004, and this is my fifth time testifying on this piece of legislation,” he said.
Rep. Christine Canavan, a registered nurse who represents Brockton, said fighting for this bill year after year is frustrating for nurses, who know the problem is real. With a sense of urgency in her voice, Canavan described the need for all patients to be taken care of by licensed nurses who are able to assess patients quickly, often in life-threatening situations.
Speaker Pro-Tempore Patricia Haddad (D-Somerset) became emotional when testifying about the need for adequate nurse staffing. Haddad said she has spent a lot of time in hospitals in the past two months, with her father first at her local hospital and now at Massachusetts General Hospital.
“I have experienced the one-on-one care, and I have experienced… three times my father has flat-lined. Three times nurses have been there. Three times nurses have taken care of me, who was falling apart,” Haddad said. “You can never, never underestimate the good things that are being done.”
Despite being very emotional about the issue, Haddad she said she felt she had to testify to stress the bill’s importance. She talked about the nurse who took care of her father, who when she was off-duty kept calling to check on him.
“We came so close to this a couple of years before,” she told committee members about the bill. “I am asking you to do your magic. I know you can do it.”