News & Events

Senate Budget Includes Outside Section Establishing Commission To Recommend Legislation on Nurse-to-Patient Ratios

Your efforts have made an impact! Our campaign in May to gather and deliver more than 80,000 public signatures has caught the eye of the legislature, particularly the Senate, which has included an outside section in the budget establishing a commission to recommend nurse to patient ratios in acute care hospitals. While far from ideal, this language represents a move forward in our effort to create regulations to mandate RN to patient ratios and opens the door in coming weeks to further movement on this issue. Our legislative staff is working hard on Beacon Hill and is evaluating our options. We may soon be calling upon the membership for active support in the coming days….STAY TUNED FOR FURTHER UPDATES AND ACTION ALERTS…AND KEEP HOPE ALIVE! YOUR ACTIVISM IS MAKING A DIFFERENCE!

Senate Budget Includes Outside Section Establishing Commission To Recommend Legislation on Nurse-to-Patient Ratios

MNA Acknowledges Efforts to Address Issue of Regulating RN to Patient Ratios in Hospitals. Senate Initiative Follows Release of New England Journal of Medicine Study Demonstrating Poor RN Staffing Harms Hospital Patients and Delivery of More than 80,000 Public Signatures on Petitions in Favor of Regulating Ratios Now

The Massachusetts Nurses Association is pleased that the state senate has focused attention on the issue of nurse staffing levels in Massachusetts hospitals by including an outside section (Section 78) that calls for a "special commission on nurse staffing levels to study, evaluate and generate recommendations regarding nursing staff-to-patient ratios at acute care hospitals. However, the MNA, which has filed legislation that is pending in the legislature to actually establish registered nurse-to-patient ratios in all health care settings, is concerned that the Commission, by merely calling for study and recommendations on the issue, fails to provide meaningful resolution to the nurse staffing crisis.

"We are pleased that the efforts of nurses and patients to raise awareness of this issue have convinced the legislature to take a step forward and open the door to regulating registered nurse to patient ratios," said Karen Higgins, President of the MNA and an ICU nurse at Boston Medical Center. "We hope to use this opportunity to work with members of the legislature to craft language to provide a resolution to the nursing crisis."

According to Higgins and the MNA, inadequate staffing conditions in Massachusetts hospitals have led to a dramatic deterioration in the quality and safety of patient care, and have forced thousands of nurses to leave the bedside for fear of practicing under current conditions. In response to this issue, the state of California has passed a bill similar to that proposed by the MNA, and this year will implement regulations mandating minimum registered nurse-to-patient ratios.

The inclusion of the language in the Senate budget falls on the heels of the release last week of a groundbreaking study in the New England Journal of Medicine, which found that the number and mix of registered nurses in a hospital have a direct impact on the outcome of patient health. It also follows the delivery last month of more than 80,000 public signatures, gathered in less than 10 days by nurses across the Commonwealth, in support of HB 1186, Quality Patient Care/Safe Staffing legislation that would create a commission to actually establish registered nurse-to-patient ratios in Massachusetts health care settings.

The study published in the May 30th edition of the Journal included hospital discharge data for more than six million patients, financial reports and hospital staffing surveys from 799 hospitals in eleven states including Massachusetts. These data were analyzed to determine staffing levels of registered nurses (RN), licensed practicing/vocational nurses (LPN/LVN) and aides, and to measure the frequency of a wide range of complications that patients developed during their hospital stay.

Of the hospital inpatient nursing personnel studied, the study found that registered nurse staffing makes the biggest impact on patient outcomes. The researchers found relationships between nurse staffing and six adverse patient outcomes—urinary tract infections, pneumonia, shock and cardiac arrest, upper gastrointestinal bleeding, failure to rescue, and length of hospital stay—in medical and major surgery patients treated in hospitals. They found higher RN staffing was associated with a 3 to 12 percent reduction in these adverse outcomes and higher staffing at all levels of nursing was associated with a 2 to 25 percent reduction in these adverse outcomes.

For years, the MNA has been raising concerns about the negative impact of dramatic cutbacks in nurse staffing levels at Massachusetts health care facilities. Nurses have claimed these staffing reductions have resulted in a rapid deterioration in nurses’ working conditions, contributed to a dramatic shortage of nurses, and placed patients in jeopardy. In the last decade, nurses’ patient assignments have doubled and sometimes tripled. When nurses should be caring for no more than 4 or 5 patients, today they are often expected to care for 7, 8, 9 or even 12 patients.

"When nurses have too many patients, they have less time to spend with patients, they are rushed through their duties, they become fatigued and they lose their ability to adequately monitor and evaluate their patient’s condition. When nurses have too many patients, mistakes become more likely and the quality of care slips, as the Journal’s study confirms," Higgins explained.