News & Events

Safe RN Staffing: Fact vs. Fiction

From the Massachusetts Nurse Newsletter
November/December 2009 Edition

Opponents have spent years and millions of dollars spreading disinformation about the Patient Safety Act, which would limit the number of patients a hospital nurse is forced to care for at one time. This disinformation campaign has been effective in causing confusion in the health care community, including among nurses. Below are some examples of the hospital industry’s disinformation campaign, along with the FACTS about safe RN staffing:

Fiction: This is a narrow issue being pushed by special interests.
Fact: This is a critically important patient safety issue that affects every citizen of the commonwealth, and a strong, consistent majority of the public wants safe staffing limits. One poll after another has shown that 80 percent of the public wants limits on how many patients a nurse must care for at a time. Furthermore, registered nurses fighting for safe patient care are supported by the Coalition to Protect Massachusetts Patients, a group of over 125 health care, faith and patient advocacy organizations, labor unions, and community groups. Visit for details.
Fiction: There is no scientific evidence to support this legislation.
Fact: There are literally dozens of studies that demonstrate both the patient care and cost savings benefits of safe RN staffing. A list of such studies is available on the legislation and politics pages of MNA’s Web site:
Fiction: Safe RN staffing has been a failure in California, which has safe staffing limits.
Fact: Safe RN staffing has been a success in California! RNs are coming back to the bedside in droves, and nurses report the kind of job satisfaction that will keep them at the bedside. Furthermore, hospitals have been able to meet the nurse staffing levels required without significant financial disruption. According to the California Health and Human Services Agency there has been “no negative impact on the health care system. [Their] data shows that hospitals have been able to meet the lower ratios.”
Fiction: There aren’t enough nurses to meet the limits
Fact: All across the state, hospitals are presently implementing layoffs and hiring freezes. New RN grads cannot find jobs. Hospital managers even admit this. “There is this ginormous glut of new grads,” Steve Taranto, head of human resources at MGH, recently told NPR. Clearly, the claims that hospitals simply couldn’t find nurses even if they tried to staff safely are false. Rather than exacerbating shortages, Safe RN Staffing will help alleviate long term nursing shortages. Since California’s Safe RN staffing law was signed, the number of actively licensed RNs has grown by an average of more than 10,000 a year, compared to under 3,000 a year prior to the law.
Fiction: Safe RN Staffing will result in layoffs of support staff
Fact: There is language in the Patient Safety Act that specifically prohibits hospitals from meeting the staffing limits by eliminating ancillary staff positions. Furthermore, unions representing ancillary staff in Massachusetts hospitals—including 1199 SEIU, UFCW 1445, and the UAW Local 2322—ALL support the Patient Safety Act. The legislation clearly protects ancillary staff.
Fiction: Hospitals can’t afford this.
Fact: The hospital industry in Massachusetts has seen surpluses of $916 million, $1 billion and $1.3 billion and $486 million in recent years. Although the recent downturn has caused some hospitals financial stress, the Patient Safety Act specifically addresses this sort of short-term financial hardship by providing a waiver process to exempt struggling institutions temporarily. But more importantly, studies report that hospital acquired infections may be causing up to $675 million a year in avoidable medical costs. Furthermore, Medicare has begun tightening its reimbursement regulations and will soon stop paying for medical errors altogether. Safe RN staffing will reduce costly medical errors. In reality, hospitals can’t afford not to staff safely.
Fiction: The bill uses an inflexible “cookie cutter” approach.
Fact: This bill will use an acuity system so that the level of care provided is based on the sickness of each individual patient, as well as the support services available in each individual hospital. In fact, the bill provides considerable flexibility while still ensuring that limits are real and enforceable. Nowhere in the bill are there specific ratios, nor have there been since 2006. The only flexibility the hospital industry will lose is the flexibility to understaff.
Fiction: The hospital industry is voluntarily addressing this problem. The industry can regulate itself.
Fact: Indeed, the hospital industry promised to regulate itself three years ago when, to great fanfare, it introduced a Web site that purported to post staffing plans that hospitals would voluntarily put in place and that the public could review. Leaving aside the question of whether or not a Web site would actually make patients safer, the Web site itself has proved to be a farce. Halfway through 2009, the industry had yet to report on 2008, let alone post their 2009 plans.

In truth, the industry’s efforts at “self regulation” have resulted in the current dangerous conditions. Their voluntary efforts to staff safely are clearly a sham designed to thwart legislative action on this important patient safety issue. The hospital industry cannot police itself, any more than Wall Street has successfully policed itself. Some basic regulation is needed. The Patient Safety Act provides that. The hearing on the Patient Safety Act was Nov. 3 at the State House. If you are interested in becoming involved with the campaign for Safe RN Staffing, or for more information, contact Riley Ohlson at 781.830.5740 or at

MNA president Donna Kelly-Williams, RN, and Board member Barbara Tiller, RN, meet with Rep. Richard Ross (R-Wrentham), who is Tiller’s state representative, to discuss the Patient Safety Act. Ross is a supporter of the legislation.

Nurses, seniors and labor allies went to the State House in October to talk to legislators about the cost effectiveness of requiring hospitals to provide safe RN staffing. Specifically, the group talked to legislators about the impact of pressure ulcers, which are linked to unsafe staffing. These preventable complications result in both increased suffering for patients and dramatically increased costs. Pictured are: rear row, Barbara “Cookie” Cooke, RN, Pam Edwards, Mass. Senior Action, MNA President Donna Kelly-Williams, RN, Barbara Tiller, RN; middle row, Ava Gomes, Barbara Mann, Allene Greenwood, Bob Lennon, UFCW, and Elliot Shepatin; front row, North Shore Labor Council organizer Rosa Blumenfeld and Tina Russell, RN.