News & Events

MNA member offers testimony at hearing on payment reform

From the Massachusetts Nurse Newsletter
June/July 2011 Edition

Marie Ritacco, an RN at St. Vincent Hospital in Worcester, testifies before the Joint Committee on Health Care Finance on May 23. Seated, from left, Rep. Carolyn Dykema, D-Holliston; Rep. Denise Garlick, D-Needham; committee staff member; Senate Chairman Richard Moore, D-Uxbridge; House Chairman Steven Walsh, D-Lynn.

On May 23, RN and MNA activist Marie Ritacco participated in a legislative hearing with the Joint Committee on Health Care Finance regarding H.1849, An Act Relative to Improving the Quality of Health Care and Controlling Costs by Reforming Health Systems and Payments. What follows is her powerful, expert testimony.

“Good morning. My name is Marie Ritacco, and I am a registered nurse. I live in Auburn, and I am a post anesthesia care nurse at St. Vincent Hospital in Worcester. I am here today with some of my sister nurses from Central Massachusetts. I do want to thank the Committee for conducting these hearings all over the state. This is obviously an important topic, and I think it is great that you are making the debate on this process so accessible.

“I do not pretend to understand the complexity of payment systems, but I do understand what is happening to patients at the hospital bedside. I have been a nurse for more than 25 years, and I have had a bedside view of how the hospital industry has responded to the changing environment. In addition, what I can tell you is that every time there has been any kind of change in health policy, the hospital industry has always responded in the same way. They have consistently attempted to cut costs by reducing the level of nursing care in their facilities. Specifically, they have assigned more and more patients to every nurse, they have increased the use of mandatory overtime to staff their facilities, and they have tried to delegate nursing duties to staff people who might not be qualified to perform them.

“There are two problems with these strategies. The first is that they are dangerous for patients. All of these practices result in compromised patient care. This leads to the second problem, which is that they do not save money, at least not in the long term. All of these strategies result in preventable medical errors and complications, and treating those complications is expensive. As the legislature debates a bill expressly designed to reduce costs, I fear, and I know my sister nurses fear, that the hospital industry will respond to this round of reform in the same old way—they will cut nursing care.

“In fact, as you may know the nurses at my facility—St. Vincent Hospital—just finished a round of extremely difficult and contentious negotiations for a new contract. Throughout those negotiations, we heard repeatedly from the hospital administration that they had to cut nursing costs and could not staff the hospital safely in anticipation of payment reform. If hospitals like mine are already cutting nursing services in anticipation of payment reform legislation, I can only imagine what they are going to do when such legislation passes.

“I agree with the governor and with the committee that the problem of escalating health care costs has to be addressed. However, I am equally concerned that the trends of the last two decades—assigning more and more patients to every nurse, extensive use of mandatory overtime, and delegating clinical nursing duties to unlicensed personnel—will be further accelerated unless this bill includes some specific provisions to improve and protect quality standards. For a nurse like me, working at the hospital bedside, that means limits on RN patient loads, a prohibition on mandatory overtime, and maintaining the scope of nursing practice. Thank you for this opportunity to weigh in on this important legislation.”