A new approach to an old and persistent problem of the critical need for safe patient limit MNA’s expertise, resources and humanity key to success
From the Massachusetts Nurse Newsletter
July/August 2013 Edition
By Donna Kelly-Williams
This issue of the Massachusetts Nurse is dedicated to a new and exciting approach by our members to address the single most important issue impacting the quality and safety of our patients, and the integrity of our nursing practice— the need for enforceable limits on nurses’ patient assignments in our acute care hospitals.
Numerous surveys of our membership over the years, both in our individual bargaining units and statewide, have consistently shown RN staffing levels and the safety of nurses’ patient assignments to be the most important issue for our members, and the nursing community in general. In the last 15 years, there have been more than 17 strike votes and at least three strikes where the issue of patient safety and RN staffing levels was at the center of these disputes. In the last three years, nurses at St. Vincent Hospital in Worcester, Tufts Medical Center, and UMass Memorial Medical Center were on the verge of striking over this issue and last fall Quincy Medical Center conducted a one-day strike to win limits on patient assignments to protect their patients.
At our annual convention last year, a motion was put forth and passed by our membership that called upon the Board of Directors to move this issue directly to the public—our patients— through the creation of a binding question on the 2014 ballot.
The true victims of this crisis have been our patients. According to the CDC, more than 2,000 patients a year die from preventable medical errors and infections, complications directly related to the lack of safe limits on nurses’ patient assignments. More than 40 studies in the most prestigious medical and nursing journals in the world have been published that clearly show that unsafe patient limits for nurses is a direct cause of a number of serious complications, increased cost for health care and, yes, as stated above, thousands of preventable patient deaths. And the situation is only getting worse as hospitals , many of them owned by Wall Street conglomerates, or massive health care networks, have embarked on an unprecedented effort to slash services, cut staff and increase patient assignments – in the interest of profits.
If you have been a member of the MNA/NNU for any length of time, you are well aware of our long struggle to win passage of legislation to establish safe limits on nurses’ patient assignments to address this crisis. The first version of this legislation was introduced in 1995, and we have filed versions of the bill every legislative session since then. Earlier in the decade, a version of this bill passed the House of Representatives two times with veto proof majorities, yet we have never been able to get the legislation through the Senate.
In the wake of the economic crisis of 2009, the legislative appetite for this legislation waned, and the MNA/ NNU changed its emphasis on addressing this issue away from the legislature and focused more on winning staffing changes at the bargaining table. As mentioned above, we have found that any attempt to win staffing protections in our union contracts require a minimum of an overwhelming strike vote or strike. And when we win those protections, they come with a price, which is the hospital’s call to pay for appropriate staffing by lowering nurses’ pay and benefits.
Once again we have filed legislation to address this issue, but our membership has made it clear that they want us to simultaneously pursue a different approach to winning these much-needed patient protections. At our annual convention last year, a motion was put forth and passed by our membership that called upon the Board of Directors to move this issue directly to the public—our patients—through the creation of a binding question on the 2014 ballot that would result in a law to establish safe limits on nurses’ patient assignments for every unit in the hospital, with the addition of an acuity system to further codify safe patient limits based on the acuity of their patients for that shift.
In response, the Board has worked with MNA staff to develop a campaign to pursue the will of the membership to embark on the campaign to place this question on the 2014 ballot, and eventually to win the public vote to pass this long-awaited law.
We believe nurses are in a perfect position to succeed in this approach, as you are the most trusted professionals on the planet, and because, within your own network of family and friends, you have an easily identifiable group of folks who understand what you do and who would be readily willing to sign petitions in support of this initiative. That doesn’t mean this effort won’t take a concerted effort from our membership and staff, as well as the resources to mobilize this campaign. To that end, the Board of Directors, as directed by the membership, is applying all the required resources to this campaign, and our national organization, National Nurses United, recently voted to offer us the logistical and financial support we will need to win this fight.
This issue of the Massachusetts Nurse provides information about this exciting initiative and how it works (see MNA launches Safe Patient Care ballot campaign). In addition, MNA/NNU members in all of our bargaining units are joining this effort, and organizing in your facilities to gather support for this initiative.
Be on the lookout for information in your bargaining unit as to how you can join the campaign. You can also find more information on this web site as well as a new campaign web site we have launched to educate the public about this issue with the theme “Just Ask About Patient Safety.” The theme is based on the fact that the most important variable impacting the safety of our patients is the number of patients assigned to a nurse at one time. As you know, that number can have life and death consequences for our patients. The site helps the public understand the importance of safe RN staffing, shares research on the issue, and tells them how to get involved in our campaign to make hospitals safer for them and their families. The new ballot campaign website is www.PatientSafetyAct.com. We encourage you to visit the page and to share it with your friends and neighbors.