News & Events

‘State of Nursing in Massachusetts’ Survey Released for National Nurses Week – Results Strike Alarm for Patient Safety amid Drastic Changes to Health Care


BOSTON, May 11, 2017 — "The State of Nursing in Massachusetts," an annual survey of the Commonwealth’s registered nurses released for National Nurses Week, sounds a blaring alarm that the quality and safety of patient care is being significantly compromised due to the corporatization of health care, chronic understaffing of nurses and the practice of assigning too many patients for nurses to care for at one time.

Watch video series ‘What Nurses Really Do’ at 


According to the survey, released by the Massachusetts Nurses Association at the State House on May 11, having too many patients at one time to care for is the most significant challenge to RNs providing high-quality patient care, with 77 percent of nurses identifying unsafe patient assignments as a problem.

The survey also shows that patients are sicker than ever before, requiring highly specialized nursing care. To help educate the public about the role of RNs in today’s complex health care environment, the MNA also premiered at the State House a video series called "What Nurses Really Do" alongside the survey. The first video and a call to action for more nurse videos can be seen at

"When it comes to the delivery of patient care and the safety of patients, registered nurses are at the front lines of the health care system," said MNA President Donna Kelly-Williams, RN. "What happens to nurses and the nursing profession is directly connected to the ultimate health and well-being of every patient we encounter. In hospitals, nurses deliver 90 percent of the clinical care patients receive, and are the only caregivers legally and ethically accountable for the safety of patients every minute they are in the hospital."

Nurses providing direct care report their patients have increased medical complications and are admitted to the hospital with more serious illness and injury today. Wide majorities of nurses – nearly eight-in-ten – say their patients are sicker now than patients ten years ago. More than half (53%) say their patients are much sicker – a figure that jumps to 63% among nurses working at community hospitals.

Quality of Patient Care

Twice as many nurses say the staffing situation in their facility has gotten worse over the past four years (39%) as say it has gotten better (21%). Staffing issues are particularly problematic at community hospitals (8% gotten better, 41% gotten worse). Just one-in-ten nurses (10%) feels administrators at their hospital are very responsive to input from RNs about patient assignment levels. Three-in-ten (28%) say management rarely or never adjusts nurse staffing levels when RNs face unsafe patient loads.

In each of these categories, RNs reported an increase in patient safety concern over 2015 survey results:

  • Alarmingly, 29 percent of RNs report patient deaths directly attributable to having too many patients to care for at one time.
  • 63% report injury and harm to patients do to understaffing.
  • 62% report longer hospital stays for patients.
  • 71% report readmission of patients.
  • 73% report medication errors due to unsafe patient assignments.
  • 87% report RNs don’t have the time to properly comfort and care for patients and families due to unsafe patient assignments.
  • 83% report RNs don’t have the time to educate patients and provide adequate discharge planning.

"Our nurses are telling us that things are not working," said Rep. Denise Garlick, D-Needham. "We need to listen to them. Three years ago, I worked with my colleagues in the House and Senate to pass safe patient limits in our Intensive Care Units, knowing that it was the first step towards limits in all hospital units. Today’s survey confirms that we must take that next step. Our nurses are telling us we need safe limits in all units to protect patients."

Hospital Business Practices and Insurance Policies

By wide margins, nurses are more likely to say hospital mergers and acquisitions (21-point margin) and emerging business relationships between hospitals and pharmaceutical companies and/or medical device manufacturers (19-point margin) worsen the quality of patient care. Nurses are even more critical of the impact of insurance reimbursement changes, saying new insurance policies do more to worsen care by a 33-point margin.

What Nurses Really Do

For 15 straight years, nurses have topped Gallup’s annual survey of the most honest and trustworthy professions. But many people don’t really know what nurses do on a daily basis. "The State of Nursing in Massachusetts" shows that 43 percent of RNs do not believe patients understand their role.

The reality is that nursing today is a complex and demanding profession. Patients are sicker than ever and are admitted to hospitals with serious medical complications. The MNA’s video series, "What Nurses Really Do" features Massachusetts nurses speaking directly to the public, telling them about the specialized patient care they provide every day.

The first installment in the series, debuting May 11 at the State House, features RNs from Cape Cod Hospital, Norwood Hospital and Brigham and Women’s Faulkner Hospital. Nurses are encouraged to share their own experiences as nurses and tell the public what they really do at

"The State of Nursing in Massachusetts" was commissioned by the MNA and conducted between April 5 and April 25, 2017 by Anderson Robbins Research, an independent research firm headquartered in Boston. The 2017 survey respondents were all registered nurses working in Massachusetts health care facilities randomly selected from a complete file of the 100,000 nurses registered with the Massachusetts Board of Registration in Nursing. │ │

Founded in 1903, the Massachusetts Nurses Association is the largest union of registered nurses in the Commonwealth of Massachusetts. Its 23,000 members advance the nursing profession by fostering high standards of nursing practice, promoting the economic and general welfare of nurses in the workplace, projecting a positive and realistic view of nursing, and by lobbying the Legislature and regulatory agencies on health care issues affecting nurses and the public.