MNA nurses and healthcare professionals have long been concerned about how the corporatization of healthcare has negatively impacted patient safety and the nursing workforce
Nurses highlight a longstanding crisis in care that has been exacerbated by the COVID pandemic
BOSTON, Mass. – Nurses and healthcare professionals represented by the Massachusetts Nurses Association will describe to lawmakers the forces jeopardizing patient care conditions and negatively impacting the nursing profession during a virtual hearing of the Future of Work Commission on Friday, December 17.
The commission, created by legislation signed by Gov. Charlie Baker in January 2021, is studying the impact of new workforce developments on workers, employers, and the economy. While the COVID-19 pandemic has impacted almost every industry, and especially healthcare, MNA testimony will demonstrate that the challenges facing the nursing workforce are rooted in changes that predate the pandemic.
Future of Work Commission Hearing
What: The Massachusetts Legislature’s Future of Work Commission will hear testimony from stakeholders on issues affecting the future of work and the workplace, including from Mary Havlicek Cornacchia, OR nurse at Tufts Medical Center and member of the MNA Board of Directors.
When: Friday, December 17 at 11 a.m.
Where: Virtual Hearing. To watch, go to: https://malegislature.gov/Events/Hearings/Detail/4113
“My colleagues and I have been on the frontlines of a pandemic for two years and we are yet again riding another wave of increasing hospitalizations and infections. Morale is low, burnout is high, and many nurses are walking away from the bedside with no plan to return. But even before the pandemic, nursing was in a precarious position,” said Mary Havlicek Cornacchia, OR nurse at Tufts Medical Center and member of the MNA Board of Directors.
“I do want to be clear. This crisis is not a nursing shortage,” Cornacchia said. We have plenty of nurses. What we do not have is nurses willing to work under the current conditions at the bedside. These conditions did not start with the COVID-19 pandemic. For years, the hospital industry has been creating the conditions for moral injury among nurses and other healthcare workers. Hospitals increasingly use just-in-time staffing models, scheduling barely enough nurses to be able to move patients through a revenue-generating system. This approach maximizes profits and leads to growing executive pay. It absolutely fails nurses who are trying to fulfill our professional and moral obligations to provide safe, high-quality patient care.”
Numerous surveys and studies published over the past year have shown approximately 20% of nurses are planning to leave the field within the next year. These nurses are most often the direct care nurses who have been on the frontlines of the pandemic and who, even before that, were burning out and leaving the bedside. According to a survey of Massachusetts nurses completed earlier this year, almost all nurses felt most supported by friends, family, and co-workers, over seven-in-ten (73%) felt support by Massachusetts residents in general during the pandemic, but just over a third (37%) felt supported by the hospital industry.
Although nurses feel supported by their closest contacts, COVID has taken a toll on retention – over a third (37%) of nurses reported being more likely to leave the nursing profession sooner because of the impact of COVID, according to “The State of Nursing in Massachusetts,” a randomized survey of Massachusetts RNs conducted March 25 to March 30 by Boston-based Beacon Research.
For new graduates, the numbers are also abysmal. Despite high enrollment in nursing schools – enrollment that has increased over the past year – new graduate nurses are leaving at alarming rates. Per a decade-long study by the RN Work Project, 17.5% of new nurses left their position within a year of starting a new job, 33% within two years, and 60% within eight years. This leaves Massachusetts with a diminished talent pipeline and threatens the future of healthcare, for without nurses there is no future for healthcare in the Commonwealth or anywhere else.
The nursing workforce crisis is having a direct impact on the quality of patient care in Massachusetts. Fifty-five percent of nurses surveyed in “The State of Nursing in Massachusetts” said hospital care was getting worse, compared to only 10 percent who said it was improving. This is a significant acceleration of a trend seen in previous “State of Nursing in Massachusetts” surveys. Since 2014, with only one exception in 2017, more nurses have reported care is getting worse rather than better. This year the number of nurses concerned about care quality exploded.
Closely linked to the diminishment of care quality is time nurses can spend with patients. Nearly twice as many nurses (60%) reported not having enough time with their patients as those who felt they had adequate time (33%). This problem saw a marked increase from the 2019 survey, when 47% said not having enough time with patients was a major challenge.
The MNA has proposed several recommendations to improve the future of nursing in Massachusetts, including:
- Increase the number of nurses working at one time to allow for the proper care of patients. This is beneficial to both nurses and patients. More than two decades of scientific research demonstrate that when nurses have too many patients assigned to them at one time, there is an increase in negative outcomes such as infections, injury, longer hospital stays, medication errors, and re-admissions.
- End “just in time” scheduling where hospitals understaff or send nurses home from work only to have a patient surge overwhelm the staff.
- Provide full time work for nurses- rather than relying on per diem positions and capping nurse hours to avoid paying for certain employee benefits.
- Provide adequate support staff. In many cases, hospitals have reduced or eliminated key support staff positions, creating an additional workload on nurses, and impacting the ability of patients to receive quality care and support in a timely manner.
- Prioritize patients over profits. Despite the pandemic, most hospital systems in Massachusetts are profitable (47 out of 59), benefitting both from federal COVID relief grants and loans and the surge in patient census and procedures this year. Overall acute hospital profitability increased 1.7 percentage points from 2019 levels to an average 5.3% profit margin during the period ending June 30, according to the Center for Health Information and Analysis.
- Listen to those doing the work on the frontlines.
- Generate additional information to help address the worsening staffing crisis through the creation of an independent legislative commission to conduct studies on the state of nursing in Massachusetts. The Workforce Development and Patient Safety Act (S. 1422/H. 2398) is sponsored by Senator Diana DiZoglio and Representative Dan Ryan.
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.