Citizens View Understaffing of Registered Nurses as a Problem That Requires Urgent Attention by Massachusetts State Legislators
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CANTON, Mass.—With health care quality front-and-center in public debate, over three-quarters (76%) of Massachusetts citizens support legislation that would set minimum safe RN-to-patient ratios, according to a statewide survey conducted by Opinion Dynamics Corporation (ODC) of Cambridge, Massachusetts.
The February 16-20, 2005 survey found that the public believes the quality of care in Massachusetts hospitals is suffering due to nurses being forced to care for too many patients at once. Now that the Massachusetts Hospital Association (MHA) has joined the MNA in acknowledging the need for patient safety measures, the primary issue before the Legislature is how best to solve this problem.
Massachusetts residents prefer the Safe Patient Care Act, which would set flexible minimum patient-to-nurse ratios, by a margin of 3-1 (62% to 21%) over the MHA proposal for toothless disclosure of staffing levels. The Patient Safety Act is supported by the Massachusetts Nurses Association (MNA), and by the Coalition to Protect Massachusetts Patients, an alliance of 86 of the Commonwealth’s leading health care groups. The bill was filed by Rep. Christine E. Canavan (D-Brockton) and Sen. Marc R. Pacheco (D-Taunton).
Furthermore, the public says that legislators and administrators should listen to nurses when they say that ratios save lives. "The voters of the Commonwealth have stated that they view the current nurse staffing situation as a clear and present danger," said John Gorman, president of ODC. "The attitude of the majority of voters on the issue remains particularly striking. Most issues either polarize the electorate or don’t have an impact on how they will vote. The safe staffing issue has consistent support across the electorate, and could clearly influence voters’ choices."
"Massachusetts residents understand that quality care requires real action, not public relations ploys," said MNA President Karen Higgins, RN. "Nursing is the key to quality hospital care. An RN cannot be in two places at once, much less six or more. Yet because of chronic understaffing, that is the prevailing situation in the state’s acute care hospitals. The way to ensure that patients get the care they need is to set flexible patient-to-nurse ratios."
Key findings of the survey:
- 89% agree that since both the hospitals and nurses in the state are proposing plans to address nurse staffing levels, there must be a problem with the current system.
- 77% agree that the quality of patient care in Massachusetts hospitals is suffering because there are not enough RNs working in hospitals.
- Similarly, 71% believe that nurses being forced to care for too many patients at once is a serious problem.
- Over three quarters (76%) of residents favor legislation regulating minimum staffing levels.
- Less than half (48%) favor legislation sponsored by the MHA that requires the posting and disclosure of staffing plans, but does not regulate minimum staffing levels.
- 74% believe it is a serious problem that HMOs and insurance companies are concerned only with profits.
- Hearing that Massachusetts hospitals are sponsoring the proposal to require the posting of staffing levels without regulating minimum staffing causes just 7% of residents to say they are more inclined to support it.
- Arguments in favor of MNA’s plan are much more persuasive than those in favor of MHA’s plan. After hearing a series of arguments in favor of each, support for MNA’s plan versus MHA’s increases by 18%.
The survey also found a growing sense of impatience by the public for the Legislature to take action on the issue of minimum nurse staffing levels.
- 66% say it is time for the Legislature to back up the nurses’ judgment, while just 25% say the Legislature should keep its hands off the kinds of medical decisions involving staffing.
- 76% of residents say they are more likely to vote for a candidate for state Legislature who supports regulating minimum staffing levels, while just 12% say they would be more likely to vote for a candidate who opposes regulating minimum nurse staffing levels.
This survey also established that nurses receive the highest job ratings (89%) of all hospital employees including doctors, and are perceived as having the most significant impact on the quality of patient care.
A 2003 survey of registered nurses in Massachusetts found that 87% of nurses supported legislation to establish safe minimum RN-to-patient ratios.
The bill would protect Massachusetts patients by ensuring that they receive nursing care appropriate to the severity of their medical conditions. To ensure maximum flexibility, the bill also requires that the Department of Public Health develop an objective system for monitoring patient medical conditions so that staffing levels can be adjusted and improved to meet patient needs. The bill would set minimum staffing standards specific to every unit and department in a hospital to ensure that major disparities in care levels do not exist in the Commonwealth’s hospitals, and specifically provides that nothing in the bill "shall be deemed to preclude any facility from increasing the number of direct-care registered nurses."
As of today, 106 legislators, a majority in both houses, have signed on as sponsors to the Patient Safety bill.
MNA commissioned the ODC poll. The survey of 400 Massachusetts residents has a margin of error of—4.9 percent at a 95 percent confidence interval.
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