BOSTON, Mass – As the state and the nation begins celebrations for National Nurses Week (May 6 – 12) an annual survey of the state’s nurses sounds a blaring alarm that the quality and safety of patient care continues to be significantly compromised due to the corporatization of health care and the practice of assigning too patients for nurses to care for at one time.
The survey also finds the majority of nurses report that in the wake of these dangerous conditions, hospital executives too often refuse to heed their calls for needed staff and resources to safely care for their patients, which prompts nearly 90 percent of nurses to support a pending ballot measure that would set safe patient limits for nurses in all hospitals based on the needs of patients. Email dschildmeier@mnarn.org for a copy of the survey’s executive summary.
The survey, “The State of Patient Care in Massachusetts,” is an annual survey of the state’s nurses commissioned by the Massachusetts Nurses Association and conducted by Anderson Robbins Research, one of the state’s leading polling organizations. A majority of the nurses surveyed are not members of the MNA.
According to the survey, being assigned too many patients to care for at one time 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 81 percent of patients are sicker than ever before, requiring highly specialized nursing care.
The survey takes on added significance as the issue of providing nurses with safe patient assignments will be the focus of a ballot initiative proposed to go before the voters this November. This week, a coalition of consumer, health care and nursing advocacy groups has begun collecting the last round of signatures needed to place a question on the ballot that would set safe patient limits for nurses in all hospitals with the flexibility to adjust nurses’ patient assignments based on the needs of each patient.
“Massachusetts nurses report a growing number of barriers to delivering quality patient care,” said Chris Anderson, President of Anderson Robbins Research. “A lack of time to give patients needed care and attention and having to care for too many patients at one time are by far the most frequent challenges faced by bedside nurses.”
Nurses Report Serious Patient Safety Concerns
RNs report these challenges are leading to a sharp increase in negative outcomes (readmissions, infections and even death) for patients and that these reports of negative outcomes have increased over previous years’ results:
“These finding provide an indictment of the hospital industry in Massachusetts and the need for safe limits on nurses’ patient assignments to ensure the safe, quality care our patients deserve,” said Donna Kelly-Williams, RN, President of the MNA and a maternity nurse at Cambridge Health Alliance. “Reports by the state’s nurses echo the findings of dozens of peer reviewed studies, including five studies of Massachusetts hospitals that show patients suffer a number of negative outcomes when nurses have too many patients to care for, and conversely, patient care significantly improves when nurses have a safe patient assignment as would be provided by the Patient Safety Act.”
Hospital Executive Response to Nurses Concerns
In response to nurses concerns about patient safety and negative patient outcomes, nurses report that hospital executives are not responsive to their feedback regarding patient loads and nurse staffing levels. Most of the time, management does not adjust patient assignments to meet patients’ needs, nurses said. More than six-in-ten (63%) nurses report that hospital management only occasionally adjusts their patient assignments when it is needed to meet patients’ needs.
The survey’s findings on hospital executive responsiveness to safety concerns is important as it provides a striking counterpoint to the hospital industry’s contention about flexibility in its opposition to the ballot measure requiring safe patient limits. Hospital executives argue that they need to maintain flexibility to adjust RN staffing levels and nurses patient assignments based on the unique needs of patients.
“The sad truth, as this survey demonstrates, is that hospital executives do not adjust nurses’ patient assignments based on the needs of patients,” Kelly-Williams said. Instead, more often than not executives force nurses to care for too many patients at once, with devastating consequences for those patients. The only flexibility hospital executives want is the flexibility to continue the dangerous status quo.”
Health Care Corporatization Puts Concern for Profits over Patients
For nurses, the driving force behind the continued deterioration in patient care conditions in our state is the increasing corporatization and consolidation of the health care system.
“Over the past decade, RNs have seen hospital patients become sicker, and hospitals themselves become more corporate,” Robbins explained. “RNs say the result is more decisions being made based on profit margin than on patient care.”
Most nurses do not believe that hospital corporatization is having a positive effect on quality of care. In line with last year, less than a third (31%) of nurses think that Massachusetts hospitals’ mergers and acquisitions have made the quality of care better. Similarly, just over a quarter (27%) believe that hospitals’ business relationships with pharmaceutical companies and/or medical device makers actually make patient care better.
“The State of Patient Care in Massachusetts” was commissioned by the MNA and conducted between April 9 and April 25, 2018 by Anderson Robbins Research, an independent research firm headquartered in Boston. The 2018 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. The majority of those surveyed were not members of the Massachusetts Nurses Association.
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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.
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