News & Events

MNA Files Quality Patient Care/Safe RN Staffing Bill to Regulate RN-to-Patient Ratios in Massachusetts Hospitals

Legislation is Key to Improving Patient Care & to Ending the Nursing Shortage

CANTON, Mass. — The Massachusetts Nurses Association (MNA) announced today that it will file legislation on Dec. 4th that would require all Massachusetts hospitals to adhere to Department of Public Health (DPH)-established minimum registered nurses (RN)-to-patient ratios as a condition of licensure by DPH. The filing of the legislation follows the recent release of prominent research studies and reports that clearly demonstrate that safe RN staffing produces dramatic cuts in patient mortality and is a key element in stemming the flood of RNs from Massachusetts hospitals.

The most recent study in the Journal of the American Medical Association (JAMA) shows that for each additional patient assigned to an RN, there is a 7% increase in the likelihood of death within 30 days from a complication not present upon admission to the hospital. The difference between 4 to 6 and 4 to 8 patients per nurse is accompanied by 14% and 31% increases in mortality respectively. It is common for RNs in Massachusetts to be assigned 6, 8, and even up to 10 patients on a given shift, placing thousands of patients at risk for serious complications and death.

"The scientific evidence is clear and overwhelming: when nurses have too many patients, patients’ lives are in jeopardy. The evidence also makes clear that poor staffing conditions in Massachusetts hospitals have caused and are exacerbated by a growing shortage of nurses willing to work in hospitals," said MNA President Karen Higgins, RN. "Passage of this legislation is key to improving care for our patients and to creating conditions that will retain and recruit the nurses we need to provide safe patient care."

Nurses are not alone in their desire for minimum RN-to-patient ratios. Support among the public for this legislation is strong in Massachusetts. A poll of Massachusetts residents found that more than 75% of the public supports legislation regulating RN-to-patient ratios. And last May, more than 80,000 Bay State residents signed petitions calling upon the legislature to pass a measure requiring an improved RN-to-patient ratio.

Similar legislation was passed in California in 1999, where ratios are scheduled to be implemented in 2003. While MNA has filed safe staffing legislation in the past, the new bill is based on the most recent scientific data, the experience in California and a special legislative commission, chaired by State Rep. Christine Canavan (D-Brockton) in 2001, which released a report recommending the regulation of RN-to-patient ratios as a means of addressing the nursing crisis in Massachusetts. Rep. Canavan, who is a registered nurse, is the lead sponsor for the bill, which is entitled "An Act Ensuring Quality Patient Care and Safe Registered Nurse Staffing."

In addition to this bill, the MNA will work with Senate Health Care Committee Chair Richard Moore on a comprehensive package of bills he has filed to address the nursing shortage. Included in his package is the Clara Barton Nursing Excellence Program, which would provide nursing scholarships for students entering the profession, establish student loan repayment programs, and a signing bonus for those who have demonstrated an excellence in nursing. It would provide grants to healthcare institutions and institutions of higher education for the establishment and maintenance of a mentoring and internship program for new nurses.

Senator Moore’s efforts last session helped establish a center for patient safety and medical errors in the Commonwealth.