National Nurses United

J U LY | A U G U S T | S E P T E M B E R 2 0 1 8 W W W . N A T I O N A L N U R S E S U N I T E D . O R G N A T I O N A L N U R S E 7 MASSACHUSETTS M assachusetts nurses Associa- tion RNs are waging one of the most important campaigns of their history: Working to pass Question 1, the Patient Safety Act, on the statewide November ballot, which would establish safe nurse-to-patient staffing ratios in Massachusetts hospitals and make Massa- chusetts only the second state in the union to enjoy these lifesaving health care regula- tions. Nurses in California and across the nation are supporting and cheering on the Massachusetts nurses' hard-fought, decades- long campaign for limits on the number of patients that can be assigned to an RN. "The need for safe patient limits is one that is shared by nurses in every state and in many countries," said Donna Kelly- Williams, RN and president of the Massa- chusetts Nurses Association (MNA), which drafted and shepherded the measure onto the ballot. "We are proud and empowered that so many organizations and so many nurses have endorsed our initiative, particu- larly because these organizations represent frontline nurses." Except for California, no hospital-wide safety laws currently exist to specify how many patients a nurse can safely care for at one time. Since hospitals prioritize profits and routinely short staff units to cut labor costs, such rules are desperately needed. According to MNA surveys, some 77 percent of Massachusetts RNs believe that they are assigned too many patients to care for at one time, 90 percent report that they don't have the time to properly comfort and care for patients and families due to unsafe patient assignments, and 86 percent say they don't have the time to educate patients and provide adequate discharge planning. Nearly 9 in 10 patients say that they will vote yes on the Patient Safety Act, also according to survey results. It is not uncommon for nurses in Massa- chusetts to be assigned six or seven patients at one time, when a safe limit would be no more than four patients to one nurse on a typical medical-surgical floor. Numerous studies show that when nurses have safe patient limits, readmissions, medical errors, infections, and other complications are dramatically reduced. In addition, California's experience has shown that safe staffing ratios attract licensed nurses back to the profession and bedside, reduce burnout, and help with retention and costs associated with staff turnover. In March 2018, Linda Aiken, a Universi- ty of Pennsylvania professor considered the nation's leading researcher on the nursing workforce, said in an interview with the Agency for Healthcare Research and Quality that "one of the best natural experiments occurred when California enacted mandat- ed nurse-to-patient ratios." Hospitals that were not in compliance came into compli- ance, and in the 15 years since ratios took effect, California hospitals became the best staffed in the country and have seen steep declines in mortality. Predictably, the Massachusetts hospital industry and organizations representing nurse managers and executives, such as the American Nurses Association Massachu- setts, are spending millions of dollars on television ads and other misleading propa- ganda to defeat Question 1, the Patient Safety Act. They are making the same claims that the California hospital industry made back in 1999 in their attempt to defeat ratios there, saying that improving RN staffing under these new regulations would bankrupt the industry and cause hospitals to close. Luckily, Massachusetts nurses have been able to point to California's experience after ratios to show that this is far from the case. No hospitals closed solely due to ratios and, in fact, net hospital income rose dramatical- ly after California's law was implemented, from $12.5 billion from 1994 to 2003 to more than $41.1 billion from 2004 to 2013. According to the MNA, Massachusetts hospitals posted profits of more than $1 billion in 2017 and can well afford to meet safe staffing regulations. "We are all watching Massachusetts and hoping the voters see right through the hospital industry's deceptive advertising," said Deborah Burger, a California RN and a National Nurses United copresident. "We nurses absolutely know that limits on the number of patients a nurse is required to care for at any one time will do wonders for improving the safety and quality of patient care, and our satisfaction as nurses. We made it a reality here in California, and it should be a reality for every patient and nurse throughout the country, and the world for that matter." —Staff report Nurses fight to win safe staffing limits Question 1, the Patient Safety Act, on state's November ballot

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