National Nurses United

the safe limits nurses are seeking through the Patient Safety Act will significantly reduce complications, short- en lengths of stay, and dramatically reduce patient read- missions, saving the Commonwealth hundreds of millions of dollars each year. A delegation of nurses helped drive the point home when they presented each of the legislators on the dais with a 10-inch-thick stack of paper containing the dozens of studies that underscore the need for safe patient limits. The hospital industry provided no data or evidence to support their dangerous practices because none exist. Judith Shindul-Rothschild, an associate professor at the Connell School of Nursing at Boston College, pre- sented groundbreaking findings from two recently pub- lished studies that for the first time provide concrete, peer-reviewed data comparing standards of nursing care and patient outcomes for hospitals in Massachu- setts, where there is no limit on nurses' patient assign- ments, and California, where such a law has been in place for more than a decade. Rothschild's study provides conclusive evidence that Massa- chusetts hospital nurses are caring for significantly more patients than their counterparts in California and that patients in Massachusetts are receiving over three hours less care per day from registered nurses than patients on the West Coast ( just over six hours of care for patients in our hospitals vs. over nine hours of care per day in California). "From the public's perspective, it is absolutely in their interests to support this ballot initiative so that when they're in the hospital or a loved one is in the hospital, there is no doubt there will an adequate number of registered nurses to care for them to assure they get safe, quality nursing care," said Shindul-Rothschild, whose article in the Journal of Nursing Care Quality showed an association between nurse staffing in Massachusetts and a higher rate of readmissions for heart failure. She pointed out that heart failure is the most com- mon and most expensive condition for which patients are admitted to hospitals, and the number one cause of death in America. Shindul-Rothschild's testimony was buttressed by that of Peter Arno, a senior fellow and director of health policy research for the Political Economy Research Institute at UMass Amherst. His research into the state's high incidence of hospital readmissions and the cost to taxpayers found that hospitals with higher nurse staffing levels had 25 percent lower odds of Medicare readmission penalties, that 85 percent of Massachusetts hospitals are currently penalized for excessive rates of Medicare readmissions, and that this rate was nearly 20 percent higher than the national average. The state's own Health Policy Commission reports that its hospitals waste more than $700 million a year due to preventable readmissions. "Raising inpatient nurse staffing levels, which have been demon- strated to improve quality of patient care, is a moral, political, and economic imperative whose time has come," concluded Arno. Ultimately, it's the patients who suffer, and Pamela Woodbury, a for- mer patient and director of the seniors group Spencer Council on Aging, also shared at the hearing her story about the consequences of hospital understaffing. During Woodbury's stay, her frail, elderly roommate with a broken hip—who had waited hours in the emergency department because there were not enough RNs to staff beds—needed the bulk of their RN's care. Woodbury said she was reluctant to ask the RN for help, even when she felt her IV site begin to throb and burn where her Vancomycin was being infused, because the nurse was already overburdened. The IV ended up infiltrating her arm, causing tissue damage and excruciating pain. "In no way do I blame the nurse," said Woodbury. "She was doing all she could for both of us—and no doubt for all of the other patients assigned to her. That poor nurse was running in and out of our room all night. As both a patient and as someone who is responsible for the care of seniors, I am here today to emphasize the need for pas- sage of the Patient Safety Act. As patients, we are admit- ted to the hospital because we need nursing care and deserve for that care to be the safest it can be. Every day that goes by without this law, patients in our hospitals are suffering and that is unacceptable—both to me and to the vulnerable senior citizens I am responsible for." If voters approve the Patient Protection Act in November, Massachusetts will be just the second state to have minimum RN staffing ratios. Currently, only California has a mandated ratios law, AB 394, which passed in 1999. Today, many for- mer doubters about the law's effects are now boosters. Dean Florez, former majority leader of the California Senate, was the legislator who cast the deciding vote in favor of AB 394, and traveled to Massachu- setts to testify in support. "I was initially torn about whether to vote for the Patient Safety Act in California because I wondered if administra- tors from the hospital industry might be right," said Florez. "Today, I am so pleased with the improvements in patient safety and outcomes which resulted from the law, I now consider that vote to be one of my proudest legislative moments." Massachusetts Nurses Association research shows that California healthcare costs are lower than Massachusetts and the rest of the nation, that California spends less on healthcare than Massachusetts and the nation, and that premium costs for insurance are lower in California than in Massachusetts and the nation. Many RNs who testified protested that their hospitals' chief exec- utive officers were making exorbitant salaries in the millions, with car allowances, travel allowances, and other perks, while adminis- tration continued to make cuts to staffing and critical patient servic- es. "How can they justify paying a failed CEO millions of dollars for years, while they close down our endoscopy service which treats thousands of elderly patients who can't afford to go elsewhere for that service?" said Kim Adam, an RN from Cape Cod Hospital. "As a nurse who struggles every day to provide the best care pos- sible to vulnerable patients in my community, I am appalled that our tax dollars are being used to compensate the extravagant lifestyle of a corporate CEO," said Linda Judd, an RN from Baystate Franklin Medical Center. "That's why we need H. 3844." Massachusetts nurses are on a mission to pass both ballot measures this fall. "The research is irrefutably clear, the most important factor contributing to the health and safety of patients in hospitals is the num- ber of patients your nurse is caring for at any one time," said Donna Kelly Williams, RN and MNA/NNU president. "This ballot measure will ensure patients receive the care they need and deserve, preventing thousands of patient complications, saving thousands of lives, and mil- lions of dollars that are being wasted now because patients aren't receiv- ing adequate, timely care from their nurse." David Schildmeier is communications director of the Massachusetts Nurses Association/National Nurses United. A P R I L | M AY 2 0 1 4 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 15 For more information on both measures, visit www.PatientSafetyAct.com "As a nurse who struggles every day to provide the best care possible to vulnerable patients in my community, I am appalled that our tax dollars are being used to compensate the extravagant lifestyle of a corporate CEO."

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