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MASSACHUSETTS R egistered nurses packed a hearing room at the Massachusetts State House on Oct. 20 to advocate for the safe patient limits proposed in the Massachusetts Nurses Association's Patient Safety Act. They stood before lawmakers in solidarity, representing thou- sands of their colleagues across the state. "Our patients are suffering," MNA Presi- dent Donna Kelly-Williams, RN, testified, with three dozen RNs united silently behind her. "Every day that goes by without a law in place means more preventable medical errors, more avoidable complications, increased lengths of stay and readmissions. In some cases, it is the difference between life and death." RNs were joined at the hearing by many of the 80 legislators who have co-signed the Patient Safety Act, social and labor leaders from across the state, and academic experts who testified in support of the bill. In 2014, after many years of MNA efforts to pass similar legislation, a bill was signed into law mandating safe limits for intensive care unit patients in Massachusetts. The Patient Safe- ty Act would build upon that ICU law by setting a safe limit on the number of patients assigned to a nurse at one time in all units in all hospitals, while providing the flexibility to adjust staffing upward based on patients' needs. Newly developed research, presented during the hearing by registered nurse and Boston College Associate Professor Judith Shindul-Rothschild, demonstrated the need for the legislation. Throughout Massachu- setts, there are hospitals with emergency departments that far exceed the number of patients a nurse can care for safely. There is a strong relationship between the numbers of patients cared for by an RN in Massachusetts EDs and how quickly patients are evaluated by a qualified healthcare professional, according to Shindul-Rothschild. For example, at UMass Marlborough Hospital, where patient loads are high, patients on average wait more than two hours to be evaluated. At Boston Medical Center, a Level 1 trauma center, patients wait an aver- age of 94 minutes to be treated for a long bone fracture. This kind of data provides the public "with a meaningful, evidence-based context within which we can appreciate the human suffering that is extended, unneces- sarily, due to insufficient RNs in Massachu- setts' EDs," Shindul-Rothschild testified. Last year, Shindul-Rothschild presented concrete, peer-reviewed data showing that Massachusetts patients are receiving more than three hours less care per day from registered nurses than patients in California, where a safe patient limits law has been in place for more than a decade. Karen Higgins, an acute-care RN at Boston Medical Center and co-president of Nation- al Nurses United, testified that California's law has not led to any hospital closures. In fact, California hospitals have seen an increase in profits since it was enacted. The Oct. 20 hearing followed the release earlier this year of two independent national reports showing that Massachusetts hospi- tals rank near the bottom nationally (46th 4 N A T I O N A L N U R S E 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 O C T O B E R 2 0 1 5 NEWS BRIEFS Massachusetts RNs push to expand ratios to all units