Every day in Massachusetts, patients in our hospitals push a call button and wait…and wait…for a registered nurse to come to their aid. You could be one of those patients. You might be in severe pain, or frightened or disoriented. You need help, but you wait, sometimes for hours, to receive the care you need. Thankfully, in some cases the wait causes no serious harm. But with some frequency, the lack of a quick response from a nurse can trigger a downturn in a patient’s condition; or lead to a serious and costly complication. And a two-day hospital stay turns into a six-day stay.
Today, you are only admitted to a hospital if your medical condition is severe enough that you require around-the-clock monitoring and care from a registered nurse. However, hospital executives assign nurses too many patients to safely care for at once, a dangerous practice that leads to more patient infections, bedsores, medication errors, and worse.
Currently, there is no limit on the number of patients hospital executives can assign to a nurse at one time, except in intensive care units. Question 1 would set maximum patient limits for nurses that varies based on the type of unit and severity of patient needs. It would mean better care for hospital patients.
Today, decisions about patient assignments are made by a hospital executive whose focus is on the bottom line and increasing profits. Question 1 will put patients ahead of profits – where they belong.
Dozens of independent scientific studies, including those published in the New England Journal of Medicine and the Journal of the American Medical Association, have consistently found that the quality of care decreases dramatically when nurses are forced to care for too many patients at once. According to Mathew McHugh, a leading researcher on nursing and patient safety from the University of Pennsylvania, “The evidence on the relationship between nurse staffing and patient outcomes is one of the most robust in the health services literature.”
More than 14 years ago, California established maximum limits on the number of patients assigned to a nurse at one time and the results have been universally positive. Studies show that patients in Massachusetts receive less time with their nurses, resulting in higher rates of complications and average emergency department wait times that are 11 minutes longer in Massachusetts than in California. Not only is care better, but spending on health care in California is significantly lower, they have lower health insurance premiums than here in Massachusetts and no hospital or service has closed as a result of the law.
Hospital executives have had two decades to address this issue. It’s 2018, and instead of fixing it, hospital executives are spending tens of millions of dollars on misleading television advertisements opposing Question 1 to continue the dangerous status quo.
Massachusetts’ hospitals can afford to invest in better patient care. This is a $28 billion industry that has tallied up $7.6 billion in profits in the past five years. These are large wealthy corporate healthcare networks. Additionally, Massachusetts has more RNs per capita than nearly every state in the country. We are one of two states without a nursing shortage and we graduate 3,500 new nurses from our nursing programs each year.
Question 1 is not a government mandate. Nurses put it on the ballot because the legislature has refused to take action for 20 years, while hospital executives continue to assign nurses too many patients to safely care for and then tell nurses to deal with it when they ask for help.
Now hospital executives are using those same bullying tactics on Question 1, threatening to close units and fire staff if it passes,—even claiming that having more nurses in hospitals would somehow lead to worse care and longer work times. The opposition arguments just don’t add up, unless you are a hospital executive protecting corporate profits.
When you look behind the false claims and fearmongering about this measure, the important truth about Question 1 is that it gives patients more time with their nurse – so when your loved one hits the call button they can be sure their nurse is there when they need them most.
Donna Kelly-Williams, RN, 40-year maternity nurse at Cambridge Health Alliance and Co-chair of the Committee to Ensure Safe Patient Care. 110 Mary St., Arlington MA 02174