Mass. voters see robust 'Nurse Staffing Act' on horizon, finally!

  1. Massachusetts will likely vote on the issue this November. Unsurprisingly, the Boston Globe featured a rather poorly written, one-sided, article on the matter - leaving out the meat & potatoes. "Studies from several researchers, including Judith Shindul-Rothschild, a professor at Boston College's nursing school, have shown links between a higher level of nurse staffing and improved pain management, wait times, patient satisfaction, and other measures." Other measures....what a convenient way to gloss over fewer medication errors, decreased mortality and morbidity, and better outcomes for pediatric patients, to name a few.

    What's more, the writer went all the way to Montana to find a nursing professor, Dr. Peter Buerhaus, willing to defame his research peers in pursuit of a political agenda. "These are associations - this isn't cause and effect". Funny you say that Dr. Buerhaus, since just about every study shows the opposite, including your own research that found, "staffing of RNs below target levels was associated with increased mortality, which reinforces the need to match staffing with patients' needs for nursing care". This act will ensure that each hospital has the staff on hand to provide such care.

    What else should we expect from a company owned by a local billionaire and Red Sox co-owner, John Henry. Massachusetts might be blue, but make no mistake, the wealthy run the show and will protect what they see as theirs - until we vote.

    Nurses in Massachusetts, let's get out their and share our stories with those we know. Women and their newborns especially deserve the staffing that this proposition would provide. This fall, women are likely to turn out in droves for a variety of reasons. Let's ensure that adequate nursing care during labor, delivery, and postpartum is a part of their vision.

    DB

    https://www.bostonglobe.com/metro/20....html#comments

    Massachusetts Nurse-Patient Assignment Limits Initiative (218) - Ballotpedia

    disclaimer: I am no longer working as a RN, but will be a practicing APRN soon enough.
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  2. Visit DannyBoy8 profile page

    About DannyBoy8, BSN

    Joined: Mar '18; Posts: 66; Likes: 146

    9 Comments

  3. by   herring_RN
    I hope the nurses of Massachusetts work to keep this on the ballot. And educate the public.
    It will save lives.

    The opposition, Steward Health Care, the largest for-profit private hospital operator in the United States, is already trying to get it off the ballot:
    A ballot initiative that could have a drastic effect on how hospitals assign patients to nurses has come under fire, and next month the state's highest court will consider whether voters should have a chance to consider the controversial proposal.
    Four voters have asked the Supreme Judicial Court to decertify the Patient Safety Act, arguing that Attorney General Maura Healey improperly certified it for the November ballot.
    The voters, who have received the backing of Steward Health Care System LLC, say it violates the Massachusetts Constitution...
    SJC to consider ballot question affecting nursing assignments | Boston Herald
  4. by   herring_RN
    The Patient Safety Act: What the Bill Does
    It protects patients safety

    The Patient Safety Act:*What a Bill Does

    "How to get involved" for Massachusetts voters:
    The Coalition to Protect Massachusetts Patients
  5. by   TriciaJ
    The media have never been nurse-friendly. One episode that stands out for me was when nurses in my home province went on strike in the 1999. The media behaved like absolute dirt bags and the nurses ended up taking it in the shorts. The province had a socialist government at the time, so no point kidding ourselves on that score.

    I do hope the bill in Massachusetts passes, and I hope there is a provision for nurses to have some outside agency to report to in the event of substandard staffing. In other words, I hope the bill has teeth.
  6. by   JS McCabe, RN
    What an important vote this will be!! Praying it passes in Massachusetts and spreads across the US!
  7. by   AceOfHearts<3
    The MA chapter of ANA is opposing it! So is the Organizations of Nurse Leaders.


    "Amanda Stefancyk Oberlies, CEO of the Organization of Nurse Leaders, stated, "Make no mistake: this proposal threatens the high quality of care we provide patients. It will force many hospitals to reduce critical services and will dramatically increase emergency room wait times. This measure will prevent nurses and doctors from being able to use their best judgment in times of crisis."[6]"

    It will INCREASE the quality of care. Five patients as a tele nurse was too much most of the time, especially with the high acuity many of them were. Heck, even 2 patients as an ICU nurse is too much if one is really critical.
  8. by   dchicurn
    Remind me NOT to go to that hospital if she's the one running it. Was that comment published? I wonder sometimes how people get in those positions. It makes zero sense. Praying it comes to fruition. We desperately need the same in the south. Thanks for posting.
  9. by   herring_RN
    Quote from AceOfHearts<3
    The MA chapter of ANA is opposing it! So is the Organizations of Nurse Leaders.


    "Amanda Stefancyk Oberlies, CEO of the Organization of Nurse Leaders, stated, "Make no mistake: this proposal threatens the high quality of care we provide patients. It will force many hospitals to reduce critical services and will dramatically increase emergency room wait times. This measure will prevent nurses and doctors from being able to use their best judgment in times of crisis."[6]"

    It will INCREASE the quality of care. Five patients as a tele nurse was too much most of the time, especially with the high acuity many of them were. Heck, even 2 patients as an ICU nurse is too much if one is really critical.
    That quote is included here:
    Massachusetts Nurse-Patient Assignment Limits Initiative (218) - Ballotpedia

    Also the ratios and text of the initiative.
  10. by   herring_RN
    This "leader" is just plain wrong. There have been MANY scientific studies demonstrating that safe staffing ratios save lives.
    It is dishonest and harmful to patients who die due ti failure-to-rescue. The profession of nursing is considered the most honest of occupations.
    Any nurse who denies the importance of sufficient nurse staffing is hinderingv the profession of nursing.

    "Massachusetts has some of the best hospitals in the country. Make no mistake: this proposal threatens the high quality of care we provide patients," said Amanda Stefancyk Oberlies, CEO of the Organization of Nurse Leaders. "It will force many hospitals to reduce critical services and will dramatically increase emergency room wait times.
    This measure will prevent nurses and doctors from being able to use their best judgment in times of crisis. Further, there are no scientific studies or reports that demonstrate the effectiveness of this one-size-fits-all staffing requirement improving quality of care."...
    Coalition to Protect Patient Safety Launches 218 Ballot Question Opposition Effort - Coalition to Protect Patient Safety
    By it's opposition the ANA is violating it's own resolution:
    In 2012 the ANA stated, "The nurse staffing resolution identifies short-staffing as a top concern for direct care nurses that negatively affects patient care and nurse job satisfaction. It notes that staffing decisions remain largely outside of nurses' control, and that staffing plans lack enforcement mechanisms.
    The resolution requests ANA to "reaffirm its dedication" to advocating for a staffing process, directed by nurses, that is enforceable and that includes staffing principles, minimum nurse-to-patient ratios, data collection, and penalties for non-compliance in all health care settings where staffing is a challenge".
    OOPS!
    * JAMA surg June 2016
    Hospitals with better nursing environments and above-average staffing levels were associated with better value (lower mortality with similar costs) compared with hospitals without nursing environment recognition and with below-average staffing
    Comparison of the Value of Nursing Work Environments in Hospitals Across Different Levels of Patient Risk | Nursing | JAMA Surgery | JAMA Network

    * Medical Care, November 2014
    The study findings provide support for the value of inpatient nurse staffing as it contributes to improvements in inpatient care; increases in staff number and skill mix lead to improved quality and reduced length of stay at no additional cost.
    Examining the value of inpatient nurse staffing: an assessment of quality and patient care costs. - PubMed - NCBI

    * Agency of Health Research and Quality, AHRQ Healthcare Innovations Exchange, Sept. 26, 2012.
    Higher nurse workloads are associated with more patient deaths, complications, and medical errors - "State Mandated Nurse Staffing Levels Alleviate Workloads, Leading to Lower Patient Mortality and Higher Nurse Satisfaction,"
    State-Mandated Nurse Staffing Levels Alleviate Workloads, Leading to Lower Patient Mortality and Higher Nurse Satisfaction | AHRQ Health Care Innovations Exchange

    * Medical Care Journal of the American Public Health Association: January 2013
    Improving nurses' work environments and staffing may be effective interventions for preventing readmissions. Each additional patient per nurse was associated with the risk of within 30 days of readmission for heart failure (7%), myocardial infarction (9%), and pneumonia (6%). "In all scenarios, the probability of patient readmission was reduced when nurse workloads were lower and nurse work environments were better."
    Hospital Nursing and 3-Day Readmissions among Medicare Patients with Heart Failure, Acute Myocardial Infarction, and Pneumonia

    * New England Journal of Medicine, March 17, 2011
    "Studies involving RN staffing have shown that when the nursing workload is high, nurses' surveillance of patients is impaired, and the risk of adverse events increases."
    "We estimate that the risk of death increased by 2% for each below-target shift and 4% for each high-turnover shift to which a patient was exposed."
    NEJM - Error

    If Pennsylvania and New Jersey matched California state-mandated ratios in medical and surgical units, New Jersey hospitals would have 13.9 percent fewer patient deaths and Pennsylvania 10.6 percent fewer deaths.
    * Health Services Research, August 2010
    The researchers surveyed 22,336 RNs in California and two comparable states, Pennsylvania and New Jersey, with striking results, including: if they matched California state-mandated ratios in medical and surgical units, New Jersey hospitals would have 13.9 percent fewer patient deaths and Pennsylvania 10.6 percent fewer deaths.
    "Because all hospitalized patients are likely to benefit from improved nurse staffing, not just general surgery patients, the potential number of lives that could be saved by improving nurse staffing in hospitals nationally is likely to be many thousands a year," according to Linda Aiken, the study's lead author. California RNs report having significantly more time to spend with patients, and their hospitals are far more likely to have enough RNs on staff to provide quality patient care. Fewer California RNs say their workload caused them to miss changes in patient conditions than New Jersey or Pennsylvania RNs
    https://onlinelibrary.wiley.com/doi/...3.2010.01114.x

    * Lancet Infectious Disease, July 2008
    This study finds that understaffing of nurses is a key factor in the spread of methicillin-resistant Staphylococcus aureus (MRSA), the most dangerous type of hospital-acquired infection. The authors note that common attempts to prevent or contain MRSA and other types of infections such as requirements for regular and repeated hand washing by nurses are compromised when nursing staff are overburdened with too many patients.
    Overcrowding and understaffing in modern health-care systems: key determinants in meticillin-resistant Staphylococcus aureus transmission - ScienceDirect

    * Critical Care, July 19, 2007
    Understaffing of registered nurses in hospital intensive care units increases the risk of serious infections for patients; specifically late-onset ventilator-associated pneumonia, a preventable and potential deadly complication that can add thousands of dollars to the cost of care for hospital patients. Curtailing nurse staffing levels can lead to suboptimal care, which can raise costs far above the expense of employing more nurses
    Staffing Level: A Determinant of... (PDF Download Available)

    * Medical Care: Journal of the American Public Health Association, June 2007
    A review of outcomes for more than 15,000 patients in 51 U.S. hospital ICUs showed that those with higher nurse staffing levels had a lower incidence of infections, such as central line associated bloodstream infections, a common cause of death in intensive care settings. The study found that patients cared for in hospitals with higher staffing levels were 68 percent less likely to acquire an infection. Other measures such as ventilator-associated pneumonia and skin ulcers were also reduced in units with high staffing levels. Patients were also less likely to die within 30 days in these higher-staffed units.
    http://protectmasspatients.org/docs/...0Infection.pdf

    * Evidence Report/Technology Assessment for Agency for Healthcare Research and Quality, May 2007
    A comprehensive analysis of all the scientific evidence linking RN staffing to patient care outcomes found consistent evidence that an increase in RN-to-patient ratios was associated with a reduction in hospital-related mortality, failure to rescue, and other nurse sensitive outcomes, as well as reduced length of stay.
    https://archive.ahrq.gov/downloads/p...nursestaff.pdf

    * Archives of Internal Medicine, Dec 2006
    A national study of the quality of care for patients hospitalized for heart attacks, congestive heart failure and pneumonia found that patients are more likely to receive high quality care in hospitals with higher registered nurse staffing ratios.
    https://massnurses.org/files/file/Le...tals_Study.pdf

    * Journal of Nursing Administration, Jan. 2006
    Increasing RN staffing increased patient satisfaction with pain management and physical care; while having more non-RN care "is related to decreased ability to rescue patients from medication errors."
    https://pdfs.semanticscholar.org/1c0...8558fd5481.pdf

    * Cancer, Sept. 2005
    Patients undergoing common types of cancer surgery are safer in hospitals with higher RN-to-patient ratios. High RN-to-patient ratios were found to reduce the mortality rate by greater than 50% and smaller community hospitals that implement high RN ratios can provide a level of safety and quality of care for cancer patients on a par with much larger urban medical centers that specialize in performing similar types of surgery.
    https://www.massnurses.org/files/fil...d_Staffing.pdf

    * Nursing Research, March/April 2003
    Increasing nurse staffing by just one hour per patient day resulted in a 9% reduction in the incidence of hospital-acquired pneumonia. The cost of treating hospital-acquired pneumonia was up to $28,000 per patient. Patients who had pneumonia, wound infection or sepsis had a greater probability of death during hospitalization.
    http://www.nationalnursesunited.org/...-ADE-costs.pdf
  11. by   DannyBoy8
    Yes, the ANA opposes this ballot initiative. Why? IMO, they're a fickle organization when they don't get the attention. They've been parading their own version of a staffing act around since the ice age with no success. Unions wage their battles on the front lines and take action while the ANA sits in their cushy Silver Spring, MD office debating which salutation to use for the next position statement.

    Your thoughts?

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