Should the state limit the number of patients hospitals can assign to any one nurse?

Boston Globe | By John Laidler | January 8, 2016 


Susan Howe

Framingham resident, registered nurse

I have been a registered nurse, at the bedside, for 41 years. Over time, I have seen many changes in the health care industry, and not all for the best. Hospitals today are increasingly focused on their bottom lines, often to the detriment of patient care and working conditions for nurses. We used to have time to get to know patients. Now hospitals have as few nurses as possible on each shift in the name of “flexibility” and at the expense of patient outcomes.

For the last 14 years, I have been caring for mothers and newborn babies at Newton-Wellesley Hospital. My fellow nurses and I believe that nurse staffing in the maternity unit is at a crisis point. Between May and November of this year, nurses filed 116 unsafe staffing reports, describing the instances they say they were forced to care for too many patients at once.

Moreover, maternity patients today often need extra care. We see many older mothers now, even first-time mothers in their mid-forties. Their age can lead to risks related to diabetes, high blood pressure, and medications. Plus each assignment for a maternity nurse is actually double — mother and baby. It is not uncommon for nurses to have to care for four or five mothers — meaning at least eight to 10 patients — at once.

Numerous studies show that unsafe staffing hurts patients. Last year, researchers analyzed responses from 26,500 nurses and reviewed medical records for 422,730 patients. Their findings, published in The Lancet, showed that every extra patient added to a nurse’s average workload increases the chance of surgical patients dying within 30 days of admission by 7 percent.

This is why we need the Patient Safety Act. It would establish scientifically supported limits on how many patients a nurse can care for, with flexibility depending on illness or injury. As a maternity nurse, the benefits are easy to see. Hospitals would have to value patient care ahead of profits, and assign only a safe number of mothers and babies to each nurse. We want to provide care to the best of our ability. We need the Patient Safety Act.


Boston Globe | By John Laidler | Dec. 31, 2015 
Kristina Kenyon
Registered nurse; Carver resident
As a registered nurse at Beth Israel Deaconess Hospital-Plymouth, I understand firsthand the need for the Patient Safety Act, which would limit the number of patients assigned to a nurse, with flexibility to adjust based on patients’ needs. I have worked at the former Jordan Hospital for nearly a decade, including the last two years in the emergency department. For many patients, the emergency department is the face of a hospital. For too many, it is where they come to wait in pain.
We know from research that the fewer the nurses, the longer the wait for patients in emergency departments. I also know this from experience. Currently, my department is dealing with low retention and high turnover rates due in part to what we contend are unsafe staffing levels. Not having enough nurses on any given shift has been overwhelming and frustrating for the nurses, and we believe negatively impacts patients, who have to wait longer to be seen. That is not how any nurse wants to practice.
It is not just a problem in Plymouth. New research by Boston College assistant professor and registered nurse Judith Shindul-Rothschild shows the need for legislation that would ensure safe patient limits in all units of every Massachusetts hospital. At Boston Medical Center, a Level 1 trauma center, patients wait an average of 94 minutes to be treated for a long bone fracture. It takes about the same time at Sturdy Memorial Hospital in Attleboro. No one should have to wait in pain that long, especially at a hospital in one of the richest states in the wealthiest country in the world.
As nurses, we want to provide care to the best of our ability. But that has become increasingly difficult. Hospitals making millions of dollars in profits claim they are in the poorhouse and refuse to support scientifically supported, safe patient limits. Six years ago, at the height of the economic downturn, I traveled to Washington, D.C., to talk about unsafe staffing conditions for nurses. Since then, the problem has only gotten worse. We should not have to wait any longer for our lawmakers to stand up for patients and nurses. It is time to pass the Patient Safety Act.

Should the state limit the number of patients assigned to any one nurse? Two nurses say YES! Both believe Massachusetts needs the Patient Safety Act, which would establish scientifically supported limits on how many patients a nurse can care for, with flexibility depending on illness or injury.

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