Bad News for the Safe Staffing Legislation

The Massachusetts Senate Ways and Means Committee has released a gutted version of the Safe Staffing legislation which has undone all the compromises achieved in the House. I'm going to print the Mass. Nurses Association's press release in its entirety. You can still take action.

(I must say that Bay State Medical Center and hospitals around the state have pulled out all the stops to defeat this legislation. the other day my senior aide showed me a letter she'd received from Bay State Medical that included four stamped postcards addressed to our area legislators in opposition to the Safe Staffing legislation. My senior aide is very old and if her health care provider tells her to do something, she will. A sleazy effort, I must say.)

Nurses/Advocates Outraged by Senate Ways & Means Committee’s

Gutting of Safe Staffing Bill, Which Will Codify Current Unsafe Conditions in Hospitals and Continue to Place Thousands of Patients in Jeopardy

Measure Eliminates House Compromise Bill’s Call for Safe Staffing Standards and Patient Limits, Allowing Hospital Administrators to Continue to Set Their Own Staffing Levels.

Nurses and patient advocates, who have been awaiting Senate action on pending legislation to guarantee safe RN staffing and improved patient safety, are outraged by the Senate Ways and Means Committee’s release of a harmful version of the bill that will allow the state’s hospitals to continue the dangerous and deadly status quo.

The new senate bill removes all key compromise provisions achieved through negotiations with legislators and key stakeholders which were contained in the version that passed the House (119-35) on May 22. The House version called upon the Massachusetts Department of Public Health to create industry-wide staffing standards and patient limits to assure safe patient care in all Massachusetts hospitals. The new Senate version continues to place hospital administrators in charge of setting their own staffing standards, a practice that has led to a health care crisis in Massachusetts, where more than 45,000 patients a year are injured and more than 2,000 patients – six a day – die from preventable infections and complications they get in the hospital. The Senate version also guts protections against the dangerous practice of mandatory overtime, which is key to preventing medication errors by exhausted staff.

Additionally, the Senate bill fails to recognize the overwhelming body of research that links safe patient outcomes directly to the number of patients a nurse is caring for at one time. It also greatly broadens the power of hospital administrators, who can cut corners and dangerously increase a nurse’s patient load.

Under the new law, there would be no uniform standard of care, and instead, the Department of Pubic Health would only be in charge of enforcing varying and inadequate standards created by the private sector hospital industry - including the for profit hospitals. Simply put; this legislation is a hazardous step backward, and would ensure that current unsafe conditions continue to deteriorate.

We call upon our senators to reject this bill that is so dangerous to the public’s safety. We ask instead that senators build upon the negotiated compromise that has already been reached and passed the House. This would allow the Department of Public Health to enforce limits that it determines are in the public’s best interest, rather than leaving that critical job to the very institutions that created the crisis we now face.

The new bill, S. 2805, is scheduled to be taken up for a debate and vote as early as tomorrow, Thursday, July 17. Nurses and patient advocates are now mobilizing to urge Senate adoption of amendments that reinstitute the protections in the House bill.

The original compromise bill is supported by more than 130 of the state’s leading health care and consumer advocacy organizations, as well as more than 80 percent of the bedside nurses and 70 percent of physicians whose ability to care for the safety of their patients would be favorably affected by passage of the House version of the bill.

Patient Safety Act passes the Massachusetts House

Last February I wrote about why we need the Patient Safety Act, which would require a certain ratio of nurses to patients. Hey, we go into the hospital hopefully to get better, not to catch a hospital-related infection or get an overdose of a drug-- or the wrong drug entirely!

Naturally, hospitals oppose such legislation-- just like the drug companies are opposing legislation prohibiting them from giving gifts to doctors and nursing homes are opposing legislation requiring a 50/50 split of state money with home care providers.

Looks like institutional power may be giving way to common sense, at least as far as the Patient Safety Act goes. The legislation has been passed by the House and is now going to the Senate.

You can find out your senator and his/her phone number here. There's a new bill number-- HB 4714. Let them know you want to be safe in the hospital. You can get more infromation at the Mass. Nurses Association website.

Why we need more nurses

The first time I heard a nurse speak about the need for the Patient Safety Act, she said that when she went home at night, she worried about mistakes she might have made, what she might have forgotten to write down in a chart, what she might have left undone, because there were too many patients and not enough nurses.

I was shocked by her honesty but not surprised. The previous year my sister had had an emergency splenectomy and then gone two days without seeing a doctor because someone had neglected to put her on the medical rotation list. Later she was accidentally over-medicated.and her breathing was suppressd. She survived both events, minor in the grand scheme of things, but others have not been so fortunate.

Don't get me wrong-- I'm not saying that hospital-acquired illnesses, complications and mortality are all attributable to a shortage of nurses. But consider the following

• One out of ten patients admitted to six Massachusetts hospitals :suffer serious and avoidable medication mistakes, according to a Boston Globe article last week.
• The higher the patient to nurse ratio, the more likely there will be patient deaths or complications after surgery. Each additional patient per nurse over four is associated with a 7% increase in mortality.
• Inadequate staffing precipitates one-fourth of all unexpected occurences that lead to patient death, injuries or permanent loss of function.
• The more nurses, the lower the infection rate in patients. Sources for this information can be found at the Mass Nurses Association.

Nurses become nurses because they want to help people, but they can wind up working in conditions we wouldn't tolerate on the assembly line. Overworked nurses quickly burn out and many leave the profession or cease to work at the bedside.

You'd think that hospital administrators would want to do everything possible to maintain a good workforce and ensure safety for its patients, but no-- they've been vehement in opposing legislation requiring safe staffing ratios, saying hospitals can't afford it. This year, however, H. 2059, the Patient Safety Act, has a good change of passing.

You can send a message to your legislators asking them to support H. 2059 at the Mass Nurses Association website.