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<DIV><?/x-tad-smaller><?fontfamily><?param Lucida Grande><?x-tad-bigger>Still at
odds, hospitals and nurses revisit staffing ratio debate<BR>Catherine Williams,
State House News Service, October 24, 2007<BR><BR>Boston - By 11 AM today, the
state capitol's largest meeting space was filled to capacity for an emotional
Public Health Committee meeting where nurses, hospital officials and lawmakers
debated whether hospitals should be required to employ mandated numbers of
nurses.<BR><BR>At issue in Gardner Auditorium was a pair of bills designed to
regulate Bay State hospital nursing staff and which have fueled a longstanding
dispute within one of the state's leading industries, health care.<BR><BR>Citing
concerns about patient safety, the Massachusetts Nurses Association supports
requiring hospitals to employ a set number of nurses working at Bay State
hospitals. If the bill is passed, patients suffering from chronic illnesses
would be required to get more nursing attention than patients with minor
injuries, say those in favor of the quotas.<BR><BR>Three hospital workers
traveled from San Diego - despite the ongoing public health and safety emergency
caused by the state's wildfires - to testify in favor of quotas, which are
already in place in California.<BR><BR>But opponents of the quotas, including
the Massachusetts Hospital Association, say patients are guaranteed the best
care when staffing decisions are left in the hands of nurses and hospital staff
on a patient-by-patient basis.<BR><BR>"We need to put an end to this madness
around fighting this issue. This is getting in the way of other things including
health care reform, rising health care costs and workforce shortages," said Lynn
Nicholas, CEO of the Massachusetts Hospital Association, in an
interview.<BR><BR>The Committee on Public Health, which is co-chaired by Sen.
Susan Fargo (D-Lincoln) and Rep. Peter Koutoujian (D-Waltham), is debating two
bills designed to regulate hospital nursing staff. One bill, (S.1244), would
require hospitals to publicly post nurse staffing plans and file staffing plans
with the Massachusetts Department of Public Health. If passed, the bill, which
is co-sponsored by Fargo, would also limit nursing work hours.<BR><BR>A second
bill, (H.2059), requires hospitals to adhere to staffing levels set by the
Massachusetts Department of Public Health. If passed, the law would also ban
mandatory overtime. The first version of the bill appeared eight years ago, said
Rep. Christine Canavan (D-Brockton), a registered nurse and lead sponsor of the
quota bill.<BR><BR>The issue has long riled those on both sides of it. Early in
today's hearing Fargo banged the gavel several times to call the audience to
order after waves of applause broke out. "Remember this is not a rally. This is
a legislative hearing," said Fargo.<BR><BR>At the suggestion of Sen. Dianne
Wilkerson (D-Roxbury), who testified in favor of an oral health bill, the
audience began waving their hands in the air silently to show support for
speakers testifying before the committee. The trend continued throughout the
hearing.<BR><BR>Emotions hit a high point during the testimony of Pembroke
resident John McCormack, who testified in favor of nursing quotas because his
13-year (sic) old daughter Taylor died in 2000 after what he called poor care at
Children's Hospital Boston.<BR><BR>"I am a father with a broken heart," said
McCormack. A medical malpractice law, known a Taylor's Law, was passed in 2004
after the death of Taylor McCormack.<BR><BR>Meanwhile, legislators testifying in
opposition to the quotas included Sen. Richard Moore (D-Uxbridge), who is the
lead sponsor of the nursing reform bill.<BR><BR>"We need to be very careful that
we balance politics with good health practice and that's never an easy process,"
said Moore.<BR><BR>Lawmakers testifying in favor of the quotas included Sen.
Harriette Chandler (D-Worcester).<BR><BR>"I believe if this bill is passed it
will address the problems facing nurses, including fatigue, and ensure patients
will get the quality care they deserve," said Chandler.<BR><BR>Nurses on both
sides of the issue attended the hearing.<BR><BR>Three (sic) Quincy Medical
Center-based nurses, including 42-year nursing veteran Mary Ryan, attended the
hearing in support of the quotas. Ryan, a critical care nurse, supports the
ratios because she believes it protects patients and resembles the teacher to
student ratios required at daycare schools.<BR><BR>Rose Brisson, a clinical
nurse manager at St. Luke's Hospital in Fall River, attended the hearing with
two other nurses from the South Coast Health System and said she is concerned
that imposed ratios would prevent her from doing her job.<BR><BR>"My fear is if
we had ratios then it would minimize the nursing team," said
Brisson.<BR><BR>Nurses presented new evidence that Massachusetts patients are
unhappy with the care they are receiving.<BR><BR>The Coalition to Protect
Massachusetts Patients released a survey of Massachusetts hospital patients that
determined 28 percent of hospital patients and their families say their safety,
or a family member's safety, was directly compromised by nurse understaffing.
The coalition said that "translates into" 235,000 patients a year feeling their
"safety is compromised" by a lack of available nurses. The Cambridge-based
research organization Opinion Dynamics Corp. conducted the statewide survey. The
results also indicate that 49 percent of those surveyed felt they would have
received better care if their nurses had fewer patients.<BR><BR>Meanwhile, there
is some common ground between the opposing sides. Both nursing bills include
funding for nursing scholarships and nurse training.<BR><BR>However, lawmakers
and nursing and hospital advocates have debated the staffing quota issue for
almost a decade. A previous version of the Canavan's quota's bill passed in the
House with 133 votes in favor and 20 votes in opposition last year. But the bill
failed to move forward in the Senate before formal sessions ended in
July.<BR><BR>It's unclear why the Senate failed to take up the bill. And until
the House takes up the new bills the fate of hospital nursing staffing
regulation is up in the air.<BR><BR><A
href="http://www.massnurses.org/News/2007/10/Patient_Safety_Act.htm">http://www.massnurses.org/News/2007/10/Patient_Safety_Act.htm</A><BR><BR>Patient
Safety Advocates of all Ages Urge Passage of “The Patient Safety Act” at State
House Hearing<BR>Hundreds Come Together to Expose Dangers of Hospital
Understaffing.<BR>Cite New Survey Showing Almost One-Quarter of A Million
Massachusetts Patients Per Year Feel Their Safety Has Been Compromised in Bay
State Hospitals.<BR>Alex Zaroulis, Fifield Strategies, October 24,
2007<BR><BR>Boston – Armed with new statistics on patients’ increased concern
over quality care in Massachusetts hospitals as well as evidence linking disease
and deaths to poor patient oversight, hundreds of elderly Massachusetts
residents, mothers and children, nurses, and other consumer and health-care
advocates from across the state converged on the State House this morning to
urge passage of The Patient Safety Act, House Bill 2059, at a hearing before the
Joint Committee on Health Care. The Bill would set limits on the number of
patients a nurse can be forced to care for at one time.<BR><BR>For more than a
decade, bedside nurses in Massachusetts have been sounding an alarm that
patients are being harmed because nurses are being forced to care for too many
patients at one time. A version of the safe staffing legislation was first
introduced in 1994. Since the bill’s initial introduction, hospital-acquired
infections and medical errors have soared, with the Centers for Disease Control
(CDC) now reporting that 2,000 people, or 6 people per day, are dying because of
them every year in Massachusetts. Nationally, 2 million people are harmed by
hospital-acquired infection and medical error, and nearly 100,000 of them die
each year. As of today, more patients are killed each year by hospital-acquired
infections than by AIDS and breast cancer combined.<BR><BR>A statewide survey
conducted by Opinion Dynamics Corporation (ODC) and released in conjunction with
the hearing indicates that more than one-quarter (28 percent) of Massachusetts
hospital patients and their families say that their safety, or a family member’s
safety, was directly compromised by nurse understaffing, Based on the total
number of hospital stays in the Commonwealth as tabulated by the state’s
Department of Health Care, Finance and Policy, this translates into more than
235,000 Massachusetts patients annually whose safety is compromised by a lack of
available nurses.<BR><BR>In addition, nearly three-quarters (73 percent) of past
patients agree that the overall quality of patient care in Massachusetts
hospitals is suffering because nurses are forced to care for too many patients
at once. And more than one-third (35 percent) of these past patients and their
families say that their nurse had too many patients to care for during a recent
hospital stay.<BR><BR>“Massachusetts patients are saying loudly and clearly that
they are concerned about the impact that the persistent understaffing of nurses
in Massachusetts hospitals is having on the safety of their care during their
hospital stay,” said John McCormack, the co-chair of The Coalition to Protect
Massachusetts Patients, which comprises more than 120 leading health-care and
consumer organizations. “My baby daughter, Taylor, died in 2000 at the age of
two in a Boston hospital because she didn’t get the care she needed. When I
carried her to the hospital morgue, I promised her that I would fight my hardest
so that this wouldn’t happen to another child.”<BR><BR>The elderly and the
parents of young children have coalesced around the issue of setting safe limits
on nurses’ patient loads because those populations (seniors and children) are
most at risk of contracting hospital-acquired infections.<BR><BR>John Bennett,
president of the Massachusetts Senior Action Council, is disturbed by the fact
that so many of the state’s elderly are at risk for injury or harm in the
hospital as a result of understaffing.<BR><BR>“As an older citizen and leader of
a grassroots organization of seniors, I have been continually hearing complaints
from our members about problems they and their family members have experienced
as a result of nurse understaffing,” Bennett said. “Members of my own family
have been hospitalized and over the years I have watched the care they received
deteriorate – not because nurses don’t care or aren’t working hard, but
precisely because they are working too hard, running from patient to patient to
doing what they need to do. The suffering the lack of nursing care causes is
unacceptable.”<BR><BR>A number of studies link the rise in hospital-acquired
infections and other medical complications to understaffing of nurses, including
one published in the July issue of the journal Medical Care that found that
safer RN staffing levels could reduce hospital acquired infections by 68
percent.<BR><BR>“The hospital industry’s mantra every year for more than a dozen
years has been, ’Leave it to us to fix this problem. We know best’,” said Karen
Higgins, co-chair of The Coalition to Protect Massachusetts Patients. “ While we
have waited for the hospitals to ’fix it,’ thousands of patients have died and
continue to die throughout the Commonwealth. The time for waiting is over. The
Commonwealth’s hospital patients and their families can’t afford to wait any
longer.”<BR><BR>The Patient Safety Act (HB 2059) would improve hospital
conditions by setting a rational, safe limit on the number of patients a nurse
can be forced to care for at one time, while also creating initiatives to
increase nursing faculty and nurse recruitment. Similar legislation to set safe
patient limits was passed in California and was implemented in 2004. Testimony
about the bill’s success in California was presented by a panel of frontline
nurses from California and by Karin Berntsen, RN, BSN, a California nurse
administrator and one of the nation’s leading patient safety
experts.<BR><BR>Leading National Patient Safety Expert and California Nurse
Administrator Endorses Mass Staffing Bill<BR><BR>Contradicting assertions by the
hospital industry that the bill is inflexible and the wrong approach to
improving patient safety, Karin Berntsen testified about the success of the
California law and said that the Patient Safety Act introduced in Massachusetts
is even better than the California legislation.<BR><BR>Ms. Berntsen, the author
of the books The Patients Guide to Preventing Medical Errors and Fatal Care,
testified that she observes a “Massachusetts understaffing crisis,” and that
Massachusetts hospitals “approach is counterproductive and dangerous to
patients.”<BR><BR>“One of the nation’s leading organizations on patient safety,
the Agency for Healthcare Research and Quality, examined over 90 studies on
nurse staffing and reported that reducing the number of patients a nurse cares
for at one time is associated with reduced hospital mortality and reduced
adverse patient events,“ she said. “Furthermore, The Patient Safety Act has been
well thought out and builds in the principles of improved safety and efficiency,
including a balanced approach to nurse staffing, ramping up of the staffing
requirements, and supporting nurse recruiting to assist with the bedside nursing
shortage,” Ms. Berntsen added. “The legislation is flexible, and promotes
staffing plans that are balanced for all hospitals,” she
concluded.<BR><BR>Evidence Presented at Hearing Calls the Hospital Industry’s
Solutions Into Question<SPAN class=563544015-25102007><FONT face="Courier New"
size=2> </FONT></SPAN></DIV>
<DIV><SPAN class=563544015-25102007> </SPAN><BR>At a time when patient
safety is being increasingly endangered by RN understaffing, the state’s
hospitals continue to post record profits of nearly a half-billion dollars for
the first six months of 2007 – a 35 percent increase over the previous year’s
second quarter profits. If the trend continues, the hospital industry is poised
to record its third straight year of profits in excess of $1
billion.<BR><BR>Instead of investing in safer nursing care, the Massachusetts
hospital industry’s response to the mounting death toll has been to create a
“Patients First” web site that posts proposed nurse staffing “plans” with no
guarantee that the staffing plans are accurate, and with no uniform standard of
care that patients can expect in all hospitals.<BR><BR>The patients who
responded to the ODC survey said the web site is of little or no value to them.
Nearly 90 percent of recent hospital patients report that they did not have the
time to research staffing levels prior to their hospital visits. In fact, only
14% were aware of the web site, and only 4 percent used it.<BR><BR>Audrey Heath,
a senior from Worcester, said she was insulted by the assumption that she would
be able to check a web site to safeguard her hospital stay. “You think I have
time to look at a web site when I’m on my way to the hospital? Most people my
age are in serious condition when they arrive at the hospital. They’re not
thinking about the internet.”<BR><BR>The Patient Safety Act is co-sponsored by
State Senator Marc Pacheco (D-Taunton) and State Representative Christine
Canavan (D-Brockton).<?/x-tad-bigger><?/fontfamily></DIV></BODY></HTML>
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