Nurse staffing bill passes in House

By Owen Boss

BOSTON — In an effort to make hospitals safer for patients, the state House of Representatives voted 115-35 to approve a landmark bill that would guarantee safe registered nurse staffing at all Massachusetts hospitals. The measure states that it is now up to the Massachusetts Department of Public Health to determine the limits on nurses’ patient assignments, prohibits mandatory overtime, and includes initiatives to increase nursing faculty and nurse recruitment. The law, if enacted, will make Massachusetts the only state other than California that has legislation that sets safe staffing limits in hospitals. The Patient Safety Act, which is now going before state Senate, is a bill that responds to the increased concern over quality care in Massachusetts hospitals, as well as to evidence linking disease and deaths to poor patient oversight caused by nurses being forced to care for too many patients at one time. In recent years, research has shown that medical errors and hospital-acquired infections have been increasing, and numerous studies have linked this trend with the frequent understaffing of nurses. State Rep. Robert Rice, D-Gardner, said the bill, which was presented 2007 and defeated in the Senate, was purposely passed without specific rations and regulations included because it has been deemed the responsibility of the public health department to determine the numbers following preliminary research. “The main reason we didn’t put the numbers in it is because we do not feel that it is a proper role for us to be playing; we have instead empowered the department of public health to do that after a study,” said Mr. Rice. “Hopefully it will pass the Senate this year. I think this bill is sucking a lot of the air out of the room in terms of health issues.” In addition to regulating how many nurses hospitals must have per patient, the bill will enact legislation aimed at enticing the state’s unusually large number of nursing students to go into hospital care, said David Schildmeier, spokesman for the Massachusetts Nurses Association. “The situation with the number of nurses in Massachusetts is different because we have more nursing students than any other state in the nation,” said Mr. Schildmeier. “This bill includes a number of incentives for nursing students to go into hospital care, which is often considered either too dangerous or unsatisfying, which include loan forgiveness programs.” If the the Senate passes the bill, some hospitals may have a hard time getting their units staffed within the regulations, and Mr. Schildmeier said the bill has been written so that it will give hospitals adequate time to adapt and hospitals facing financial hardships will be granted special consideration. “We realize that this bill is a change for hospitals, and we need to give them enough time to deal with the transition. Regular hospitals will have four years and teaching hospitals will have two years to comply with the numbers,” said Mr. Schildmeier. “Also written into the law is legislation that states that if some of these hospitals are in financial trouble, they can opt out until they have sound financial footing.” Although the bill will eventually set a specific ratio between nurses and patients, Mr. Rice said that it is important to remember that the proposed bill does not advocate standardized health care. “This is not a bill for standardized care,” said Mr. Rice. “This is a bill that will ensure that all citizens of the commonwealth are receiving care that is equivalent to another resident of another state going to another hospital. Top-of-the-line health care shouldn’t depend on geography.” oboss@thegardnernews.com

Appeared on Page 1 on 5/28/2008 (Vol. 206 No. 126)