Bill on RN Staffing in Hospitals is Approved by Public Health Committee,
Clearing Hurdle for a House Vote on May 23rd
Calls for Safe Limits on Nurses’ Patient Assignments, Prohibits
Mandatory Overtime and Includes Initiatives to Increase Nursing
Faculty & Nursing Scholarships
Applauds the Measure as a Balanced and Fair Solution that will Protect
Patients While Addressing Every Concern Raised by the Hospital Industry
of Final Redraft of Compromise Bill - H. 2663]
Sheet on Compromise Bill]
Mass.—The Massachusetts Nurses Association and the
104-member Coalition to Protect Massachusetts Patients applaud the
vote on Wednesday by the Public Health Committee to endorse and
release for a vote a compromise bill to guarantee safe RN staffing
in all Massachusetts hospitals. The measure, which was crafted after
more than 15 hours of negotiations between legislative leaders,
the Massachusetts Nurses Association and the Massachusetts Hospital
Association, calls upon DPH to set safe limits on nurses’
patient assignments, prohibits mandatory overtime and includes initiatives
to increase nursing faculty and nurse recruitment.
redrafted "Patient Safety Act, H. 2663," will now move
to the floor of the House of Representatives for a debate and vote
on Tuesday, May 23. Frontline nurses from across the Commonwealth,
who have waited ten years for a vote on this measure, will be closely
monitoring the debate and vote.
commend the Public Health Committee for their favorable vote on
this bill and we look forward to a successful vote in the full House,”
said Beth Piknick, president of the MNA.
to Julie Pinkham, executive director of the MNA who sat in on all
of the negotiations, the redrafted compromise addresses all of the
objections expressed by the hospital industry.
hospital industry had objected to having legislators set staffing
levels. The compromise bill directs the DPH to set the staffing
limits. The hospital industry opposes a rigid ratio. The compromise
provides for staffing based on patients needs. The hospital industry
said setting limits will cause financially strapped hospitals to
close. This bill provides hospitals in legitimate financial distress
an extension and oversight to reach compliance. The hospital industry
said we need to focus on recruitment of nurses. This measure includes
the recruitment initiatives put forth by their own bill, while giving
hospitals time to prepare for the implementation of the staffing
addition to the final language released yesterday is a provision
to protect valuable members of the patient care team who support
nurses in caring for patients, which was the major sticking point
identified by the hospital industry following the completion of
negotiations on the compromise bill. The new provision prevents
“understaffing of other critical health care workers, including
licensed practical nurses and unlicensed assistive personnel.”
wins here; hospitals, nurses, and most important of all, the patients,”
components of the bill include:
Directs the Massachusetts Department of Public Health to develop
and implement specific minimum RN staffing standards for all units
in the state’s acute care hospitals, which would include an
optimum RN-to-patient assignment, as well as an enforceable limit
on the number of patients assigned to each registered nurse.
The staffing standards would be developed within 12 months of
the bill’s passage and be based on scientific research on
nurse staffing levels/patient outcomes, expert testimony and standards
of practice for each specialty area.
The bill calls for the safe staffing limits to be implemented
in all teaching hospitals by 2008, with implementation in all
community hospitals by 2010.
Provides flexibility in staffing and accounts for patients who
require more care. The measure calls on DPH to create a standardized
acuity-based patient classification system, which is a standardized
formula for rating the illness level of patients. Based on the
acuity of the patients assigned to a nurse, if those patients
require more intensive care the nurse would be assigned fewer
Prohibits the practice of assigning nurses mandatory overtime
as a means of staffing the hospital.
Allows hospitals that can prove a financial inability to comply
with the law to delay implementation of the staffing standards,
with oversight provided by DPH.
Assures that institutions cannot delegate to unlicensed personnel
duties which demand nursing expertise. Throughout the 1990s, the
hospital industry attempted to cut costs by replacing nurses with
unlicensed personnel, which led to deterioration in patient care
and led to the exodus of nurses from bedside care.
Establishes a number of nurse recruitment initiatives sought by
the hospital industry, and supported by MNA, to increase the supply
of nurses, including nursing scholarships and mentorship programs,
and support for increases in nursing faculty to educate new nurses.
It also would create refresher programs to assist nurses in returning
to practice at the hospital bedside. A survey of Massachusetts
nurses found that more than 65 percent of those not practicing
in hospitals would be likely to return if a law providing safe
limits was passed.
Establishes strong consumer protections for safe RN staffing,
including a prominent posting of the daily RN staffing standards
on each unit.
Calls upon DPH to monitor compliance and to investigate violations,
with the ability to impose fines.