Massachusetts Nurses Association

1
The State of Nursing and Patient Care
Massachusetts Nurses Association Prepared
by Opinion Dynamics Corporation July 2005
2
Two-Thirds of RNs Interviewed Do NOT Belong to
the MNA
Do you belong to the Massachusetts Nurses
Association?
Yes 34
No 67
Q20
3
Understaffing Most Likely to Be Rated Very
Serious Problem
Rate the seriousness of the following problems
facing the nursing profession as they relate to
providing health care to patients. Use a scale of
"1" meaning "not a problem at all, to "7"
meaning "a very serious problem".
very serious problem
The acute care units are understaffed and nurses
working in acute care are forced to care for too
many patients
Fewer young people are choosing nursing as a
career
RNs are forced to work mandatory overtime
Registered nurses are too often floated from one
unit to another without appropriate training and
orientation
Liability and malpractice lawsuits
Low pay
Managers rarely implement recommendations made by
staff nurses regarding patient care
Q12 - 18
4
One-Half of RNs Cite Understaffing As The Single
Most Serious Problem Facing Profession
Which one of the above problems do you think is
the most serious problem facing the nursing
profession today?
The acute care units are understaffed and nurses
working in acute care are forced to care for too
many patients.
Fewer young people are choosing nursing as a
career.
Registered nurses are too often floated from one
unit to another without appropriate training and
orientation.
RNs are forced to work mandatory overtime.
Low pay.
Liability and malpractice lawsuits.
Q19
5
9-in-10 Nurses Agree Patient Care is Suffering
Due to Nurse Staffing Issues
Some people say that the quality of patient care
in Massachusetts hospitals is suffering because
there are not enough registered nurses working in
the hospitals and nurses are being forced to care
for too many patients at once. Do you agree or
disagree?
Q20
6
RNs Report Wide Range of Adverse Patient
Outcomes As A Result of High Patient Loads
Are you aware of any incidents in Massachusetts
hospitals that a registered nurse having to care
for too many patients has led to...
Nurses not having enough time to educate patients
and their families
Nurses not having enough time to comfort and
assist patients and their families
Patients having to wait for long periods of time
for their medication and medical procedures
Medical errors, such as improper medication or
dosages
Complications or other problems for a patient
Re-admission for a patient
Injury or harm to patients
Longer hospital stays
Mortality for patients
Q38 - 46
7
Establishing RN-to-Patient Ratios Seen As Most
Effective Solution to Nurse Staffing Issues
Rate how effective you feel each one would be as
a solution for addressing the nurse staffing
issue using a scale of "1" meaning "not effective
at all" to "7" meaning "very effective".
very effective
Regulating RN-to-patient ratios
Providing flexible scheduling programs
Increasing nursing salaries
Scholarships and loan forgiveness programs to
recruit new nurses
Weekend and Off-shift bonus programs
Prohibiting mandatory overtime
Requiring hospitals to post a nurse-staffing plan
Sign-on bonuses
Utilization of agency and travel nurses
Utilization of foreign-schooled nurses
Q21 - 30
8
RN-to-Patient Ratios Seen As Single Most
Effective Solution to Nurse Staffing Issue
Of the possible solutions we just discussed,
which one do you feel would be the single most
effective for addressing the nurse staffing
issue?
Regulating RN-to-patient ratios
Increasing nursing salaries
Providing flexible scheduling programs
Scholarships and loan forgiveness programs to
recruit new nurses
Prohibiting mandatory overtime
Sign-on bonuses
Requiring hospitals to post a nurse-staffing plan
Weekend and Off-shift bonus programs
Utilization of foreign-schooled nurses
Utilization of agency and travel nurses
Q31
9
8-in-10 RNs Favor Ratios Less Than Half Favor
Hospital Proposal
One proposal is a bill that would require
hospitals to appropriately staff acute care
facilities and limit the number of patients RNs
could care for at one time by setting minimum
registered nurse-to-patient ratios. These ratios
would vary by unitin an ICU the ratio would be 1
nurse to not more than 2 patients in
Medical/Surgery units the ratio would be 1 nurse
to not more than 4 patients. Would you favor or
oppose the legislature passing such a bill?
The second proposal is a bill that would not
regulate a nurse to patient ratio but require
each hospital to post a nurse-staffing plan that
has been approved by the hospitals board of
directors, and require hospitals to report their
nurse staffing plan to the Department of Public
Health. This plan is designed to ensure
transparency in hospital nurse staffing, and to
provide a process for evaluating measures to
improve the quality of patient care. Would you
favor or oppose the legislature passing such a
bill?
Q32, 33
Oppose
Favor
Favor
Oppose
10
By Wide Margin, RNs Favor Ratio Plan Over Posting
and Reporting Plan
Which do you think is a better approach to
addressing the nurse staffing issue
The plan which would regulate staffing levels and
set a minimum nurse staffing level
The plan which would require hospitals to post a
nurse staffing plan and report it to the
Department of Health, but would not set minimum
staffing levels
Neither/not sure
Q34
11
Nearly Two-Thirds of RNs Not Currently at the
Bedside Would Consider Returning To Acute Care
Settings if Ratios Are Established
(Non-acute care nurses) Let's say this safe
staffing law was passed by the Legislature and
registered nurses were required to care for fewer
patients at once - for example, a 12 ratio was
the standard in an ICU and 14 in Med/Surg. Would
you consider taking a job as a staff nurse
providing direct patient care in a hospital if
such a law were passed to regulate RN-to-patient
ratios?
Q37