The Massachusetts Hospital Association released a statement calling the ballot initiative “an arcane idea that has no merit.”
SPRINGFIELD - With staffing battles ongoing at some hospitals across the state, the Massachusetts Nurses Association is turning to the public in its effort to have limits on how many hospital patients can be assigned to each nurse.
The nurses union, which is some 23,000 members strong, has been pushing for legislation that would cap the number of patients per nurse in emergency rooms, intensive care units and other hospital departments. Frustrated in those efforts, it now wants to put the matter on a ballot initiative called the Patient Safety Act.
If approved by voters, the act would require all Massachusetts hospitals to adhere to the new staffing standards and would fine those that don’t $25,000 a day. Supporters must gather 70,000 signatures to put the question on the November 2014 ballot.
The Patient Safety Act comes amid labor struggles that have arisen at hospitals in recent years. Consolidations, changes in health care laws and a trend toward out-patient care and preventive medicine have reduced the length and number of in-patient stays and caused some hospitals to reduce staff.
Baystate Franklin Medical Center in Greenfield, which has been locked in contract negotiations with the Massachusetts Nurses Association for two years, announced job cuts last month that would decrease the number of medical surgical nurses from 49 to 40. In making the cuts, the hospital cited a drop in the number of in-patient stays. Nurses at Baystate Franklin say the drop-off is due to a deficit of physicians at the hospital. According to the hospital, the number of surgeons at Baystate Franklin has dropped from 15 to 13 over the past year.
Donna Stern, a nurse at Baystate Franklin and one of the 10 original signers of the ballot petition, said the Patient Safety Act goes far beyond the issues at her own hospital.
“For more than 15 years we’ve been trying to get safe staffing,” she said.
Stern said the House of Representatives has supported the bill but it has failed in the Senate. Now the union is taking the matter to the people.
“The citizens of Massachusetts recognize that when they come into a hospital they want to be taken care of and that a nurse will be able to safely take care of them,” she said. “It’s absolutely a no-brainer.”
Stern said a similar measure that passed in California in 2003 has been successful.
But hospital administrators insist they can function better without mandated staffing levels. Steven Bradley, the vice president for government and community relations at Baystate Health, the parent of Baystate Medical Center in Springfield, Baystate Mary Lane Hospital in Ware and Baystate Franklin, said the nurses union is trying to do an end-run around the Legislature with its ballot initiative.
“This petition is a direct result of the Massachusetts Nurses Association’s failure to get the same legislation passed,” he said.
Bradley contends that lawmakers who are savvy about health care feel the bill is without merit.
“It’s scare tactics that hospitals are unsafe,” he said. “It’s patently untrue. The (state) Department of Public Health would cite a hospital if it were unsafe.”
Rather, said Bradley, the mandated staffing is an attempt to pump up nursing jobs at a time when in-patients care is decreasing.
“These are not bad changes,” he said. “Nurses have saved a lot of lives. But unions have not saved any.”
The Massachusetts Hospital Association released a statement this week calling the ballot initiative “an arcane idea that has no merit.”
“Nurses don’t treat numbers, they treat people,” the association said. “Hospital shouldn’t be required to staff by numbers, either.”
Jeff Harness, the director of integrated care and population health at Cooley Dickinson Hospital in Northampton, said his facility does not support the Patient Safety Act.
“We do not need a ballot initiative to determine the staffing ratio,”
he said. “We already work in partnership with our nurses and other staff to determine safe and effective staffing levels.”
Cooley Dickinson recently finalized an affiliation with Massachusetts General Hospital in Boston that administrators say will reduce its costs and help the smaller hospital navigate the complicated and evolving world of health care. Although no layoffs have resulted from the affiliation, Cooley Dickinson has reduced its staff several times over the past decade as it has tried to adjust to changes in the health care system.
Mary Blumberg, a medical surgery nurse at Cooley Dickinson and a member of the Massachusetts Nurses Association, contends that the shorter in-patient stays cited as a cause for cutting staff are mostly insurance-driven. When patients do end up at Cooley Dickinson, she said, they need a lot of attention.
“Patients are sicker than they used to be,” she said. “It’s sad when you have five patients and see one for 20 minutes and the others tie up an entire shift.”
Blumberg said the ratio of patients to nurses in medical surgery at Cooley Dickinson is currently 5-1. The Patient Safety Act would reduce that to 4-1.
Mark Fulco, the senior vice president of strategy and marketing for Sisters of Providence Health System, which operates Mercy Medical Center in Springfield, is also opposed to the ballot initiative. Although there have been no major staff reductions at the hospital in recent years, Fulco said it is unfair to apply the same staffing standards to all hospitals.
“Individual patient care is too complex to be determined by fixed ratios,” he said. “Every hospital is slightly different in its model of care. Our staff levels are safe and appropriate.”
Fulco said Sisters of Providence staffing plans are transparent and can be reviewed, along with the staff plans of any Massachusetts hospital at www.patientcare.org.