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October 24, 2007

Patient safety job No. 1

An excellent example as to why Massachusetts hospitals need to retain the ability to control their own staffing levels is the flood that devastated the region last year, forcing the evacuations of thousands of residents.

It was fortunate our hospitals had the flexibility to call in more nurses, LPNs, aides and administrators during a time of need.

The Legislature's Joint Committee on Public Health is scheduled to hold a hearing tomorrow on two competing nurse staffing bills -- a Senate and a House version. The House bill, being pushed by a nursing union, would impose government-mandated registered nurse ratios on hospitals, which we find troubling.

This issue was last debated more than a year ago, and there is still no solid scientific evidence to support an RN ratio. Equally important, the union's bill has not been modified to take into consideration the entire caregiving team.

A frightening thought is that if the proposed nurse-staffing ratio bill had been in effect, local hospitals would have been unable to react as quickly as they did during last spring's flooding. There's a good chance some patients -- including those evacuated from nursing homes -- would have been turned away and sent to hospitals farther from family and friends.
The nurse-staffing ratio bill would mandate the staffing ratios of registered nurses to patients. On the surface, that sounds acceptable. However, the legislation would not allow hospitals to factor in the many other caregivers assisting patients, such as licensed practical nurses, physical therapists and aides. In California, which has a registered nurse ratio requirement, hospitals are sometimes forced to send patients elsewhere to meet the state mandates. We don't think that best serves the needs of patients.

Another significant concern is that having such a requirement could force hospitals to eliminate jobs of other caregivers to hire more registered nurses. And the RNs then would be required to perform less-skilled tasks because there would be fewer LPNs and aides to handle those duties. Again, we find this troubling.

It is no secret that Massachusetts is experiencing a nursing shortage, so hospitals could well end up in registered-nurse bidding wars with each other as well as with nursing homes and visiting-nurse organizations, creating patient-care problems in those institutions.

It makes far more sense to us for hospital staffing needs to continue to be assessed on a shift-by-shift basis, taking into consideration the number of patients and their specific needs as well as the skills and experience of the staff.

The Senate's Patient Safety Act calls for increased accountability by health-care providers while also recognizing the contributions of all caregivers -- RNs, LPNs, aides and those who transport patients. We support this measure and believe legislators should vote against House Bill 2059 which could jeopardize jobs and patient care.

Posted by Admin at October 24, 2007 4:14 PM