Weatherford Democrat

November 13, 2013

Nurses in Mass. want to limit number of patients

By Douglas Moser
CNHI News Service

METHUEN, Mass. — Nurses in this state are trying to get support for a ballot initiative that would limit the number of patients they can treat at one time.

The proposal, which could reach the ballot for next year’s gubernatorial and midterm Congressional election, would limit many nurses in hospitals to four patients at a time. Critical care and intensive care nurses and emergency room nurses would be limited to fewer patients, depending on those patients’ conditions.

Hospitals and hospital groups oppose the proposal, saying it reduces flexibility by binding their hands in providing care and could jack up already high medical costs in the state.

"There is no limit to the number of patients a nurse cares for," said Karen Higgins, a staff nurse at Boston Medical Center and a member of the Massachusetts Nursing Association, which was collecting signatures in Methuen, Mass., last month. "You could have four (per nurse) or you could have eight."

Lynn Nichols, president of the Massachusetts Hospital Association, said in a statement that the group opposes assigning ratio limits. 

"Patient care staffing decisions should always be based on the best interest of the patient – not a number," she said. "Nurses don't treat numbers, they treat people. Hospitals shouldn't be required to staff by numbers, either."

Donna Kelly-Williams, president of the Massachusetts Nurses Association, said that the requirements would mean more nurses would have to be hired, increasing payroll costs to hospitals. But she argued it would not increase the overall cost of care because high staffing levels would reduce expensive complications.

"Caring for the patient right the first time decreases the cost of care," she said.

A 2004 study conducted by the Agency for Healthcare Research and Quality, in the federal Department of Health and Human Services, found that lower staffing levels are linked to higher "adverse outcomes," including infection, pneumonia and internal bleeding.

However, two studies of a similar law enacted in California in 2004 showed conflicting results on the reduction of death or adverse outcomes.

The Mass. Nurses Association has collected about 114,000 signatures statewide, and has sent them to cities and towns for certification.

Petitions must be filed by Nov. 20 and must have 68,911 – or 3 percent of the total ballots cast for governor in the last election – valid signatures to make it unto the 2014 ballot, according to the Secretary of the Commonwealth’s office.

Douglas Moser writes for The Eagle Tribune in North Andover, Mass.