Nurses Sound Alarm on Safe Patient Limits

An annual survey of the state’s nurses sounds a blaring alarm that the quality and safety of patient care continues to be significantly compromised due to the corporatization of healthcare and the practice of assigning too patients for nurses to care for at one time. 

The survey also finds the majority of nurses report that, in the wake of these dangerous conditions, hospital executives too often refuse to heed their calls for needed staff and resources to safely care for their patients, which prompts nearly 90{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of nurses to support a pending ballot measure that would set safe patient limits for nurses in all hospitals based on the needs of patients.

The report, “The State of Patient Care in Massachusetts,” is an annual survey of the state’s nurses commissioned by the Massachusetts Nurses Assoc. (MNA) and conducted by Anderson Robbins Research. A majority of the nurses surveyed are not members of the MNA.

According to the survey, being assigned too many patients to care for at one time is the most significant challenge to RNs providing high-quality patient care, with 77{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of nurses identifying unsafe patient assignments as a problem. The survey also shows that 81{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of patients are sicker than ever before, requiring highly specialized nursing care.

The survey takes on added significance as the issue of providing nurses with safe patient assignments will be the focus of a ballot initiative proposed to go before voters this November, proposing to set safe patient limits for nurses in all hospitals with the flexibility to adjust nurses’ patient assignments based on the needs of each patient.

“Massachusetts nurses report a growing number of barriers to delivering quality patient care,” said Chris Anderson, president of Anderson Robbins Research. “A lack of time to give patients needed care and attention and having to care for too many patients at one time are by far the most frequent challenges faced by bedside nurses.”

RNs report these challenges are leading to a sharp increase in negative outcomes (readmissions, infections, and even death) for patients, and that these reports of negative outcomes have increased over previous years’ results:

In response to nurses concerns about patient safety and negative patient outcomes, nurses report that hospital executives are not responsive to their feedback regarding patient loads and staffing levels. Most of the time, management does not adjust patient assignments to meet patients’ needs, nurses said. More than six in 10 nurses (63{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5}) report that hospital management only occasionally adjusts their patient assignments when it is needed to meet patients’ needs.

The survey’s findings on hospital executive responsiveness to safety concerns is important as it provides a striking counterpoint to the hospital industry’s contention about flexibility in its opposition to the ballot measure requiring safe patient limits. Hospital executives argue that they need to maintain flexibility to adjust RN staffing levels and assignments based on the unique needs of patients. 

For nurses, the driving force behind the continued deterioration in patient-care conditions in our state is the increasing corporatization and consolidation of the healthcare system.

“Over the past decade, RNs have seen hospital patients become sicker, and hospitals themselves become more corporate,” Robbins explained. “RNs say the result is more decisions being made based on profit margin than on patient care.”

Most nurses do not believe that hospital corporatization is having a positive effect on quality of care. In line with last year, less than one-third (31{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5}) of nurses think Massachusetts hospitals’ mergers and acquisitions have made the quality of care better. Similarly, just 27{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} believe hospitals’ business relationships with pharmaceutical companies and/or medical device makers actually make patient care better.