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March 8, 2006 - Nurse staffing legislation being touted by nurses union leaders as a landmark compromise between nurses and hospitals falls short of being a true agreement, according to state Sen. Richard T. Moore, D-Uxbridge, who is offering a competing proposal.
Mr. Moore, the Senate chairman of the Legislature’s Health Care Financing Committee, has been a steadfast opponent of the nurses’ main goal: setting mandatory nurse-to-patient staffing ratios on hospital wards.
Nurses say patients receive better treatment when they are cared for by more nurses. But Mr. Moore and hospital officials argue there is no scientific evidence for that assertion and that hospitals need the flexibility to move nurses between floors and units and to use other caregivers such as licensed practical nurses, nurse’s aides and technicians.
The so-called compromise bill now being considered in the House and expected to come up for a vote later this month does not include mandatory staffing ratios, but rather calls on the state Department of Public Health to set nurse staffing standards, including an enforceable limit on the number of patients assigned to each registered nurse.
House leaders have promoted the measure as a compromise because hospitals, represented by the Massachusetts Hospital Association, have appeared recently to drop their blanket opposition to all staffing standards.
However, Mr. Moore said that any fixed ratios, whether established by lawmakers or the state agency, are unacceptable.
“These standards have to be evidence-based and there is no evidence that specific ratios have any effect on patients’ health,” he said. “I don’t think there’s any deal yet.”
The Uxbridge lawmaker said his bill, which he is offering in the Senate as an alternative to the House plan, deals better with nursing problems by providing financial incentives to recruit more nursing students and faculty, limiting mandatory overtime, monitoring health care quality and requiring the state to collect more data from hospitals.
The Moore bill also requires hospitals to post nurse staffing plans that take into account the needs of different units, and “ancillary” personnel.
Nurses union leaders, however, also maintain that the House measure is a breakthrough because nurses have let go of their longstanding insistence on fixed specific ratios and have consented to have a third party, the DPH, set standards.
“It is a true compromise. We did not get our numbers. And most importantly, the single solitary concern that the hospital association had has been addressed,” said Sandy A. Ellis, a nurse at St. Vincent Hospital in Worcester and board member of the Massachusetts Nurses Association. “A group of experts will be determining what the limits will be, based on scientific data. That’s acceptable to us.”
Meanwhile, hospital officials, including some from Central Massachusetts, are heading to Boston today to lobby legislators in anticipation of a debate on the House bill later this month. Mr. Moore is expected to be one of the speakers at the “Hospitals on the Hill” event.
The hospital association’s official line is that no final agreement has been reached, according to Paul Wingle, a spokesman for the group.
Mr. Wingle said hospital representatives are waiting to see a redraft of the House bill now in the Committee on Public Health, whose chairman is Rep. Peter J. Koutoujian, D-Waltham.
“What we have is a framework that needs to be filled in,” he said. “We haven’t agreed to final language.”
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