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| Bill calls for minimum nursing staff levels |
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Author: Jon Brodkin Publication: Daily News |
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May 19, 2006 - A key legislative committee yesterday endorsed a bill to set minimum nurse staffing levels in hospitals, despite opposition from medical industry groups and the committee's co-chairman, who called the proposal a "sham." The state Department of Public Health would have to develop and enforce minimum nurse staffing levels at all acute-care hospitals under a bill approved by the Health Care Financing Committee by a vote of 10-2. Hospitals could be fined $3,000 for violating the rule. MetroWest Medical Center, Newton-Wellesley Hospital, Milford Regional Medical Center and Marlborough Hospital would have to follow the new standards if lawmakers give final approval to the bill. Sen. Richard Moore, D-Uxbridge, argued that forcing hospitals to hire more nurses will cause some to close units or even entire hospitals. "I cannot support this sham," Moore, the committee's co-chairman, wrote in a dissent. "I firmly believe that it will not improve the workplace for nurses. It will not improve patient outcomes. It will increase health care costs and reduce access to care." Moore's argument mirrors that of the Massachusetts Hospital Association and the Massachusetts Organization of Nurse Executives, who say minimum staffing levels are inflexible and prevent them from responding to changing conditions. The staff bill has been heavily promoted by the Massachusetts Nurses Association, a union that says unsafe staffing levels are harming patients and causing nurses to leave the profession. Originally, the bill prevented hospitals from assigning more than four patients to one registered nurse on medical and surgical floors, and limited nurses to two patients each in intensive care units. The latest version of the bill leaves it up to the DPH to set limits. The nurses union said it expects the full House to debate the bill Tuesday. The union has called the proposal a "compromise," saying legislative leaders drafted the new version after negotiations with both sides. "The key sticking point was we had numbers written into the law itself," said union Executive Director Julie Pinkham. "They said they would prefer that the numbers be created (by state health officials)." The Massachusetts Hospital Association objected to the term "compromise" because the group opposes the newest version of the bill. "The MNA's out there celebrating and saying hooray. The hospitals, nurse leaders and other professional health care groups are saying this is a sham. By that observation alone you should know we don't have a compromise here," said Paul Wingle, the hospital group's spokesman. Wingle said instead of enforcing nurse-to-patient ratios, the state should measure performance by "hours of care per patient day," a tool that shows the average number of hours patients are cared for by nurses and other caregivers. Hospitals also object to the bill counting only registered nurses toward the minimum standards, saying that excludes nursing assistants, physical therapists and other staff. "There are many complex factors that go into patient care," Wingle said. "This bill reduces it down to nurse assignments and patients. Not all nurses are the same. Not all patients are the same. We need a lot of flexibility to deal with the unique needs of patients." |