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| EDITORIAL: No to nursing bill |
| Publication: Boston Globe |
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May 22, 2006 - The Massachusetts House has no business trying to set limits on the number of patients in the care of a nurse. If oversight of nurse staffing is necessary, the Department of Public Health should be given the resources to monitor the hospitals, but staffing decisions are best left to administrators of these facilities, not state government. The original bill filed by the Massachusetts Nurses Association would have the Legislature set the standards. A revised bill, to be considered by the House this week, would have DPH set them, but under such strict rules that the department would have little leeway but to demand a significant increase in nursing staff. National studies show that patients do better with more rather than fewer nurses, but the issue of staffing goes beyond simple nurse-to-patient ratios. It also depends on the number of nursing assistants, occupational therapists, pathologists. social workers, and other members of the team treating a particular patient. The bill would order hospitals to maintain this support staff, but not even the most regulation-happy legislator contemplates rules for these varied positions. It's just too complicated to micro-manage a hospital from Beacon Hill. The Legislature should not single out nurses for special treatment. A secondary weakness of the bill is that it would dump this regulation-setting on the Department of Public Health, without giving it a penny to do the work. The state budget for DPH is still 14 percent below its peak in 2001. Before the Legislature imposes new duties, it should provide enough money to pay for smoking-cessation programs and all the other important functions of the department that have endured deep cuts. If the Legislature wants to address the nursing issue, it should look to a bill proposed by Senator Richard Moore, Democrat of Uxbridge, which would increase the amount of money to train nurses with a special focus on increasing the number of nursing teachers. A shortage of faculty is a bottleneck in nursing education. Legislators might even toughen the bill to give DPH the power (and the money) to post comparative nurse staffing levels on a website and to investigate hospitals where staffing seems unreasonably low. There is no need to act immediately. The Legislature last month approved an innovative plan to provide health insurance to just about everyone in the state. This law requires a new health council (fortunately not the overworked Department of Public Health) to establish quality and cost containment goals. Another option would be to add the nursing issue to its duties. One major healthcare initiative should be enough for the Legislature this year. |