80% of nurses say hospital care quality has
deteriorated over the past two years; many nurses see vacancies
remaining unfilled, increased use of travel nurses.
Four-in-ten nurses would not feel safe
admitting a family member to the unit on which they
work.
76% of nurses say Beacon Hill is not acting on unsafe staffing
problems; Half say management does not adjust patient assignments
as needed.
CANTON,
Mass., May 6, 2024 /PRNewswire/ -- As the nation
kicks off National Nurses Week (May 6
– 12) a newly released "State of Nursing in Massachusetts" survey provides a stark look at
the worsening state of patient care and the lack of responsiveness
by industry and state officials to nurses' concerns about unsafe
patient assignments. The 2024 edition of the annual Beacon Research
survey gives the public and healthcare stakeholders a view into the
current crisis through the eyes of registered nurses. In
addition to the release of the survey, hundreds of the state's RNs
will be flooding the State House on May
8th at 10 a.m. to
share their experiences with policy makers in the hopes of moving
legislation to address the growing nursing/patient safety
crisis.
- Nurses are extremely concerned about the quality of patient
care in hospitals, with 80% saying care quality has gotten worse
over the past two years and 49% saying it is much
worse. This concern has more than doubled over the past 10
years.
- Not having enough time with patients and caring for too many
patients at one time remain top challenges impeding the ability of
nurses to provide quality care, with two-thirds of nurses surveyed
citing each as a major challenge.
- RNs report being aware of serious negative patient outcomes as
a result of understaffing, including nurses lacking time to
properly comfort and assist patients and families (80% aware),
nurses lacking time to educate patients and provide adequate
discharge planning (76%), re-admission (65%), medical
errors (55%), and even death (26%).
- Four-in-ten nurses would not feel safe admitting a family
member to the unit on which they work.
- Most nurses (61%) say a lack of proper hospital regulations are
contributing to unsafe patient care conditions. Yet
Beacon Hill lawmakers are not
responding to concerns about unsafe staffing, according to 76% of
nurses.
- Last year, as part of their testimony to lawmakers in favor of
safe patient limits legislation, MNA nurses showed more than 12,600
unsafe staffing forms filed statewide over 18 months. These forms
document instances in which nurses were forced to take an excessive
patient assignment that "poses a serious threat to the safety and
well-being of my patients." Despite the enormous stack of unsafe
staffing forms, lawmakers did not act.
- Inside hospitals, when nurses speak up about unsafe patient
assignments they are routinely ignored. 62% of nurses say
administrators are not responsive to their feedback, and 47% say
management rarely or never adjusts their patient loads to meet
patients' needs – up 20 points from 2019.
- For-profit owner Tenet Healthcare is an egregious example. In
March, eight nurses from St. Vincent Hospital in Worcester filed a whistleblower lawsuit
against Tenet. The nurses allege they were fired for
exercising their legal and professional obligation to report
"unsafe and illegal conduct and conditions" that jeopardized the
health and dignity of the patients under their care.
- The lawsuit was filed around the same time the Joint
Commission validated St. Vincent nurses' concerns about patient
care conditions and found the hospital to be "non-compliant with
applicable Centers for Medicaid and Medicare Services (CMS)
Conditions."
- Nurses have spent months documenting safety concerns at the
hospital. In addition to the Joint Commission, they have lodged
complaints with the Department of Public Health Division of
Healthcare Quality, the Center for Medicare and Medicaid Services
and the Mass. Board of Registration in Nursing.
- Despite this advocacy, Tenet Healthcare refuses to
acknowledge the validity of the nurses' concerns and routinely
ignores contract language safely limiting patient assignments at
St. Vincent.
- Nurses do not trust their employer to keep promises and
favor unionizing.
- 64% of nurses said they are dissatisfied with the influence
they have in workplace decisions.
- 68% said they do not trust their employer to keep
promises.
- Of the 328 non-union nurses surveyed, 56% said they would vote
for a union.
- Of the 182 union nurses surveyed, 71% said they would vote to
keep their union.
"The public trusts nurses and nurses trust their own ability to
work together to overcome the dysfunctions of our healthcare
system," MNA President Murphy said. "The hospital industry
must invest in the permanent nursing workforce. State officials
must provide stronger protections for patients and nurses. Ignoring
nurses' concerns has led us to this patient care crisis. Listening
to nurses is the only way to solve our problems."
Workplace Violence a Major Concern
- Nurses experience workplace violence at extremely high rates.
Yet, the survey shows employers are not taking appropriate action
and are providing minimal support.
- The number of nurses who have experienced workplace violence
increased 11 points from 2021, to 68% in this year's survey.
- 30% of nurses said their employer never or rarely takes
appropriate action. 22% said "sometimes."
- 58% of nurses said they receive no additional support from
their employer when they encounter violence.
Study Shows Working Conditions and Failure to Address Them is
True Cause of Staffing Crisis in Massachusetts
- As a result of these types of patient care conditions and the
refusal of officials to listen and act, nurses are fleeing in ever
greater numbers. 1 in 5 nurses plan to leave the profession
within two years – twice as many as five years ago,
according to "The State of Nursing in Massachusetts." Nurses cite burnout,
exhaustion, stress, and lack of employer support as major reasons
for leaving.
"Nurses are clamoring for real solutions to fix the awful
conditions that are driving them away from the profession and
leaving patients in unsafe, overcrowded environments," said
Katie Murphy, ICU RN, and President
of the Massachusetts Nurses Association. "Unfortunately, our
annual survey shows that healthcare executives and state officials
are failing to respond to nurses' concerns. Instead, the industry
continues to move toward temporary, remote, and app-based
approaches that nurses do not like and are bad for patient
care."
> Read "The State of
Nursing in Massachusetts" Executive
Summary.
> See
a visual representation in these survey
charts.
Nurses' Real Solutions vs. Industry's False
Answers
For "The State of Nursing in Massachusetts," more than 500 nurses were
randomly selected for interviews from the Massachusetts Board of Registration in Nursing
list, including 59% who were non-union nurses. The results
clearly show solutions that nurses believe will help address the
crisis, as well as industry-led approaches that will make it
worse.
As part of the survey – conducted between
February 27 and March 11, 2024 – nurses identified
significant changes in their workplace over the past two years that
have contributed to unsafe staffing and deteriorating patient care
conditions.
- 75% of nurses have seen RN positions left vacant or
unfilled.
- 68% have seen an increase in travel nurses.
- 49% have seen an increase in the use of on-call to compensate
for the lack of staff.
- 45% have seen more nurses being engaged in tasks not covered
under nursing policies and procedures.
- 34% have seen an uptick in mandatory overtime.
Nurses came out plainly against app-based and remote nursing
strategies in the survey.
- 59% of nurses said they were not interested in using an app to
work as an independent contractor without benefits.
- 61% of nurses (including 65% and 64% at direct care teaching
and community hospitals) said they believe remote nursing is bad
for patient care.
Instead, nurses were in favor of state and industry officials
addressing the patient care crisis through safer patient
assignments, investments in the permanent nurse workforce, and
improved hospital regulations.
- 61% of nurses said hospitals are not properly regulated to keep
patients safe.
- 54% said more regulations are needed to keep patients
safe.
- 55% said salary increases could keep them from leaving the
profession.
- 43% said limits on the number of patients cared for at one time
could keep them from leaving.
- 37% said having additional ancillary staff could keep them from
leaving.
- 33% said pension benefits could keep them from leaving.
- 29% said favorable time off benefits could keep them from
leaving.
The "Shortage of Nurses" Myth
In its most recent report on the subject, "Health Care Workforce
Trends and Challenges in the Era of COVID-19," published in
March 2023, the Health Policy
Commission (HPC) concluded that the workforce challenges facing the
healthcare system do not stem from a lack of nurses, but from an
increasingly challenging work environment.
- Massachusetts has more nurses
per capita than almost any other state, with 12% per capita growth
since 2015.
- Unlike many other states, Massachusetts is on track to have a nursing
surplus by the end of the decade.
- Massachusetts has increased
the number of registered nurses by 24% – nearly 30,000 nurses over
the past several years.
- The HPC also pointed out that the nursing education pipeline
has remained steady.
Nurses Seek Safe Patient Limits
In overwhelming numbers, nurses support a legislative solution
that would develop a statewide maximum limit on the number of
patients a registered nurse at Massachusetts hospitals can be assigned at one
time.
The MNA and its State House partners filed new legislation this
term entitled "An Act Promoting Patient Safety and Equitable
Access to Care," sponsored by Sen. Lydia Edwards, D-Third Suffolk, and Rep.
Natalie Higgins, D-4th
Worcester. The bill would empower
DPH to hold public stakeholder hearings and promulgate regulations
that establish specific limits on the number of patients a
registered nurse shall be assigned to care for at one time.
Nurses surveyed in 2023 supported the legislation by a wide
margin. Seventy-six percent of all nurses said they strongly
support this safe patient limits bill, and 12% somewhat support
it.
Nearly every nurse (97%) surveyed with 0-5 years of experience
said they "strongly support" the legislation.
"There is absolutely no question that limiting the number of
patients a nurse cares for at one time is safer for patients and
the only solution to the current nurse staffing crisis,"
said Murphy. "The benefits of safe patient limits
were settled science before the pandemic, and today there is even
more research and nurse experiences to support this
legislation."
For more about the evidence behind safe patient limits,
click here.
Nurses Are Under Assault, Seek Violence Prevention
Legislation
A growing number of nurses fear violence in their workplace and
view it as a serious problem, according to the 2024 "State of
Nursing in Massachusetts."
- 64% of nurses said workplace violence is a serious problem, up
22 points from 2021.
- 68% reported experiencing at least one incident of violence in
the past two years.
- Only 6% of nurses said they received paid time off in the
aftermath of experiencing violence.
- Just 19% received emotional support, and 10% said they received
any other kind of support from their employer.
Nurses have long been subject to more violence than any other
profession. Nurses and nurses' aides were assaulted more than
police officers and prison guards, according to a 2017 OSHA report.
To combat this worsening problem, MNA nurses and healthcare
professionals have proposed violence prevention legislation at the
State House.
Last legislative term, Massachusetts senators and representatives
passed similar versions of the MNA bill – An Act requiring
health care employers to develop and implement programs to prevent
workplace violence – out of committee and to Ways and Means, the
final stop before a full vote by the legislative bodies. The
legislation, sponsored by Senator Joan
Lovely and Representative Denise
Garlick, would:
- Require healthcare employers to perform an annual safety risk
assessment and, based on those findings, develop, and implement
programs to minimize the danger of workplace violence to employees
and patients.
- Provide time off for health care workers assaulted on the job
to address legal issues.
- Allows nurses and healthcare professionals to use their health
care facility address instead of their home address to handle legal
issues related to an assault.
- Require semiannual reporting of assaults on health care
employees to District Attorneys.
"Violence is a major contributor to burnout, is driving nurses
away from the profession, and must be addressed more proactively in
cooperation with staff nurses," said Karen Coughlin, RN, and chair of the MNA
Workplace Violence and Abuse Prevention Task Force. "Patients
deserve nurses who feel safe at work and are fully supported by
their employer."
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Founded in 1903, the Massachusetts Nurses Association is the
largest union of registered nurses in the Commonwealth of
Massachusetts. Its 25,000 members
advance the nursing profession by fostering high standards of
nursing practice, promoting the economic and general welfare of
nurses in the workplace, projecting a positive and realistic view
of nursing, and by lobbying the Legislature and regulatory agencies
on health care issues affecting nurses and the public.
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SOURCE Massachusetts Nurses Association