Massachusetts Nurses Achieve Compromise on Maximum Patient Assignments

by Susan G. Fentin

Earlier this week, Governor Deval Patrick signed a bill that requires hospitals to limit the number of intensive care patients assigned to one nurse to no more than two.  This bill was the result of a compromise: nurses had fought for legislation that would have set limits on nurse-to-patient ratios throughout a hospital, including the emergency room, and both regular and maternity wards.  The Massachusetts Nurses Association had also filed a ballot initiative for the November election that would have mandated such limits. The MNA agreed to drop that initiative if this compromise legislation was signed by July 2.  The MNA has also agreed to drop another ballot initiative that that would have required hospitals to reveal financial information, including CEO salaries and offshore investments.

The new law requires that a hospital, in consultation with its nurses, develop an “acuity tool” that will determine how many patients can be assigned to a nurse.  The acuity tool will require approval from the Massachusetts Department of Public Health, and the Massachusetts Health Policy Commission will be developing regulations regarding this tool.  The HPC will also issue new regulations requiring hospitals to publicly report their nurse-ICU patient ratios, in addition to other patient-safety measures that have not yet been defined.

This is not the end of the battle, however.  The MNA has announced that it plans to try to expand these patient limits to other hospital units, and it will be advocating for legislation during the next legislative session that would accomplish that goal.  The union also plans to pursue legislation that would achieve the financial transparency that was the goal of its second ballot initiative, now withdrawn.  The MNA is flexing its muscles here, and this legislative effort is evidence that it will be seeking a high profile as it continues to represent nurses in the Commonwealth.

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