Massachusetts files legislation mandating nurse-to-patient ratios

Massachusetts lawmakers are filing legislation this week that would mandate nurse-to-patient ratios — following in the footsteps of Washington and Oregon with a statewide push toward safe staffing. 

The proposed bill is sponsored by Sen. Lydia Edwards and Rep. Natalie Higgins in partnership with the Massachusetts Nurses Association, according to a news release the union shared with Becker's. If it passes, the Department of Public Health will hold public stakeholder hearings to establish specific limits on how many patients can be assigned to one nurse at a given time. 

At least 8,320 unsafe staffing reports were filed by Massachusetts hospital nurses in 2022, according to the union. A 2022 MNA survey found that 8 in 10 Massachusetts nurses have seen care quality "worsen significantly," and 69 percent said their biggest obstacle was caring for too many patients due to understaffing. 

But hospitals and unions tend to be split on whether or not mandated staffing ratios will resolve that problem. Nationwide, hospital associations have expressed concerns that a one-size-fits-all figure would drive up operating costs, worsening the situation at financially struggling hospitals and leading to service cuts and closures. Meanwhile, unions like the MNA cite research suggesting staffing ratios lead to higher care quality. 

This is not the first time the union has tried to pass a staffing ratio in Massachusetts. Other measures to improve and research nurse staffing were proposed in 2014 and 2018, but both times, they were struck down

"To be clear, there is no shortage of nurses in Massachusetts, there is a shortage of nurses willing to continue working under the current conditions and staffing practices implemented by profit-driven hospital administrators over the last 15 years," Katie Murphy, RN, president of the MNA and a practicing intensive care unit nurse, said in the union's news release. "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."

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