Fight over nurse workload
Hospitals battle unions in Nov. ballot question
Hospitals across the state are pouring millions of dollars into an effort to campaign against a ballot question that would place a limit on the number of patients assigned to registered nurses working in hospitals, while nurses unions spend millions trying to garner support for the measure.
The opposition to Question 1, led by the Coalition to Protect Patient Safety, has received more than $11 million in campaign contributions while the support, led by the Committee to Ensure Safe Patient Care, has banked almost $6 million, according to the latest reports from the Massachusetts Office of Campaign and Political Finance.
State and local officials are weighing in as the long-disputed, hot-button issue continues to heat up prior to the November general election.
U.S. Sen. Elizabeth Warren declared her support for the measure on Tuesday, saying in a statement, “Nurses work hard to take care of all of us when it matters the most, and we should do the same for them.” Gov. Charlie Baker declined to take a stance, saying, “I’m waiting to see the report that comes out from the Health Policy Commission.” Baker’s Democratic gubernatorial opponent Jay Gonzalez said he supports the measure.
A “yes” vote on the ballot would establish patient assignment limits, which would be determined by the type of unit or patient with whom a nurse is working; a “no” vote will make no change to current law. According to a WBUR poll released Tuesday, voters are divided on the question, with 44 percent in favor, 44 percent opposed and 12 percent undecided.
The maximum number of patients to be assigned to one nurse ranges from one to five and would apply at all times except in the case of a public health emergency. Infractions, which would be handled by the attorney general, will cost hospitals up to $25,000 for each violation.
According to the U.S. Bureau of Labor Statistics, a registered nurse in Massachusetts makes an average annual salary of $85,000, and 82,000 nurses are currently employed across the state. According to a study from MassInsight and BW Research Partners, Massachusetts would need to hire 5,911 nurses within 37 days of the mandate passing. This would cost the health care system $1.31 billion in the first year and over $900 million per year thereafter, according to the study.
Dr. Anupam Jena, an associate professor at Harvard Medical school, said the cost of the mandate will trickle down to patients and nurses. He said nurses could earn less as hospitals try to compensate for the cost of complying with the mandate and health insurance premiums could increase for patients.
Dr. Jonathan Davis, chief of newborn medicine at Tufts Floating Hospital, has been working with patient safety limits in the NICU for four years and opposes Question 1. “I’ve seen the harm that it’s caused in the neonatal unit, I can just imagine the harm it will cause in the rest of the hospital,” Davis said.
Terry Hudson-Jinx, chief nursing officer at Tufts, said the hospital would have to hire between 110 and 120 nurses to meet the requirements of the mandate and worries about having to close beds to make up for the cost.
Kate Norton, a spokeswoman for the Massachusetts Nurses Association and a Question 1 supporter, said the mandate will have no additional cost to taxpayers as hospitals can “shift costs to the administrative side” to cover the nurse salaries.
“The needs of patients are being shoved to the wayside,” Norton said. “When there are safe patient assignments, patients do better.”