Transcript Document
The State of Nursing and Patient Care Massachusetts Nurses Association Prepared by Opinion Dynamics Corporation July 2005 Two-Thirds of RNs Interviewed Do NOT Belong to the MNA Do you belong to the Massachusetts Nurses Association? Yes 34% No 67% Q20 Understaffing Most Likely to Be Rated Very Serious Problem Rate the seriousness of the following problems facing the nursing profession as they relate to providing health care to patients. Use a scale of "1" meaning "not a problem at all“, to "7" meaning "a very serious problem". % very serious problem The acute care units are understaffed and nurses working in acute care are forced to care for too many patients 43% 34% Fewer young people are choosing nursing as a career 33% RNs are forced to work mandatory overtime Registered nurses are too often floated from one unit to another without appropriate training and orientation Liability and malpractice lawsuits Low pay Managers rarely implement recommendations made by staff nurses regarding patient care Q12 - 18 28% 18% 18% 16% One-Half of RNs Cite Understaffing As The Single Most Serious Problem Facing Profession Which one of the above problems do you think is the most serious problem facing the nursing profession today? The acute care units are understaffed and nurses working in acute care are forced to care for too many patients. 50% Fewer young people are choosing nursing as a career. Registered nurses are too often floated from one unit to another without appropriate training and orientation. RNs are forced to work mandatory overtime. Low pay. Liability and malpractice lawsuits. Q19 20% 11% 8% 4% 3% 9-in-10 Nurses Agree Patient Care is Suffering Due to Nurse Staffing Issues Some people say that the quality of patient care in Massachusetts hospitals is suffering because there are not enough registered nurses working in the hospitals and nurses are being forced to care for too many patients at once. Do you agree or disagree? Not sure 1% Disagree 9% Q20 Agree 90% RN’s Report Wide Range of Adverse Patient Outcomes As A Result of High Patient Loads Are you aware of any incidents in Massachusetts hospitals that a registered nurse having to care for too many patients has led to... 83% 86% Nurses not having enough time to educate patients and their families 82% 88% 77% 81% 77% Nurses not having enough time to comfort and assist patients and their families Patients having to wait for long periods of time for their medication and medical procedures Medical errors, such as improper medication or dosages 67% 68% 64% 59% 54% 53% 52% 2005 50% 2003 50% Complications or other problems for a patient Re-admission for a patient Injury or harm to patients Longer hospital stays Mortality for patients Q38 - 46 34% 29% Establishing RN-to-Patient Ratios Seen As Most Effective Solution to Nurse Staffing Issues Rate how effective you feel each one would be as a solution for addressing the nurse staffing issue using a scale of "1" meaning "not effective at all" to "7" meaning "very effective". % very effective 54% Regulating RN-to-patient ratios Providing flexible scheduling programs 50% 42% Increasing nursing salaries Scholarships and loan forgiveness programs to recruit new nurses 40% Weekend and Off-shift bonus programs 38% 34% Prohibiting mandatory overtime 30% Requiring hospitals to post a nurse-staffing plan 20% Sign-on bonuses Utilization of agency and travel nurses Q21 - 30 Utilization of foreign-schooled nurses 7% 5% RN-to-Patient Ratios Seen As Single Most Effective Solution to Nurse Staffing Issue Of the possible solutions we just discussed, which one do you feel would be the single most effective for addressing the nurse staffing issue? Regulating RN-to-patient ratios 44% 19% Increasing nursing salaries 12% Providing flexible scheduling programs 11% Scholarships and loan forgiveness programs to recruit new nurses Prohibiting mandatory overtime Sign-on bonuses Requiring hospitals to post a nurse-staffing plan Q31 4% 2% 2% Weekend and Off-shift bonus programs 2% Utilization of foreign-schooled nurses 1% Utilization of agency and travel nurses 0% 8-in-10 RNs Favor Ratios; Less Than Half Favor Hospital Proposal One proposal is a bill that would require hospitals to appropriately staff acute care facilities and limit the number of patients RNs could care for at one time by setting minimum registered nurse-to-patient ratios. These ratios would vary by unit—in an ICU the ratio would be 1 nurse to not more than 2 patients; in Medical/Surgery units the ratio would be 1 nurse to not more than 4 patients. Would you favor or oppose the legislature passing such a bill? 80% The second proposal is a bill that would not regulate a nurse to patient ratio but require each hospital to post a nurse-staffing plan that has been approved by the hospital’s board of directors, and require hospitals to report their nurse staffing plan to the Department of Public Health. This plan is designed to ensure transparency in hospital nurse staffing, and to provide a process for evaluating measures to improve the quality of patient care. Would you favor or oppose the legislature passing such a bill? 48% 46% 17% Q32, 33 Favor Oppose Favor Oppose By Wide Margin, RNs Favor Ratio Plan Over Posting and Reporting Plan Which do you think is a better approach to addressing the nurse staffing issue: The plan which would regulate staffing levels and set a minimum nurse staffing level 68% The plan which would require hospitals to post a nurse staffing plan and report it to the Department of Health, but would not set minimum staffing levels Neither/not sure Q34 25% 7% Nearly Two-Thirds of RNs Not Currently at the Bedside Would Consider Returning To Acute Care Settings if Ratios Are Established (Non-acute care nurses): Let's say this safe staffing law was passed by the Legislature and registered nurses were required to care for fewer patients at once - for example, a 1:2 ratio was the standard in an ICU and 1:4 in Med/Surg. Would you consider taking a job as a staff nurse providing direct patient care in a hospital if such a law were passed to regulate RN-to-patient ratios? Q37 Wouldn't make a difference/not sure 36% More likely to consider 64%