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Massachusetts Nurses Association A Statewide Survey of 400 Massachusetts Residents February 2005 Increased Concern With Healthcare I am going to read a list of issues facing Massachusetts, please tell me which one you feel is most important – that is, which one is of most concern to you and your family. Now Jan. ‘03 Jan. ‘02 Healthcare 31% 21% 22% Education 20 21 29 Jobs and the Economy 19 22 21 Terrorism 7 8 9 Taxes 7 8 9 Fiscal crisis/Balancing the budget 5 10 n/a Crime 4 3 4 Quality of highways and bridges 3 3 2 Registered Nurses Receive Highest Job Rating of Hospital Employees Please tell me whether you think the following people, as a group, do an excellent job, good job, fair job, or a poor job. Registered nurses Good 44% 45% 32% Doctors Technicians 24% Nurses' aides 23% Hospital administrators Excellent 10% 89% 83% 51% 83% 59% 75% 52% 41% 51% Registered Nurses Seen As The Key to Quality Care Of the types of hospital employees I just mentioned, which one do you think has the greatest impact on the quality of patient care? 61% Registered nurses 23% Doctors 8% Nurses' aides Hospital administrators Technicians 3% 2% Biggest Hurdles to Improving Quality of Care Please rate the seriousness of each of the following problems related to the quality of patient care on a scale of 1 to 7, where “1” means “not a problem at all” and “7” means “very serious problem”. “Very serious problem” shown (ratings of 6 and 7 combined) 74% HMOs/insurance companies only concerned with profits 71% Nurses being forced to care for too many patients at once 68% Cuts in government funding for Medicare and Medicaid Understaffing of registered nurses 64% A shortage of nurses 64% 62% Hospitals that are only concerned with profits 61% Overcrowding and slow care in emergency rooms 56% Forced, mandatory overtime for registered nurses Low pay among registered nurses 38% Strong Agreement that the Quality of Care Is Suffering Due To Understaffing 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 patients have to share their nurse with too many other patients. Do you agree or disagree? Now 56% Strongly agree Somewhat agree 21% Strongly disagree 77% Agree 8% Somewhat disagree 4% 49% Strongly agree Jan ‘02 Somewhat agree 27% 10% Somewhat disagree Strongly disagree 5% 76% Agree Sustained High Support For Establishing Minimum Staffing Levels One proposed way to ensure that there are enough registered nurses working in the hospitals is to pass a law saying that acute care patients are entitled to a nurse who is caring for no more than a certain number of patients at the same time. This proposed law is being called An Act Ensuring Patient Safety. Would you favor or oppose passing An Act Ensuring Patient Safety, thereby regulating minimum staffing levels of registered nurses in Massachusetts hospitals? Now Oppose Jan ’02* *Slightly different wording 76% Favor 10% 77% Favor Oppose 14% Support for Minimum Staffing Levels, by Subgroups Would you favor or oppose passing An Act Ensuring Patient Safety, thereby regulating minimum staffing levels of registered nurses in Massachusetts hospitals? Favor Oppose All 76% 10 Democrats 79% 4 Independents 78% 9 Republicans 71% 27 18 – 30 76% 8 31 – 45 75% 10 46 – 64 77% 12 65+ 72% 9 Agree care is suffering 83% 6 Disagree 60% 27 Better Care Is Biggest Reason for Favoring MNA Proposal Why would you favor this law? (n=303) More personal/better care/patient safety 45% Lower ratio is better 19 Nurses are overworked/understaffed 11 Agree/good idea/logical 7 Will make them hire/encouraging training more nurses 6 Acute care/need more attention 5 Less Than Half Support Hospital Plan A second proposed way to address the issue of nurse staffing levels in hospitals is to pass a law requiring hospitals to post a nurse staffing plan that has been approved by the hospital board of directors. This law would also require hospitals to report their nurse staffing plan to the Department of Public Health, but it would not set any required staffing levels. Would you favor or oppose passing this legislation that would require hospitals to post and report their nurses staffing plans? Favor 48% Not sure 23% Oppose 30% Democrats Independents Republicans 49% 45 56 Agree care suffering Disagree 49 48 3-to-1 Support for Regulating Nurse Staffing Levels vs. Posting and Reporting Which proposal 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 62% The plan which would require hospitals to post a nurse staffing plan, report it to the department of health, but would not set minimum staff levels 21% Democrats Independents Republicans 68% 66 47 Agree care is suffering Disagree 67 53 Not sure 11% Neither 6% Democrats Independents Republicans 19% 17 35 Agree care is suffering Disagree 20 25 Public Overwhelming Accepts Dueling Proposals As Evidence of a Problem With Current System of Nurse Staffing Do you agree or disagree that since both hospitals and nurses in the state are proposing plans to address nurse staffing levels, there must be some sort of problem with the current system? Agree 89% Disagree 6% Not sure 5% 2/3rds Think It Is Time For Legislature to Back Up Nurses’ Judgment Some people say that if the legislature passes legislation regulating nurse staffing levels they will be substituting political judgment for professional judgment. Other people say that nurses have been fighting to have their opinion heard and haven’t gotten anywhere against insurance companies and hospital administrators who control the money? Do you think… It is time for the legislature to back up the nurses’ judgment 66% Democrats Independents Republicans Legislature should keep its hands off the kinds of medical decisions that involve staffing 25% 73% 62 58 Not sure 10% Public More Likely to Vote for Candidate Who Supports Minimum Nurse Staffing Levels All else being equal between two candidates for state legislature, would you be more likely to vote for a candidate who supports regulating minimum nurse staffing levels, or would you be more likely to support a candidate who opposes regulating minimum nurse staffing levels? Candidate who supports 75% Democrats Independents Republicans 87% 77 51 No difference/ Refused 13% Candidate who opposes 12% Nearly 3/4ths Say They Would Vote Yes on a Ballot Initiative Let’s say the Legislature does not pass legislation regulating minimum nurse staffing levels. If in November 2006, there were a ballot question that asked voters to enact a law regulating minimum nurse staffing levels at the ballot box, would you personally vote yes or no? Probably yes 21% Definitely yes 52% Probably no 5% Definitely no 11% Not sure 11%