Transcript Document

The State of Nursing: 2003
Massachusetts Nurses Association
Prepared by
Opinion Dynamics Corporation
June 2003
Which of the following best describes your
current work situation?
28%
Provide direct patient care outside a hospital
setting
Staff nurse providing direct patient care at a
teaching hospital
Staff nurse providing direct patient care at a
community hospital
Work in health care outside the direct patient care
area
I am not currently working but might return to some
job at some point
Work at a teaching hospital but do not provide acute
care
Work at a community hospital but do not
provide direct patient care
Q1
Employed, but do not work in the health care area at
all
26%
21%
10%
5%
4%
4%
2%
Do you currently belong to the
Massachusetts Nurses Association?
No
68%
Yes
32%
Q2
How many years have you been working as
a nurse?
100%
80%
52%
60%
40%
15%
20%
3%
5%
11%
14%
0%
2 yrs or
less
Q3
3-5 yrs
6-10 yrs 11-15 yrs 16-20 yrs Over 20
yrs
What is the most rewarding or positive thing
about your current job?
For the patients/Rewarding to help/Care
Q8
73%
Staff contact/Team attitude
7
Job/Schedule flexibility
7
Pay
4
Teaching staff/Mentoring
4
Independence/Autonomy
3
Nothing
-
Other
4
(Not sure)
2
(Refused)
1
What is the biggest problem or negative
thing you face in doing your job?
Staffing/Short staffing/Shortages
31%
Paperwork/Reimbursement/Insurance
12
Management – lack of respect/support
11
Politics/Staff conflict – peers, physicians
9
Time/Not enough time
7
Workload
Q9
6
Bad scheduling/Long hours/Mandatory overtime
5
Pay/Benefits
4
Cutbacks/Financial resources
4
Stress/Too much responsibility
3
Nothing
3
Other
5
(Not sure)
5
Do feel that the amount of paperwork you do
on an average shift:
Is unnecessarily burdensome
and could be reduced
50%
28%
Is not really that much of a
burden
Is a burden but probably can't be
reduced safely
Not sure
Q10
19%
3%
At any time in your nursing career have you
been employed as a staff nurse providing
direct patient care in a hospital setting?
No
5%
Q11
Yes
95%
(Acute care nurses): Have you considered
leaving direct patient care at the bedside?
55%
44%
2%
Yes
Q63
No
Not sure
What is the reason that you decided to stop
practicing direct patient care in a hospital
setting?
Q12
Short staffed/Too many patients
21%
Better career opportunity/Promotion
20
The long hours/Bad schedule/Mandatory overtime
19
Personal reasons – raise family, home life
12
Wanted different atmosphere/setting
10
Injury/Age/Health reasons
8
Stress level/Burnout
6
Money/Benefits
5
Other
3
(Not sure)
1
(Refused)
2
What is the reason why you never decided
to practice direct patient care in a hospital
setting?
Prefer long term care
31%
Working conditions
23
Not enough experience
15
Other
23
(Not sure)
Q13
8
Do you agree or disagree with the following
statements?
Stronlgy/Somewhat agree
RNs are burned out with high
patient loads.
Registered nurses working in
hospital units have to care for too
many patients.
Managers schedule too few
nurses per shift.
Legal liabilities in case of error are
too risky.
Hospital managers float
registered nurses without
appropriate training and
orientation.
Hospital finances are not properly
being spent on patient care.
Q20,15,17,19,22,21
93%
87%
75%
75%
70%
66%
Do you agree or disagree with the following
statements?
Stronlgy/Somewhat agree
Working conditions in
hospitals are brutal to nurses.
Dealing with sick people wears
you out after awhile.
Hospital managers assign
mandatory overtime instead of
staffing properly.
Hospital managers assign
traditional nursing duties to nonnurses instead of hiring registered
nurses.
An RN can make more money in
areas other than in acute care.
Q18,16,23,24,14
65%
62%
60%
58%
54%
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".
Mean
Fewer young people are choosing
nursing as a career.
5.77
The acute care units are understaffed
and nurses working in acute care are
forced to care for too many patients.
Registered nurses are too often floated
from one unit to another without
appropriate training and orientation.
RNs are forced to work mandatory
overtime.
Liability and malpractice lawsuits.
Low pay.
Q36,32,30,31,39,33
5.41
4.82
4.68
4.56
4.50
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".
Mean
Managers assign traditional nursing
duties to non-nurses instead of hiring
registered nurses.
4.25
Managers rarely implement
recommendations made by staff nurses
regarding patient care.
4.24
Physicians are disrespectful of registered
nurses.
3.83
Board of Registration does not take an
active role in protecting the public's health.
3.70
Workplace violence.
Q38,35,37,40,34
2.91
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.
7%
Low pay.
7%
RNs are forced to work mandatory
overtime.
5%
Liability and malpractice lawsuits.
Q41
18%
3%
The Massachusetts Legislature is considering a bill
that would require hospitals to adequately staff acute
care facilities and limit the number of patients an RN
would need to care for at one time by setting minimum
registered nurse-to-patient ratios. Would you favor or
oppose the Legislature passing such a bill?
Not sure
5%
Strongly favor
70%
Strongly oppose
5%
Somewhat
oppose
4%
Q42
86%
Favor
Somewhat favor
16%
(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-topatient ratios?
Much more
likely to consider
42%
Not sure
3%
Q43
Wouldn't make a
difference
32%
Somewhat more
likely to consider
23%
What other factor(s) would encourage you to
practice direct patient care?
Q44
Better hours/Scheduling/No mandatory OT
21%
Better pay/Benefits
21
Retraining back to the workforce
19
Refresher courses
19
More staff/Better patient-nurse ratio
14
If management listened
5
Age/Health
3
Nothing
2
Other
7
(Not sure)
13
(Refused)
2
Are you aware of any incidents in
Massachusetts hospitals that a registered
nurse having to care for too many patients has
Yes
led to...
Nurses not having enough time to
comfort and assist patients and
their families
88%
Nurses not having enough time to
educate patients and their families
86%
Patients having to wait for long
periods of time for their medication
and medical procedures
The frequency of medical errors,
such as improper medication or
dosages
Complications or other problems for
a patient
Q50,51,52,53,45
81%
67%
64%
Are you aware of any incidents in
Massachusetts hospitals that a registered
nurse having to care for too many patients has
Yes
led to...
54%
Re-admission of a patient
Injury or harm to patients
52%
Longer hospital stays
50%
Mortality for patients
Q48,47,46,49
29%
Which of these statements about health care
coverage is closer to your opinion:
Not sure
7%
It is NOT the
responsibility of the
24%
government to
ensure that every
citizen has access to
healthcare
Q28
It is the responsibility
of the government to
ensure that every
citizen has access to
health care
69%
And which of these is closer to your opinion:
The health care system in
Massachusetts could use
some minor changes, but
overall it is in pretty good
shape
23%
Not sure
6%
Q29
The health care
system in
Massachusetts has
real problems and is in
need of a major
overhaul
71%
Let's talk briefly about health care more
generally. Please rate the quality of health care
that you think most hospitals in Massachusetts
deliver to patients. Is it:
41%
32%
16%
4%
Excellent
Q25
1%
Very
good
Good
Only fair
Poor
5%
Not sure
Do you think the overall quality of health care in
Massachusetts hospitals has gotten better,
worse or stayed the same in the past 5 years?
38%
14%
15%
17%
13%
2%
Much
better
Q26
Somewhat Stayed the Somewhat
better
same
worse
Much
worse
Not sure
Looking towards the future, in 5 years do you
expect the overall quality of health care in
Massachusetts to be better, worse or the same
as it is now?
40%
21%
14%
12%
8%
5%
Much
better
Q27
Somewhat Stayed the Somewhat
better
same
worse
Much
worse
Not sure