Massachusetts Hospitals Oppose Initiative for Mandated Nurse Staffing Ratios

Earlier this year, the Massachusetts Nurses Association proposed a ballot initiative to mandate nurse staffing ratios in Massachusetts hospitals. The proposed mandate would lead to the reduction of 1,000 behavioral health beds, increase emergency room boarding for mental health patients, and decrease access to recovery services statewide according to a study by the Massachusetts Association of Behavioral Health Systems.

The mandate calls for one nurse to be responsible for no more than four typical medical or surgical patients at a given time. Different guidelines would apply for sicker patients and staffing ratios would differ by unit. Supporters of the initiative argue that legislating nurse-to-patient ratios will improve patient care. Nurses are currently overworked, which keeps them from doing their best and can lead to medical errors.

David Matteodo, executive director of the hospital association, tells BeckersHospitalReview.com, “If the initiative passes, it will result in a 38 percent decrease in patient volume. That’s the equivalent of removing roughly 1,000 behavioral health beds from service. This result would be devastating to both patients and the behavioral health system as a whole, as there would be no place for displaced patients to go when they are in acute distress and need immediate behavioral health services.”

The Coalition to Protect Patient Safety opposes the initiative and was assembled by the Massachusetts Health and Hospital Association, which argues that the proposal would negatively affect nurse care delivery.

Under the initiative, emergency departments at maximum nurse-to-patient ratios would have to turn away patients. Patients seeking inpatient psychiatric or substance abuse care in an emergency department would have to wait longer for a bed and mental health providers would face nurse recruitment challenges to meet staffing mandates.