With New Death Stats, Nurses Go Nuclear in Long-Running War over Staffing Legislation

Friday, June 6, 2014

If you accept the findings of the latest survey by the Massachusetts Nurses Association (MNA) as 100% sound -- a big if -- you will open your mind to an old but endlessly potent species of dread: the fear of what can go wrong in a hospital.

On Wednesday of this week, June 4, the MNA announced that a survey of bedside nurses in Massachusetts had found that one in four (23%) “report patient deaths directly attributable to having too many patients to care for.”
In a press release, the MNA said the survey respondents “were all nurses currently working in Massachusetts hospitals randomly selected from a complete file of the 92,000 nurses registered with the Massachusetts Board of Registration in Nursing.”  (The total number of respondents was not disclosed.)

Further, the release said that, according to the firm that conducted the survey, the results “can be assumed to be representative” of the 92,000 nurses to within 7 percentage points, plus or minus, “at a 95% confidence level.”  (Bold facing added.)  Translation:
If you could somehow ask each of the 92,000 nurses if they were personally aware of a patient having died because there weren’t enough nurses on hand to care for all of the patients who needed care, you could be confident that between 16% and 30% of them would answer in the affirmative. 

Sixteen percent of 92,000 is 14,720.  Thirty percent is 27,600. 

This is a startling assertion.

Assuming just one witnessed patient death per surveyed nurse, the MNA is implying that at least 14,720 patients have died because not enough nurses were assigned to care for them. 
The Massachusetts Hospital Association quickly challenged the findings.  In a statement to the State House News Service, the MHA said:  

“It (the survey) is not credible, and it is troubling that the union, to advance its political agenda, would issue such unsubstantiated safety claims that run counter to the publicly available data and evidence.  No federal and state government agency that routinely monitors and licenses hospitals for performance or quality of care has raised concerns on issues that the union makes claims about.  There is no evidence to support the union’s claims regarding patient safety.  (Bold facing added.) But there is evidence that the quality of patient care in Massachusetts hospitals is of high quality.”
The survey comes amid an intensifying effort by the MNA to get a law enacted that would allow the Department of Public Health to establish mandatory nurse-to-patient staffing ratios. 

A co-sponsor of the bill in the House, registered nurse and state representative Denise Garlick of Needham, said on Wednesday, “There’s an old adage in medicine that says: ‘If you don’t listen to nurses, you will not hear the patients.’  If we listen to the registered nurses of this Commonwealth and what they are saying, we will hear the sound of patients who are suffering needless complications, medical errors and readmissions, and the silence of those who cannot speak at all.”
State Senator Marc Pacheco of Taunton, who’s the lead sponsor of the bill in the upper branch, said, “Just think about the liability issues that are out there for all these hospitals.”

On a parallel track, the MNA is working to put a nursing ratio question on the November, 2014, statewide ballot.  If approved by the voters, the measure would limit the number of patients that could be assigned to a registered nurse in a hospital and certain other health care facilities.
It will be interesting to see how aggressively and how extensively hospitals (and others) question the survey results going forward.  Will they, for example, ask state and federal health care regulators to furnish the figures on how many registered nurses in Massachusetts have filed formal complaints to the effect that a patient died on her/his watch because of inadequate staffing?

If those figures were made available, I’d be surprised if the total was anywhere near 14,720.
Then the question would be: How come the nurses did not come forward?

A full summary of the survey may be found on the MNA’s web site by going to:


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