MHA: Rigid Nursing Ratios Are Still Not the Answer

Staffing Ratios Reportedly Sought by MNA are Not Backed by Science, Would Weaken our Healthcare System

BURLINGTON, MA - The issue of fixed nurse staffing ratios has again resurfaced, this time in the reported contract negotiations at Saint Vincent Hospital and through recent comments by the Massachusetts Nurses Association.

But revisiting this issue only highlights the shortcomings of ratios that were addressed most recently during the MNA’s unsuccessful ballot question campaign in 2018, including inaccurate charges of substandard care.

In this ongoing campaign for rigid four-to-one ratios, the MNA has charged that Saint Vincent, and by implication any other hospital that does not staff at that level in every med/surg unit round the clock is unsafe. It is irresponsible and inaccurate to call any staffing below the level MNA is reportedly seeking in contract talks “unsafe.” These claims ignore patient outcomes and other key metrics recorded by our hospitals and confirmed by the Massachusetts Department of Public Health.

No hospital in Massachusetts can deliver great care without flexibility and well-rounded care teams. Staffing in our hospitals is based on the unique needs of each patient, the specific abilities of each unit, and the contributions of a wide array of clinicians. Rigid ratios, which are not backed by science, take this essential flexibility away from our caregivers.

Staffing ratios have been rejected on several fronts: first by the legislature, where bills to enact them statewide have fallen short for almost two decades, and then by Massachusetts voters, who in 2018 rejected the MNA’s ratio ballot question by a margin of greater than two-to-one. Studies by both a private research firm and the Massachusetts Health Policy Commission found that ratios would cost hospitals more than $900 million in additional costs each year, an especially severe blow to hospitals still struggling to recover from pandemic-related deficits.

Ratios would have a very real impact on patient care: they would prevent nurses from using their clinical expertise, cause emergency room times to increase, and pull nurses away from crucial settings like behavioral health and senior care. They would also stand to impact the range of services hospitals are able to provide and result in higher costs for patients. That’s why ratios were opposed by a broad coalition of dozens of leading healthcare organizations, including seven nursing associations.

Rather than fixate on rigid numbers that are not at all practical for the function of our healthcare system as we emerge from the pandemic, the conversation should instead be focused on staffing solutions that are feasible and ensure optimal patient safety.

MHA is proud to represent a healthcare community that holds itself to the highest possible standards, and we will continue to defend our providers in the face of misleading claims or measures that would weaken the care they deliver to their communities.