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Nurses and union leaders urge limits on nurse assignments; committee hears data on patient harm and staffing shortages
Summary
Nurses, union leaders and health researchers pressed the Joint Committee on Public Health to advance legislation (H.2448, S.1522) directing the Department of Public Health to set maximum patient assignments per registered nurse, citing survey data and multiple frontline accounts of unsafe staffing and patient harm.
Nurses, nursing association leaders and frontline clinicians urged the committee to report favorably on H.2448 and S.1522, legislation that would direct the Massachusetts Department of Public Health to set maximum patient assignments per registered nurse in hospitals.
Katie Murphy, president of the Massachusetts Nurses Association and a critical care nurse, said research shows patient outcomes fall when nurses care for too many patients: "Each additional patient assigned to a nurse above safe level increases the risk of mortality by 7 percent," she testified, and added that understaffing is driving nurses out of bedside care.
Survey data presented by Beacon Research on behalf of the Massachusetts Nurses Association indicated 78% of registered nurses said hospital quality had worsened in the previous two years, and 67% reported not having enough time to provide patients the care they need. Beacon’s March survey, cited in testimony, also found broad support among nurses (89%) for legislation directing DPH to set statewide maximum patient assignments.
Multiple nurses gave first‑hand accounts of shifts with dangerously high assignments and missing support staff. Michael Robichaud, an ICU nurse, described a shift in which hospital administration floated staff and a heart‑team alert arrived; he said the required one‑to‑one attention for a critically ill patient could not be provided for hours and that existing ICU regulations lack enforcement. Liz Taylor and Molly Donovan, among other bedside nurses, described seeing delayed treatments, patient falls and nursing burnout resulting in departures from bedside care.
Senator Lydia Edwards, a sponsor of the patient safety bill, told the committee the bill differs from past ballot‑ratio proposals because it directs DPH (and the Department of Mental Health for psychiatric settings) to set limits tailored to different units and circumstances rather than legislating a single ratio in statute.
The Massachusetts Association of Behavioral Health Systems opposed extending the bill to psychiatric hospitals and inpatient psychiatric units, saying those facilities already are regulated by the Department of Mental Health and that duplicative regulation could be harmful. The association asked the committee to rely on existing DMH oversight for psychiatric settings.
No formal committee vote was recorded. Witnesses and sponsors urged the committee to hold public hearings and to allow DPH to shape unit‑specific limits and enforcement mechanisms.
