Bad Medicine
It's called the Patient Safety Act.
While technically it's House Bill 2059, the legislation has been assigned the former title to help it win favor with the general public.
After all, who isn't for patient safety? Everyone wants to be safe, right?
But at its heart, the legislation has less to do with patient safety, and more to do with that which makes the world go 'round: money.
In short, nurses want to take more home in their paychecks and hospitals want to keep more of it in their coffers.
The Caregivers
There is no doubt nurses play a critical role in patient care at every hospital. While it may be the doctors that get the glory - and the dramatic network dramas on TV - we know it's the nurses who are watching over newborns in intensive care and the nurses that are consoling families and giving practical advice during medical emergencies.
So, when nurses ask for something, it can be hard to say no.
But in this case, the state legislature must look beyond the rhetoric and recognize that the nurse staffing mandates promised in the Patient Safety Act will only spell further trouble for an already taxed hospital system.
The fact is that state-established nursing staff levels are far too inflexible to be practical. Every patient is different, every registered nurse is different and every hospital is run differently. A small community hospital, like Athol Memorial Hospital, has a very different average patient than St. Vincent Hospital in Worcester. So nursing guidelines that work in Athol are unlikely to translate in Worcester at the bigger institutions.
Caring for the ill is as much an art as it is a science. Trying to turn nursing care into a mathematical equation simply isn't feasible.
The legislation spells out a mind-boggling system of checks and balances that is sure to cause headaches for any hospital department head. Referred to as an "acuity system," the legislation calls for "standardized criteria" that will be used to assign a number to each individual patient based on the patient's condition. Then, the "acuity system" will be used to determine a particular nurse's patient load at any given time.
It sounds like a lot of paperwork waiting to happen, which will likely get in the way of what hospitals are in the business of doing: taking care of sick people.
Hospitals are already one of the most highly regulated businesses we have. Why? Because health care is precious and because hospitals are providing a public service.
But all that regulation has made health care an arch contributor to the Bay State's high cost of living.
We hope the legislature takes into consideration the already high costs of health care in Massachusetts and the financial pressures on hospitals as it votes the legislation down.
We agree with the Massachusetts Nurses Association that patient safety should be a priority. But the real solution to over-taxed nurses requires a much more holistic approach to the problem.
Narrow staffing ratios established by the state will do little to ease the underlying problem, which is that statewide and nationally our health care system needs an overhaul. The state should be in the business of providing a scorecard on the delivery of health care hospitals. Not in micromanaging staff levels.
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