Massachusetts Nurses Association

A Statewide Survey of 400 Massachusetts Residents

February 2005

I am going to read a list of issues facing Massachusetts, please tell me which one you feel is most important – that is, which one is of most concern to you and

your family.

Increased Concern With Healthcare

Now Jan. ‘03 Jan. ‘02

Healthcare 31% 21% 22%

Education 20 21 29

Jobs and the Economy 19 22 21

Terrorism 7 8 9

Taxes 7 8 9

Fiscal crisis/Balancing the budget 5 10 n/a

Crime 4 3 4

Quality of highways and bridges 3 3 2

Please tell me whether you think the following people, as a group, do an excellent job, good job, fair job, or a poor job.

10% 41%

23% 52%

24% 59%

32% 51%

44% 45%

Hospital administrators

Nurses' aides

Technicians

Doctors

Registered nurses

Excellent Good

Registered Nurses Receive Highest Job Rating of Hospital Employees

89%

83%

83%

75%

51%

2%

3%

8%

23%

61%

Technicians

Hospital administrators

Nurses' aides

Doctors

Registered nurses

Of the types of hospital employees I just mentioned, which one do you think has the greatest impact on the quality of patient care?

Registered Nurses Seen As The Key to Quality Care

38%

56%

61%

62%

64%

64%

68%

71%

74%HMOs/insurance companies only concerned with profits

Biggest Hurdles to Improving Quality of CarePlease rate the seriousness of each of the following problems related to the quality of patient care on a scale of 1 to 7, where “1” means “not a problem at all” and

“7” means “very serious problem”.

“Very serious problem” shown (ratings of 6 and 7 combined)

Low pay among registered nurses

Forced, mandatory overtime for registered nurses

Overcrowding and slow care in emergency rooms

Hospitals that are only concerned with profits

A shortage of nurses

Understaffing of registered nurses

Cuts in government funding for Medicare and Medicaid

Nurses being forced to care for too many patients at once

5%

10%

27%

49%

4%

8%

21%

56%

Some people say that the quality of patient care in Massachusetts hospitals is suffering because there are not enough registered nurses working in the hospitals

and patients have to share their nurse with too many other patients. Do you agree or disagree?

Strong Agreement that the Quality of Care Is Suffering Due To Understaffing

Strongly agree

Somewhat agree

Somewhat disagree

Strongly disagree

Strongly agree

Somewhat agree

Somewhat disagree

Strongly disagree

Now

Jan ‘02

77% Agree

76% Agree

14%

77%

10%

76%

Sustained High Support For Establishing Minimum Staffing Levels

One proposed way to ensure that there are enough registered nurses working in the hospitals is to pass a law saying that acute care patients are entitled to a nurse who is

caring for no more than a certain number of patients at the same time. This proposed law is being called An Act Ensuring Patient Safety. Would you favor or oppose passing An Act Ensuring Patient Safety, thereby regulating minimum staffing levels of registered nurses

in Massachusetts hospitals?

*Slightly different wording

Favor

Oppose

Favor

Oppose

Now

Jan ’02*

Support for Minimum Staffing Levels, by Subgroups

Would you favor or oppose passing An Act Ensuring Patient Safety, thereby regulating minimum staffing levels of registered nurses in Massachusetts hospitals?

Favor Oppose

All 76% 10

Democrats 79% 4

Independents 78% 9

Republicans 71% 27

18 – 30 76% 8

31 – 45 75% 10

46 – 64 77% 12

65+ 72% 9

Agree care is suffering 83% 6

Disagree 60% 27

Better Care Is Biggest Reason for Favoring MNA Proposal

Why would you favor this law?(n=303)

More personal/better care/patient safety 45%

Lower ratio is better 19

Nurses are overworked/understaffed 11

Agree/good idea/logical 7

Will make them hire/encouraging training more nurses

6

Acute care/need more attention 5

Oppose30%

Not sure23%

Favor48%

Less Than Half Support Hospital Plan

A second proposed way to address the issue of nurse staffing levels in hospitals is to pass a law requiring hospitals to post a nurse staffing plan that has been approved by the hospital board of directors. This law would also require hospitals to report their

nurse staffing plan to the Department of Public Health, but it would not set any required staffing levels. Would you favor or oppose passing this legislation that

would require hospitals to post and report their nurses staffing plans?

Democrats 49%Independents 45Republicans 56

Agree care suffering 49Disagree 48

Neither6%

Not sure11%

3-to-1 Support for Regulating Nurse Staffing Levels vs. Posting and Reporting

Which proposal do you think is a better approach to addressing the nurse staffing issue?

The plan which would regulate staffing levels and set a minimum

nurse staffing level62% The plan which would require

hospitals to post a nurse staffing plan, report it to the department of health,

but would not set minimum staff levels21%

Democrats 68%Independents 66Republicans 47

Agree care is suffering 67Disagree 53

Democrats 19%Independents 17Republicans 35

Agree care is suffering 20Disagree 25

Disagree6%

Not sure5%

Agree89%

Public Overwhelming Accepts Dueling Proposals As Evidence of a Problem With

Current System of Nurse Staffing

Do you agree or disagree that since both hospitals and nurses in the state are proposing plans to address nurse staffing levels, there must be some

sort of problem with the current system?

Not sure10%

2/3rds Think It Is Time For Legislature to Back Up Nurses’ Judgment

Some people say that if the legislature passes legislation regulating nurse staffing levels they will be substituting political judgment for professional judgment. Other people say that nurses have been fighting to have their opinion heard and haven’t gotten anywhere against insurance companies and hospital administrators who control the money? Do

you think…

It is time for the legislature to back up the nurses’ judgment

66%

Legislature should keep its hands off the kinds of

medical decisions that involve staffing

25%

Democrats 73%Independents 62Republicans 58

Candidate who opposes

12%No difference/ Refused

13%

Candidate who supports

75%

Public More Likely to Vote for Candidate Who Supports Minimum Nurse Staffing Levels

All else being equal between two candidates for state legislature, would you be more likely to vote for a candidate who supports regulating minimum nurse

staffing levels, or would you be more likely to support a candidate who opposes regulating minimum nurse staffing levels?

Democrats 87%Independents 77Republicans 51

Probably yes21%

Probably no5%

Definitely no11%

Not sure11%

Definitely yes52%

Nearly 3/4ths Say They Would Vote Yes on a Ballot Initiative

Let’s say the Legislature does not pass legislation regulating minimum nurse staffing levels. If in November 2006, there were a ballot question that asked voters to enact a law regulating minimum nurse staffing levels at the

ballot box, would you personally vote yes or no?