By Cynthia Mccormick
Cape Cod Online

September 20, 2011

HYANNIS — Massachusetts hospitals need more nurses, not more nurses working overtime, health care advocates said Monday at a press conference near Cape Cod Hospital.

The press conference at noon on Park Street was one of five held concurrently across the state by the Massachusetts Nurses Association and the Coalition to Protect Massachusetts Patients to rally support for legislation on nurse staffing levels in acute-care hospitals.

The joint committee on public health is holding a hearing on the two nurse staffing bills today at the Statehouse.

The Patient Safety Act calls upon the Massachusetts Department of Public Health to set safe limits on the number of hospital patients a nurse cares for at one time.

The other bill prohibits hospitals from forcing nurses to work mandatory overtime to deal with staffing shortages.

Patients suffer when there are not enough nurses on the floor, said Shannon Sherman, a registered nurse at Cape Cod Hospital.

A nurse in an understaffed unit could have one patient in respiratory distress at the same time as another needing to use the bathroom and a third requiring pain medication, she said.

"Often what would happen is I have two or three call bells going on at one time," Sherman said. She's been a nurse at Cape Cod Hospital for more than 10 years.

In 2010, almost every hospital in Massachusetts ran a surplus, including Cape Cod Healthcare, former Falmouth Hospital vice president Alec Ziss of Falmouth said Monday.

He is a member of Health Care for All's consumer quality council. Cape Cod Healthcare is the parent company of both Cape Cod and Falmouth hospitals.

"There's enough to hire more nurses," he said. "The nurses should be fresh enough to perform all tasks."

This summer's three-year contract for registered nurses at Cape Cod and Falmouth hospitals limits mandatory overtime shifts to no more than three per quarter, or 12 per year.

The tracking of overtime shifts just started, Sherman said. She said that over the busy summer months nurses frequently worked double shifts of 16 hours.

Even though Cape Cod Healthcare is making headway on forced overtime, Sherman said she would like to see a state law prohibiting nurses from working more than 12 hours in a given shift or more than 16 hours in a 24-hour period.

That would eliminate the hassle of getting protections included in individual contract language, and of having to handle transgressions via the grievance process, Sherman said.

Hospital officials oppose the proposed legislation.

"Effective patient care has to be based on the individual needs of each patient, which could change hour to hour or even minute to minute," Cape Cod Healthcare spokeswoman Robin Lord said. "Flexibility is really the key. Nurse managers need to be able to use the resources in the best way for their unit."

The Massachusetts Hospital Association opposes what MHA president and CEO Lynn Nicholas calls "one-size-fits-all" mandates for hospital staffing.

"Innovation, flexibility, transparency, and accountability will bring us to where patients and policymakers want health care to go, but government-mandated staffing" takes nursing in the wrong direction, she wrote in an email.