Massachusetts Nurses Association

Prepared by

Opinion Dynamics Corporation

June 2003

The State of Nursing: 2003

Which of the following best describes your current work situation?

Q1

Provide direct patient care outside a hospital setting

Staff nurse providing direct patient care at a teaching hospital

Staff nurse providing direct patient care at a community hospital

Work in health care outside the direct patient care area

I am not currently working but might return to some job at some point

Work at a teaching hospital but do not provide acute care

Work at a community hospital but do not provide direct patient care

Employed, but do not work in the health care area at all

Q2

No68%

Yes32%

Do you currently belong to the Massachusetts Nurses Association?

Q3

How many years have you been working as a nurse?

Q8

What is the most rewarding or positive thing about your current job?

For the patients/Rewarding to help/Care 73%

Staff contact/Team attitude 7

Job/Schedule flexibility 7

Pay 4

Teaching staff/Mentoring 4

Independence/Autonomy 3

Nothing -

Other 4

(Not sure) 2

(Refused) 1

Q9

What is the biggest problem or negative thing you face in doing your

job? Staffing/Short staffing/Shortages 31%

Paperwork/Reimbursement/Insurance 12

Management – lack of respect/support 11

Politics/Staff conflict – peers, physicians 9

Time/Not enough time 7

Workload 6

Bad scheduling/Long hours/Mandatory overtime 5

Pay/Benefits 4

Cutbacks/Financial resources 4

Stress/Too much responsibility 3

Nothing 3

Other 5

(Not sure) 5

Do feel that the amount of paperwork you do on an average shift:

Q10

Not sure

Is a burden but probably can't be reduced safely

Is not really that much of a burden

Is unnecessarily burdensome and could be reduced

No5%

Yes95%

Q11

At any time in your nursing career have you been employed as a staff

nurse providing direct patient care in a hospital setting?

Q63

(Acute care nurses): Have you considered leaving direct patient care

at the bedside?

Q12

What is the reason that you decided to stop practicing direct patient care in a

hospital setting? Short staffed/Too many patients 21%

Better career opportunity/Promotion 20

The long hours/Bad schedule/Mandatory overtime 19

Personal reasons – raise family, home life 12

Wanted different atmosphere/setting 10

Injury/Age/Health reasons 8

Stress level/Burnout 6

Money/Benefits 5

Other 3

(Not sure) 1

(Refused) 2

Q13

What is the reason why you never decided to practice direct patient care

in a hospital setting?

Prefer long term care 31%

Working conditions 23

Not enough experience 15

Other 23

(Not sure) 8

Q20,15,17,19,22,21

Do you agree or disagree with the following statements?

66%

70%

75%

75%

87%

93%

Stronlgy/Somewhat agree

RNs are burned out with high patient loads.

Registered nurses working in hospital units have to care for

too many patients. Managers schedule too few

nurses per shift.

Legal liabilities in case of error are too risky.

Hospital managers float registered nurses without appropriate training and

orientation. Hospital finances are not properly being spent on

patient care.

Q18,16,23,24,14

Do you agree or disagree with the following statements?

54%

58%

60%

62%

65%

Stronlgy/Somewhat agree

Working conditions in hospitals are brutal to

nurses.

Dealing with sick people wears you out after awhile.

Hospital managers assign mandatory overtime instead

of staffing properly. Hospital managers assign

traditional nursing duties to non-nurses instead of hiring

registered nurses. An RN can make more money

in areas other than in acute care.

Q36,32,30,31,39,33

Rate the seriousness of the following problems facing the nursing profession as they relate to

providing health care to patients. Use a scale of "1" meaning "not a problem at all“, to "7"

meaning "a very serious problem".

4.50

4.56

4.68

4.82

5.41

5.77

Mean

Fewer young people are choosing nursing as a career.

The acute care units are understaffed and nurses working

in acute care are forced to care for too many patients.

Registered nurses are too often floated from one unit to another without appropriate training and

orientation. RNs are forced to work mandatory

overtime.

Liability and malpractice lawsuits.

Low pay.

Q38,35,37,40,34

Rate the seriousness of the following problems facing the nursing profession as they relate to

providing health care to patients. Use a scale of "1" meaning "not a problem at all“, to "7"

meaning "a very serious problem".

2.91

3.70

3.83

4.24

4.25

Mean

Managers assign traditional nursing duties to non-nurses instead of

hiring registered nurses.

Managers rarely implement recommendations made by staff

nurses regarding patient care.

Physicians are disrespectful of registered nurses.

Board of Registration does not take an active role in protecting the

public's health.

Workplace violence.

Q41

Which one of the above problems do you think is the most serious problem facing the nursing

profession today?

3%

5%

7%

7%

18%

50%

Fewer young people are choosing nursing as a career.

The acute care units are understaffed and nurses working

in acute care are forced to care for too many patients.

Registered nurses are too often floated from one unit to another without appropriate training and

orientation.

RNs are forced to work mandatory overtime.

Liability and malpractice lawsuits.

Low pay.

Strongly favor70%

Somewhat favor16%

Not sure5%

Somewhat oppose

4%

Strongly oppose5%

Q42

The Massachusetts Legislature is considering a bill that would require hospitals to adequately staff acute care facilities and limit the number of patients an RN would need to care for at one time by setting minimum registered nurse-to-patient ratios. Would you favor or oppose the

Legislature passing such a bill?

86%Favor

Much more likely to consider

42%

Somewhat more likely to consider

23%Wouldn't make a difference

32%

Not sure3%

Q43

(Non acute care nurses): Let's say this safe staffing law was passed by the Legislature and

registered nurses were required to care for fewer patients at once - for example, a 1:2 ratio was the standard in an ICU and 1:4 in Med/Surg. Would you consider taking a job as a staff nurse providing direct patient care in a hospital if such

a law were passed to regulate RN-to-patient ratios?

Q44

What other factor(s) would encourage you to practice direct patient care?

Better hours/Scheduling/No mandatory OT 21%

Better pay/Benefits 21

Retraining back to the workforce 19

Refresher courses 19

More staff/Better patient-nurse ratio 14

If management listened 5

Age/Health 3

Nothing 2

Other 7

(Not sure) 13

(Refused) 2

Q50,51,52,53,45

64%

67%

81%

86%

88%

Yes

Nurses not having enough time to comfort and assist patients

and their families

Nurses not having enough time to educate patients and their

families Patients having to wait for long

periods of time for their medication and medical

procedures The frequency of medical errors, such as improper medication or dosages

Complications or other problems for a patient

Are you aware of any incidents in Massachusetts hospitals that a registered

nurse having to care for too many patients has led to...

Q48,47,46,49

29%

50%

52%

54%

Yes

Re-admission of a patient

Injury or harm to patients

Longer hospital stays

Mortality for patients

Are you aware of any incidents in Massachusetts hospitals that a registered

nurse having to care for too many patients has led to...

7%

24%

69%

Q28

Which of these statements about health care coverage is closer to your

opinion:

Not sure

It is the responsibility of the

government to ensure that every

citizen has access to health care

It is NOT the responsibility of

the government to ensure that every citizen has access

to healthcare

6%

71%

23%

Q29

And which of these is closer to your opinion:

Not sure

The health care system in

Massachusetts has real problems and is in need of a major

overhaul

The health care system in Massachusetts could use some minor changes, but overall it is in pretty good

shape

Q25

Let's talk briefly about health care more generally. Please rate the quality of

health care that you think most hospitals in Massachusetts deliver to patients. Is it:

Q26

Do you think the overall quality of health care in Massachusetts hospitals has

gotten better, worse or stayed the same in the past 5 years?

Q27

Looking towards the future, in 5 years do you expect the overall quality of health

care in Massachusetts to be better, worse or the same as it is now?