June 24, 2008 05:42 am To the editor: I don't often find myself agreeing with the editorial opinions of Massachusetts newspapers, but I must say your editorial of June 18 ("Nurse staffing should be hospitals' call") was spot-on! As a RN with many years of real-world experience, I can attest that it's not so much the patient load, but the failure of management to trust the nurse's judgment when it comes to making patient assignments. This failure also extends to nursing unions such as the California and Massachusetts nurse associations since they seem to think that nurses lack the critical thinking skills and training to implement an acuity-based patient assignment system, and thus always push the cookie-cutter system such as California's and the one Massachusetts is attempting to emulate. A recent study from a respected nurse researcher/professor from UC San Francisco revealed that California's much-touted safe patient/nurse ratio law has had little effect on either nurse satisfaction or on the prevention of patient falls and other, similar injuries. The California law has also done little to ameliorate our state's nursing shortage, leaving us at the very bottom of the barrel when it comes to nurses per patient and allegedly causing the closure of numerous hospitals. When the C.N.A. fought to pass this arbitrary approach to patient care, I and many other nurses opposed it, asking instead that our state enforce Title 22, which mandates an acuity-based system. This system makes patient assignments based on severity of a patient's illness, complexity of treatment and nurses' skill sets. Nurses don't treat numbers, we treat people, and for this reason alone I would ask the Massachusetts Legislature to consider encouraging your Department of Public Health to institute an acuity-based system. This puts the patient assignments into the hands of the nurse, not the unions or the bean-counters. GENEVIÈVE M. CLAVREUL, RN, Ph.D. Pasadena, Calif.
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