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In ICU, 2 patients per nurse

New state rule on staffing is a first for Mass.

A Massachusetts agency approved the state’s first-ever mandate on nurse staffing in hospital intensive care units on Wednesday.

The regulations require hospitals to limit patient assignments so each intensive care nurse is responsible for no more than two patients.

The Health Policy Commission voted unanimously to apply the rules to all ICUs, including special units for burn patients, children, and premature babies.

The vote came after commissioners had raised concerns that neonatal intensive care units in particular are different from adult ICUs and will probably have a harder time complying with the regulations because their patient loads are less predictable.

The Massachusetts Nurses Association, a labor union, initially supported stricter rules that would have in nearly all cases limited ICU nurses to just one patient, but called the regulations a victory because the commission extended them to specialty units.


“Very sick babies will get the care they need.”said David Schildmeier, spokesman for the nurses union.

Timothy F. Gens, executive vice president of the Massachusetts Hospital Association, a trade group for hospitals, called the rules a good compromise.

“Overall, the commission found a thoughtful, patient- focused balance,” Gens said.

Hospitals and nurses unions have long clashed over what constitutes appropriate staffing levels. Unions have pushed for staffing mandates, saying patient care suffers when nurses are burdened with too many patients. Hospitals, however, prefer flexibility in hiring and staffing nurses and other health care workers.

The regulations approved Wednesday are the result of a compromise bill approved by lawmakers last June.

David Seltz, executive director of the Health Policy Commission, said the panel sought to write rules that were fair and put patients first.

“The proposed regulation I believe accomplishes these goals,” he said.

Priyanka Dayal McCluskey can be reached at priyanka.mccluskey
. Follow her on Twitter @priyanka_dayal.