For more than two decades nurses have advocated for so-called “nurse-staffing limits” — caps on the number of patients a single nurse in a hospital can be assigned to manage at one time. There have been bills introduced on the federal level, but so far California is the only state to have the nurse-staffing limits in place. The hospital industry bitterly fought the limits in California, and has successfully fought it everywhere else since.
The latest battle for nurse-staffing limits is on the ballot this November in Massachusetts. The $13 million opposition campaign—95 percent of which is funded by the hospital industry—is running ads on all platforms to convince voters that such “rigid government mandates” will spike health care costs, spoil health care quality, raise taxes, and lead to hospital closures. While the Democratic Party of Massachusetts and nearly all elected officials in the state back the measure (except for MA’s Republican governor) — a prominent Democratic consulting firm was hired to lead the “No on Question 1” campaign.
I talked to one of the top nurse researchers in the country about her work studying California’s nurse-patient ratios, and wrote about the fight playing out in Massachusetts.
I didn’t go into this in the piece, but I do think the whole debate over whether to establish nurse-staffing limits shares striking similarities with debates in education for smaller class sizes. Both arguments are pushed by predominately female workers, both are met with skepticism and dismissal by many influential people in healthcare and education who do not work directly with patients or students, and opponents also tend to make similar arguments: it’s expensive, it hinders needed flexibility, and the research evidence is mixed. One major difference for nurses, though, is their arguments are often made in terms of mortality.
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I also published a story today with updates on what’s been going on with Keith Ellison’s race for attorney general. While his campaign has been dogging an allegation made by his ex-girlfriend that he tried to pull her off the bed during an argument in 2016, a far-right news site and the Minneapolis Star Tribune sued the state in September to unseal Ellison’s divorce papers with his ex-wife of 25 years. They claimed the public had the right to review the records in light of the ex-girlfriend’s allegation. Both Keith Ellison and his ex-wife Kim Ellison (who is also an elected official in Minneapolis) protested vehemently to keep the records sealed, as Kim emphasized her ex-husband never abused her but that the records contained extremely private, personal information.
The Ellisons lost their fight in court, and this week the records were unsealed, revealing that Keith himself was the victim of frequent domestic violence during his marriage, as Kim suffered from then-undiagnosed medical issues.
The whole thing has grown extremely ugly, and anti-Muslim bigots have seized on the abuse allegations too. I wrote about the closely-tied race here.
Two and a half weeks till Election Day!
I think it's an excellent comparison between education class-size limits and medical nursing staff-ratio limits. The (neoliberal) politics are very similar - a workforce made of primarily of women (as you note) and people of color, "hinders needed flexibility" meaning giving management/capital the whip hand to order staff around and fire them at will (absolutely no research showing this improves outcomes in either education or health care, to my knowledge). You're also right about the use of "mixed research evidence" as an excuse for not improving working conditions in education and health care. I don't know about medical care, but in education the research evidence on just about any topic is "mixed" at best. There's more evidence in favor of class size reductions improving educational outcomes than many other reforms preferred by neoliberals and economists.