1. Massachusetts Nurses Association A Statewide Survey of 400 Massachusetts Residents February 2005

2. I am going to read a list of issues facing Massachusetts, please tell me which one you feel is most important – that is, which one is of most concern to you and your family. Increased Concern With Healthcare NowJan. ‘03Jan. ‘02 Healthcare 31% 21% 22% Education202129 Jobs and the Economy192221 Terrorism 7 8 9 Taxes 7 8 9 Fiscal crisis/Balancing the budget 510n/a Crime 4 3 4 Quality of highways and bridges 3 3 2

3. Please tell me whether you think the following people, as a group, do an excellent job, good job, fair job, or a poor job. Registered Nurses Receive Highest Job Rating of Hospital Employees 89% 83% 75% 51%

4. Of the types of hospital employees I just mentioned, which one do you think has the greatest impact on the quality of patient care? Registered Nurses Seen As The Key to Quality Care

5. HMOs/insurance companies only concerned with profits Biggest Hurdles to Improving Quality of Care Please rate the seriousness of each of the following problems related to the quality of patient care on a scale of 1 to 7, where “1” means “not a problem at all” and “7” means “very serious problem”. “Very serious problem” shown (ratings of 6 and 7 combined) Low pay among registered nurses Forced, mandatory overtime for registered nurses Overcrowding and slow care in emergency rooms Hospitals that are only concerned with profits A shortage of nurses Understaffing of registered nurses Cuts in government funding for Medicare and Medicaid Nurses being forced to care for too many patients at once

6. Some people say that the quality of patient care in Massachusetts hospitals is suffering because there are not enough registered nurses working in the hospitals and patients have to share their nurse with too many other patients. Do you agree or disagree? Strong Agreement that the Quality of Care Is Suffering Due To Understaffing Strongly agree Somewhat agree Somewhat disagree Strongly disagree Strongly agree Somewhat agree Somewhat disagree Strongly disagree Now Jan ‘02 77% Agree 76% Agree

7. Sustained High Support For Establishing Minimum Staffing Levels One proposed way to ensure that there are enough registered nurses working in the hospitals is to pass a law saying that acute care patients are entitled to a nurse who is caring for no more than a certain number of patients at the same time. This proposed law is being called An Act Ensuring Patient Safety. Would you favor or oppose passing An Act Ensuring Patient Safety, thereby regulating minimum staffing levels of registered nurses in Massachusetts hospitals? *Slightly different wording Favor Oppose Favor Oppose Now Jan ’02*

8. Support for Minimum Staffing Levels, by Subgroups Would you favor or oppose passing An Act Ensuring Patient Safety, thereby regulating minimum staffing levels of registered nurses in Massachusetts hospitals? FavorOppose All 76% 10 Democrats 79% 4 Independents 78% 9 Republicans 71% 27 18 – 30 76% 8 31 – 45 75% 10 46 – 64 77% 12 65+ 72% 9 Agree care is suffering 83% 6 Disagree 60% 27

9. Better Care Is Biggest Reason for Favoring MNA Proposal Why would you favor this law? (n=303) More personal/better care/patient safety 45% Lower ratio is better19 Nurses are overworked/understaffed11 Agree/good idea/logical7 Will make them hire/encouraging training more nurses 6 Acute care/need more attention5

10. Less Than Half Support Hospital Plan A second proposed way to address the issue of nurse staffing levels in hospitals is to pass a law requiring hospitals to post a nurse staffing plan that has been approved by the hospital board of directors. This law would also require hospitals to report their nurse staffing plan to the Department of Public Health, but it would not set any required staffing levels. Would you favor or oppose passing this legislation that would require hospitals to post and report their nurses staffing plans? Democrats49% Independents45 Republicans56 Agree care suffering49 Disagree48

11. 3-to-1 Support for Regulating Nurse Staffing Levels vs. Posting and Reporting Which proposal do you think is a better approach to addressing the nurse staffing issue? The plan which would regulate staffing levels and set a minimum nurse staffing level 62% The plan which would require hospitals to post a nurse staffing plan, report it to the department of health, but would not set minimum staff levels 21% Democrats68% Independents66 Republicans47 Agree care is suffering67 Disagree53 Democrats19% Independents17 Republicans35 Agree care is suffering20 Disagree25

12. Public Overwhelming Accepts Dueling Proposals As Evidence of a Problem With Current System of Nurse Staffing Do you agree or disagree that since both hospitals and nurses in the state are proposing plans to address nurse staffing levels, there must be some sort of problem with the current system?

13. 2/3 rds Think It Is Time For Legislature to Back Up Nurses’ Judgment Some people say that if the legislature passes legislation regulating nurse staffing levels they will be substituting political judgment for professional judgment. Other people say that nurses have been fighting to have their opinion heard and haven’t gotten anywhere against insurance companies and hospital administrators who control the money? Do you think… It is time for the legislature to back up the nurses’ judgment 66% Legislature should keep its hands off the kinds of medical decisions that involve staffing 25% Democrats73% Independents62 Republicans58

14. Public More Likely to Vote for Candidate Who Supports Minimum Nurse Staffing Levels All else being equal between two candidates for state legislature, would you be more likely to vote for a candidate who supports regulating minimum nurse staffing levels, or would you be more likely to support a candidate who opposes regulating minimum nurse staffing levels? Democrats87% Independents77 Republicans51

15. Nearly 3/4 ths Say They Would Vote Yes on a Ballot Initiative Let’s say the Legislature does not pass legislation regulating minimum nurse staffing levels. If in November 2006, there were a ballot question that asked voters to enact a law regulating minimum nurse staffing levels at the ballot box, would you personally vote yes or no?