Television spot uses scientifically inaccurate survey results and cherry-picked data

BOSTON, MA—August 29, 2018— The Massachusetts nurses’ union today released a new campaign advertisement in attempt to sway voters to a Yes vote on Question 1 by using inaccurate and deceptive survey results and misrepresenting scientific studies. The commercial repeatedly states, “86% of nurses are voting yes on Question 1,” without disclosing that this number is taken from a survey conducted by the union prior to Question 1 even being assigned. The commercial also includes a quote from a New England Journal of Medicine study that seems to support Question 1, while the report results were actually inconclusive.

The survey, which had a sample size of 302 nurses, 46 percent of which were union members, was completed in May– long before official numbers were assigned to ballot questions in July. The questions focused on whether nurses were supportive of patient limits, not on the specifics of nurses voting ‘yes’ or ‘no’ on Question 1. The ad repeats “86% of nurses are voting Yes on Question 1,” a number of times, while the bottom of the screen reads “86% of nurses = YES” for the entirety of the ad, a grossly inaccurate representation of their flawed survey aiming to intentionally mislead voters.

“Calling union nurses and asking them whether or not they would like less patients each day is entirely different than polling registered nurses on their likelihood to vote yes or no on a ballot question and all the specifics that come with it,” said Dan Cence, spokesperson for the Coalition to Protect Patient Safety. “To skew the results of this already flawed survey to mislead voters in a statewide commercial is irresponsible, and it should be taken off the air immediately.”

The survey mentioned was entirely paid for and designed by the Massachusetts nurses’ union, which oversampled union nurses by 200 percent. Since its release in May, the union has failed to disclose the margin of error or the wording of the questions, falling below the accepted standards of the American Association for Public Opinion Research (AAPOR).

The Massachusetts nurses’ union represents less than 25 percent of nurses in Massachusetts, yet made up 46 percent of respondents in the survey. Aside from claiming that the “majority of the nurses surveyed are not members of the MNA,” the union has not disclosed any details, and more information on the survey can only be found by requesting them from a union spokesperson, rather than posted online for peer or public review. In a recent standout, they clarified that the number represents nurses “surveyed randomly from the Board of Registration in Nursing who support safe patient limits.”

Deceiving voters further, the advertisement states, “independent scientific studies agree, including the New England Journal of Medicine,” and shows a corresponding graphic of a quote pulled from a study leading a viewer to believe the findings support Question 1. In reality, the 2002 study cited was not solely focused on nurse staffing, and page one of said study states, “research on the relation between the level of staffing by nurses in hospitals and patients’ outcomes has been inconclusive.”

 “There are no scientific studies or reports that demonstrate the effectiveness of government mandated, one-size-fits-all nurse staffing ratio for improving quality of care, patient outcomes or professional nursing practice.” said Donna Glynn, President of the American Nurses Association and a Nurse Scientist for the VA Boston Healthcare System. “In fact, no studies evaluating nurse staffing ratios reported a magic number as the single factor to affect patient outcomes or job satisfaction. This ballot question is ignoring scientific fact around what is best for nursing practice, decision making and quality patient care.”

The Coalition to Protect Patient Safety includes American Nurses Association Massachusetts, the Organization of Nurse Leaders, the Emergency Nurses Association Massachusetts, the Infusion Nurses Society, the Massachusetts Association of Colleges of Nursing, the Academy of Medical-Surgical Nurses’ Greater Boston Chapter, the Western Massachusetts Nursing Collaborative, the Massachusetts Medical Society, the Massachusetts Health and Hospital Association, the Massachusetts Council of Community Hospitals, the Conference of Boston Teaching Hospitals, and other healthcare and business leaders in protecting the state’s health care system and its patients from the consequences of this rigid, costly mandate that is expected to be placed before voters in the November 2018 election.

Learn more about the Coalition to Protect Patient Safety at and


Dan Cence