A newly released survey reveals 78% of Massachusetts registered nurses believe hospital care quality has worsened over the past two years, with unsafe staffing conditions continuing to drive nurses away from bedside care despite a growing nursing workforce in the state.
The 2025 State of Nursing in Massachusetts survey, conducted by Beacon Research for the Massachusetts Nurses Association (MNA), gathered responses from more than 500 registered nurses across the Commonwealth, painting a concerning picture of hospital conditions that affect both patient safety and healthcare worker retention.
“Post-pandemic, nurses are experiencing acute problems with the Massachusetts healthcare system – unsafe staffing, workplace violence, and care access – that have grown worse, threatening patient safety and the health of the nursing profession,” said Katie Murphy, MNA President and practicing ICU nurse.
Patient care concerns escalate
The survey found 67% of nurses report not having enough time to provide patients with necessary care and attention—a 22-point increase from pre-pandemic levels. Nearly half of respondents (49%) worry weekly that unsafe staffing conditions could jeopardize their nursing licenses.
Most concerning for patients and families, 37% of nurses indicated they would not feel safe admitting their own family member to the unit where they work.
Workplace violence emerges as growing threat
Healthcare violence has increased dramatically, with 69% of nurses reporting workplace violence and abuse as a serious problem—up five points from last year and 27 points since 2021. Among nurses working in direct care teaching hospitals, that number rises to 83%.
Nearly a quarter of all nurses surveyed (23%) say they do not feel safe in their workplace, with that figure increasing to 34% among teaching hospital nurses.
Despite 70% of nurses experiencing at least one incident of violence or abuse in the past two years, 64% received no support from management afterward—a six-point increase over last year.
Staffing issues drive exodus from bedside care
The survey challenges the narrative of a nursing shortage, instead pointing to working conditions driving nurses from bedside roles. While Massachusetts has increased its nursing workforce by 24% in recent years, 36% of surveyed nurses plan to leave the profession earlier than expected—rising to 50% among those with less than five years of experience.
Among nurses planning to leave, top reasons cited include burnout (27%), poor working conditions (26%), and unsafe staffing (16%). For those who previously worked in hospital settings, unsafe staffing was the primary reason for departure (24%).
Nurses seek concrete solutions
An overwhelming 89% of nurses support proposed safe patient limits legislation that would establish regulations on nurse-to-patient ratios. Additionally, nurses identified higher salaries (53%), improved time-off benefits (41%), and increased ancillary staff (40%) as key factors that would keep them in the workforce.
“Until we ensure that nurses can provide safe patient care without burning out and suffering moral injury, nurses will continue to flee the bedside,” said Murphy.
The survey also revealed significant distrust between nurses and leadership, with 71% not trusting their employers to keep promises and 64% dissatisfied with their ability to influence workplace decisions. Among non-union nurses, 54% would vote to unionize if given the opportunity.
As hospital systems continue addressing workforce challenges, this latest survey suggests that solutions focused solely on recruitment without addressing systemic workplace issues may fall short of resolving the healthcare staffing crisis facing Massachusetts.
