Vote no on Question 1: Don’t handcuff nurses

Nurses are the unsung heroes of the health care industry. On a daily basis, they attend to the sick, making numerous decisions affecting the quality of life or even the quality of the end of life. Often they work under intense pressure, in desperate situations. To the families of the ill, they can be the ideal conduit of real, pragmatic information as well as angels of compassion. Nurses empower themselves regularly in their application of care for patients. They are closer to the day-to-day suffering than anyone else, and after a while this gives them rare wisdom. It makes them efficient in navigating hospitals rife with bureaucracies and procedural mazes. Patient care is fluid. Care needs vary from patient to patient and from hospital to hospital. A one-size-fits-all approach in staffing ratios is impractical and would be detrimental to hospitals and patients alike. That is why we stand in opposition to ballot Question No. 1. Question 1, as defined by the Secretary of State’s office, “Would limit how many patients could be assigned to each registered nurse in Massachusetts hospitals and certain other health care facilities.” A “Yes” vote would mandate a precise patient-to-nurse ratio, depending on the unit or department. In some cases, there would be a ratio of one patient to each nurse and in others six patients to every nurse, for example. The results would be disastrous in a few ways. Emergency room wait times would surely increase dramatically. As the Herald reported, Tufts Medical Center has opposed Question 1 for that very reason. The hospital said if the mandate passes and limits the number of patients assigned to a nurse, wait times will soar and potentially cause the hospital to turn away patients at emergency room doors. “Question 1 will force us to downsize departments, increase wait times in our emergency room, threaten scheduling of elective surgeries, and cut important health programs that our patients depend on,” said Dianne Anderson RN, CEO and president of Lawrence General Hospital. A “patient” is a very generic description of a person in need of health services. Some patients may be very sick and some may be healthy enough to discharge at any moment. Some require much more attention than others. A rigid mandate on the number of patients a nurse could care for would undoubtedly impact the quality of care some patients would receive. A rigid staffing mandate would also be a budget buster for many hospitals. While the big teaching facilities could probably absorb the costs, community hospitals with smaller budgets would be devastated. It is estimated that to satisfy legal requirements for staffing, thousands of nurses would need to be hired in Massachusetts, though there is a nursing shortage in the Bay State. We believe voters should vote “No” on Question 1. Having cookie-cutter staffing requirements at every single hospital makes no sense. We must respect the judgment of professional nurses who are on the front lines every single day and know where and when staff is needed. Question 1 would levy a $25,000 fine per incident, per day for every violation. The costs of staffing mandates would need to be offset, ultimately by the patients themselves, whether through increased charges or insurance rates. There are no waivers offered in the language of the ballot question so every hospital would be under the gun. Do registered nurses need big, clumsy government to tell them how to do their jobs? No they don’t. “No” on Question 1.