I will be voting no on Ballot Question 1 this November. While the goals of the ballot initiative are noble, the method is flawed in a way that would be incredibly harmful to patients and community hospitals. With rigid ratios, new patients arriving to Emergency Departments would wait to be seen if staff were already “maxed out.” During high volume times in Emergency Departments, nurses would have to choose between making new patients wait or subjecting the hospital to a possible $25,000 fine for each violation of the ratio.
The nurses I work with are incredibly committed to providing the best possible patient care regardless of sometimes chaotic conditions. It is unthinkable that they could be put in a position of choosing between caring for a sick patient or incurring a costly fine for the hospital. The ballot question prohibits hospitals from altering the levels of other staff to afford the expense of meeting the ratios, essentially creating an unfunded mandate. Beyond the rigid ratios and inability to be nimble with other staffing, the eight-week implementation time frame is unrealistic.
I cannot fathom how Massachusetts hospitals would be able to find 5,000 additional nurses in a short period of time. Clinics, schools and local health centers will struggle to find nurses to serve their patients as hospitals would recruit more aggressively from these other community organizations. The MNA union, and primary backer of this ballot question, represents only 25% of nurses in this state. My hospital is staffed by nurses who are members of the MNA, and most of the nurses I have spoken with are also voting “no.”
There is no one I know or work with who does not feel that having a full complement of nursing staff is important for good patient care, but this ballot question does not accomplish that goal. It is an unfunded mandate with no clear evidence to support any improvements in patient care that will harm communities and their local hospitals. It didn’t help patients in California, and it won’t help here. Please join me in voting “no” on Question 1.
Khama Ennis, MD, MPH, FACEP
Northampton