NORTHAMPTON — A ballot measure calling for limits on how many patients can be assigned to one nurse in a hospital generated sustained and sometimes heated debate at a public forum Monday.
About 85 people packed into a meeting room at Pathways CoHousing in Florence on Monday evening to hear speakers talk about the state’s three ballot questions. The event was hosted by Indivisible Northampton, a local chapter of the national progressive group Indivisible.
Question 2 asks whether the state should form a commission to suggest an amendment to repeal Citizens United v. FEC, a Supreme Court decision that allows unlimited campaign spending from corporations and unions. Question 3 considers whether to keep in place a 2016 state law that protects transgender people from discrimination in public places.
But the bulk of the meeting centered around a heated debate over Question 1, on nurse staffing. The Massachusetts Nurses Association (MNA), a union with more than 23,000 members, is pushing for the ballot measure to pass. Kim O’Connor, who has been a nurse for 40 years and is chairwoman of the Cooley Dickinson Hospital MNA bargaining unit, and Patti Healy, a retired nurse and associate MNA member, spoke in favor of the measure.
Speaking against Question 1 were Kevin Lake, a Cooley Dickinson Health Care board of trustees member, and Margaret-Ann Azzaro, director of Medical Surgical & Childbirth Services at Cooley Dickinson Hospital. Debby Pastrich-Klemer, events coordinator for Indivisible Northampton, moderated the discussion.
“First of all, we want you to know that there should be limits. This law would put them in place,” said O’Connor, the longtime nurse. She cited a recent survey of nurses commissioned by the MNA and conducted by a separate research firm. In this poll of roughly 300 people, about half of whom were not MNA members, the majority said nurses were responsible for too many patients, and 86 percent said they would vote “yes” on the measure.
Adding nurses to hospitals is a great idea, Azzaro said, but she sees the ballot question as more complicated than that.
“There’s a $25,000 fine every time, every day, every unit, every nurse that you are short, she said. “Where the $25,000 goes, I don’t know. It will create an ethical dilemma for our nurses.”
O’Connor and Healy noted that it’s illegal to turn patients away from emergency rooms under the Emergency Medical Treatment & Labor Act.
“But,” Lake argued, “you can keep them waiting in the waiting room.”
Money was a point of controversy. When asked by the moderator how hospitals will come up with the money to hire more nurses, Healy didn’t think it would be a major issue, saying that hospitals have plenty of money. Baystate Health, for example, made $70.6 million more than its expenses in 2017, and Partners Health Care, which Cooley Dickinson Health Care is a part of, made $659 million more, according to a report from the Center for Health Information and Analysis, a state agency.
“This industry is a corporate industry,” Healy said.
The two sides strongly disagreed on issues of staffing.
Azzaro anticipated finding more nurses would be one of the hardest consequences if the bill passes.
“I don’t think we will find them,” she said. “So I think what we’re going to have to do is cut back on the amount of patients that we can take care of.”
Lake said additional nurses will have to come from places like community health centers, nursing homes and clinics — which could end up hurting low-income people.
“We think as progressive people, ‘Oh this is in favor of nurses,’ it’s got to be good,” he said. “This is going to restrict access, because you’re going to take the nurses away from other places. A lot of poor and marginalized people don’t get their care from high-priced doctors … they get it from these kind of clinics and from the emergency room which is also going to back up.”
That’s not how O’Connor and Healy see it. They said there is no nurse shortage in the state; there are just a lot of nurses choosing to not work in hospitals.
“Part of the retention issue is that we can’t keep nurses on the medical floor because the work is above what they feel safe doing … Let’s be honest here: Nurses go without lunch, they stay overtime, they’re working tirelessly, they go home in tears,” O’Connor said.
The debate grew more heated as the night went on. At one point, someone from the crowd shouted out to Lake, “Have you ever taken care of a patient?” Lake said no; he’s not a medical provider.
The discussion left some listeners unsure of how they would vote on Question 1 in November.
Shel Horowitz, who lives in Hadley and works as a consultant to social change and green businesses, came into the meeting specifically to get more information on Question 1.
“I found myself more confused than ever,” he said after the debate.
Joanna Rush Wilpan, of Northampton, also plans to do more reading before making a decision.
“I haven’t gone deeply enough into the issues,” she said.
She came in thinking she would vote yes on Question 1. “My intuition is nurses know best,” she said.
Now she’s undecided.
Greta Jochem can be reached at gjochem@gazettenet.com.