As a practicing OB/GYN physician, I am voting “No” on Question 1 –mandatory nurse/patient ratios.
Nurses are the heart of patient care. They are an effective and adaptive force, continuously compensating for fluctuations in patient numbers and severity of illness. Forcing patient limits would disrupt their ability to act and care compassionately and independently. As part of the medical team, nurses use their clinical experience, judgment, and critical thinking to provide excellent care every shift, every day.
Question 1 would impose rigid mandatory nurse to patient staffing ratios in every licensed hospital in the state. If ratios can’t be met, hospitals will face fines as high as $25,000 per incident per day. An independent analysis by the Massachusetts Health Policy Commission estimates the yearly cost of this ballot could be as high as $949 million dollars.
If passed, it would become effective in less than two months – not enough time for hospitals to hire required extra nursing staff. Many hospitals already face nursing shortages – posted jobs have remained unfilled after months, and in some cases, years.
The scope and breadth of levels of care that hospitals across the state provide would change drastically with the proposed “one size fits all” model. Larger hospitals may be forced to reduce services. Smaller hospitals may have to close, increasing the burden on surviving hospitals.
Hospital admissions could be put on hold when patient numbers exceed the mandates. Imagine your son might have appendicitis and the emergency room is at capacity. Imagine your partner is in labor and the delivery suite is closed. And there is no other place to go.
Nurses are dedicated and passionate members of the healthcare team, and they can be stressed and overworked. These facts must not be laid aside if Question 1 fails. The introduction of Question 1 has brought nursing work issues to robust debate, and regardless of the outcome, hospitals, nurses, and physicians must continue to focus on nursing staffing issues to ensure sane working conditions for nurses and safe and timely care for patients.
Question 1 raises many issues and concerns. But, it is a simplistic approach to a remarkably complex issue that could threaten patient safety. That’s why I believe a “No” vote on Question 1 is important for nurses, patients, and our communities.
James Wang, MD FACOG
Chair –
Massachusetts Section
American College of Obstetrics and Gynecology
Southwick, MA
