The Lowdown on Ballot Question 1

By: Bradley Corn (Correspondent)

Proponents of Question 1 say that nurses can’t handle the number of patients they are given. Opponents of Question 1 say if this passes, waiting times will go up in hospitals and will negatively affect patient care.

Nurse and wellness teacher Ms. Barbara Munden says she agrees with points on both sides. “I actually agree with some of the points made by both sides. I’ve spoken with my colleagues who are still bedside nurses and the vast majority of them are in favor of “Safe Patient Limits” (Ballot Question 1) because they feel the acuity level of patients is higher than it used to be and staffing is often not adequate. When staffing is inadequate, patients suffer.”

“One of the several reasons I personally left hospital nursing was because I often felt overextended. I worked 12-hour night shifts and most nights I would have zero breaks…no time to eat or do anything but patient care…and I would still go home 1-2 hours later than my shift ended feeling like I wasn’t able to administer the quality of care to my patients that I would have liked. For that reason, I understand the need to have a plan that limits the number of patients a nurse can care for at any given time,” Munden said, as she often felt exhausted at the end of her shifts.

Munden also says she has also spoken to friends who are in nurse management at major Boston hospitals. “Those that I have spoken to are all against Ballot Question 1 because of the rigid mandates that they see in the law and the potential costs. They fear that beds, and potentially even some community hospitals, may need to be closed.”

“The studies I have seen show that the impact would vary greatly hospital-to-hospital and no one really knows the true cost (a wide range of estimates have been given). In California, they also had fears about the implementation causing closure of beds and hospitals but that did not happen. They passed a similar bill that went into effect in 2004,” Munden added.

Munden says she wished they would have given the bill more time before it was implemented. “I would rather see more time before full implementation of the bill instead of by January 1st.  In California, hospitals were given much more time to become in compliance with the law.”

“I share the concern that opponents have expressed about potential loss of beds in some specialty areas that do not generate as much income for hospitals, particularly in the mental health and substance abuse areas because we cannot afford to lose any beds in those specialties. I’m not convinced that this would definitely happen but I’m not sure I want to take that risk,” Munden added.       

Registered Nurse Evelyn Finn says she has been asked by many people about ballot question because they are getting bombarded with a lot of confusing statements. “Nurses, the people that take care of us when we go to a hospital, wrote this ballot initiative. They looked at the decades worth of research that show (even though it is common sense) that more nurses equal better care, they looked at recommendations from different professional nursing organizations, and they drew on their combined centuries worth of personal knowledge and judgment and wrote question 1.”

“For 20 years nurses have been trying to get this passed in the legislature, however, the hospital executives and their association have spent 10s of millions of dollars lobbying to oppose it. Just like they lobby to oppose workplace violence legislation (despite nurses being assaulted more than any other profession) and safe patient handling legislation (despite the fact the average nurse lifts the equivalent of a baby elephant in an average shift),” said Finn.

Finn also compares the Number 1 ballot vote to the California safe limits law passed in 2004. “Patients in CA now have 3.5 more hours with their nurses than MA patients. Nurse turnover, burnout, and injuries decreased. Nurse pay increased (not decreased as some wrote). We rank 48th out of 50 for ER waits. CA has 47% shorter ER waits than we do. Their health care premiums are lower than ours. And again, most importantly CA patients are safer  and receive better care.”

If the ballot gets passed, it will implement a drastic change in patient care for everyone and limit the number of patients that nurses encounter every day, but might increase wait times for influxes of patients.

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