Ballot Question 1 Opinion: Patient Care Should Stay In Our Hands

NEWTON, MA — This opinion piece about Question 1 on the November Massachusetts ballot was written by Kevin Whitney, RN, DNP. Whitney is senior vice president of patient care services & chief nursing officer at Newton-Wellesley Hospital.

Nurse staffing is complex and constantly changing, and appropriate staffing is a critical factor in delivering the high-quality of care we expect for our patients in Massachusetts. As a Registered Nurse and Senior Vice President of Patient Care Services and Chief Nursing Officer at Newton-Wellesley Hospital, I know the amount of time and effort nurses put into determining how to best staff a unit. I am confident that the rigid nurse staffing ratios on the ballot in November will degrade patient safety, decrease access to care and threaten community hospitals across the Commonwealth.

Every day, nurses work together to plan and adjust staffing in response to fluctuating patient volume and the ever-changing needs of our patients. Numerous factors impact staffing decisions, including severity of a patient’s injury or illness and the experience level of the individual nurse. Nurses use their knowledge and clinical judgment to staff safely for their patients. This ballot question takes these complex, clinical decisions out of the hands of nurses and puts them into the hands of the government.

I can see how, at first glance, the ballot initiative sounds like a good idea—everyone wants to support nurses and improve our health care system. Unfortunately, this ballot measure will do just the opposite. The rigid nurse staffing ratios included in the proposed legislation are not practical, and will have long-standing, negative effects on patient care.

The inflexible ratios would need to be enforced 24/7 at all hospitals across the state, no matter the size or needs of the individual hospital. Hospitals will not be able to admit patients if they do not have the government mandated number of nurses, which will lead to reduced access to emergency care, delayed admissions to inpatient units and longer wait times for scheduled surgeries. There are no exceptions to this mandate, even if there is a rapid influx of patients due to an emergency!

For many Massachusetts community hospitals, the passing of this measure will lead to massive cuts in programming, and even closure, due to the incredibly high costs of meeting this mandate. Community health programs and initiatives such as cancer screenings, opioid treatment and prevention, early childhood intervention, domestic violence programs, mental health services and pre- and post-natal care are at stake.

The health care we provide here in Massachusetts is second to none, and that is in large part due to our incredible nurses. At Newton-Wellesley Hospital, our team remains 100 percent committed to appropriate RN staffing not only to meet the needs of our patients, but to support a positive, professional practice environment for our nurses and care providers.

Over the past year, we have adjusted our staffing plans and levels based on feedback from our empowered nursing staff, and in response to the changing patient care needs across the hospital. Approaches to staffing need to be collaborative efforts at each individual hospital across the Commonwealth--not a sweeping nurse staffing mandate decided by the government.

Nursing leaders and direct care nursing staff care deeply for their patients, and proactively work together to share the responsibility of appropriate staffing so that patients can receive the best care possible. Patient safety and quality of care is our profession and should be our responsibility. In November, please leave these decisions up to those who know best and vote NO on Question 1.

- Kevin Whitney is senior vice president of patient care services & chief nursing officer at Newton-Wellesley Hospital.