Question One

by Isaac Word

photography courtesy of Pexels

At some point in life, people will inevitably find themselves at a hospital. In Massachusetts, you might find yourself at a hospital with overworked and fatigued nurses. With the midterm elections just around the corner, the ballot initiative dubbed ‘Yes on 1,’ also known as the Patient Safety Act, Massachusetts voters will hopefully flood to the polls after and use their chance to have their opinions heard via their ballots.

A nurse’s union, endorsed by the Massachusetts Nursing Association, is urging these people to vote in favor of their proposed law that will limit patient-to-nurse ratios in hospitals.

If passed, the law will limit the number of patients that a nurse can attend to at a time in all hospital units in the state. These specific number vary according to the type of unit and level of care, which are major factors that these nurses claim are being overlooked when they are assigned patients. The overburdened nurses insist that not having a limit affects the quality of care, which can lead to potential infection or other complications.

“Every time you add another patient to your workload, you miss things,” Marlena Pellegrino, a union official and a nurse at Saint Vincent Hospital in Worcester for the past 31 years, told the Boston Globe. “Things fall through the cracks.”

Nurses are only human, and like all other humans, we can all get overworked by our employers. Many parents would consider having to take care of their own triplets to be more draining than if they had a single infant, and this is exactly what mother-baby nurses are being forced to do—except they have no limit.

Those opposing the possible legislation fail to take this into consideration and instead argue that it will hurt hospitals financially.

“There are no scientific studies or reports that demonstrate the effectiveness of government mandated, one-size-fits-all nurse staffing ratio for improving quality of care, patient outcomes or professional nursing practice,” said Donna Glynn, the president of the American Nurses Association of Massachusetts.

While Glynn claims that there is a lack of evidence to support Question 1, the Massachusetts Nurses Association begs to differ. The MNA has conducted many surveys which show how detrimental overloading these nurses can be.

In the spring of 2018, the Committee to Ensure Safe Patient Care distributed surveys to registered nurses in the Commonwealth. This survey shows just how alarming the recent effects of nurses being assigned too many patients has been. The results are as follows from the MNA website: 64% of RNs report injury and harm to patients due to understaffing—up from 46% in 2014. Also, 77% of RNs report medication errors due to unsafe patient assignments—up from 57% in 2014—and 90% of RNs report that they don't have the time to properly comfort and care for patients and families due to unsafe patient assignments—up from 82% in 2014.

Unsurprisingly, on that same survey, 86% of the nurses reported that they plan to vote yes for the Patient Safety Act.

Steve Walsh, the president of the Massachusetts Health & Hospital Association, claims that hospitals would have to hire about 4,500 new nurses, which would apparently lead to an $880 million cost increase. Union representatives are challenging this and claiming that the calculations are inaccurate.

“Hospitals can afford this, there is no question about that,” said Kate Norton, VP of CK Strategies, the consulting firm running the union’s ballot campaign.

Even if the cost of this policy is as high as Walsh claims, can we truly put a dollar value on a patient’s life? These nurses are not industrial machines that can effortlessly attend to 10 or more patients at a time. If these hospitals continue to push their nurses beyond what they can handle, not only will the patients’ health suffer the consequences, but so will their staffing.

This particular union has been rallying for patient-to-nurse limits for nearly two decades. This has included multiple strikes, protests and even a walkout by 1,200 nurses at Tufts Medical Center last summer, which illustrates the greatest threat to a lack of a limit: nursing burnout.

While the patient’s well-being is the top priority of nurses, a hospital needs to have satisfied nurses so that they are able to fulfil this goal. Without passing this legislation, Massachusetts hospitals will likely face the even greater costs of extreme understaffing. What are hospitals doing to stop them from being forced to quit in search of better working conditions?

I know this to be the case because this is precisely what I saw unravel in my own life. My mom, a registered nurse, decided to leave her job for a better, more feasible future last year when offered better pay as well as more hours at a Mississippi hospital. Not only did she have the opportunity to relocate permanently, but she also had several travel nursing agencies reach out to her. These typically require 12-16-week commitments across the country and, though this is not long-term, could have drastic effects on staffing at Massachusetts hospitals if these distressed nurses choose to follow the same path.

Ultimately, this issue lies in voters’ hands. Just remember that if you find yourself in a local hospital one day, no matter the reason, your vote is likely affecting the attitude and performance of your nurse.