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What do nurses think about proposed government-mandated staffing ratios?

September 09, 2018
nicole bmc nurse

This November, Massachusetts voters will decide whether or not to impose government-mandated nurse staffing ratios in every hospital across the state. Many nurses oppose the ballot initiative, which, if passed, would cause nurses to lose flexibility and care for fewer patients. Learn more.

Hear what Baystate Health nurses are saying

Patient Safety

“As a nurse I have voice to advocate for my patients. A yes on Question 1 is taking my educated voice away, and allowing the government to control nursing judgment. Patient safety is a priority to me; a yes will cause longer emergency room wait time and hospital closings, ultimately harming patients. Nurses, patients, hospitals and communities will absolutely be affected by this and if it goes through we won’t be able to change it back; this scares me as a nurse and a potential patient,” Brittany Foley, RN, said.

“Our nursing assignments are based on individual patient needs — to put a mandate on how many patients each nurse can care for would affect the quality of care we would be able to provide. I am confident that these ratios would be the wrong choice for nurses,” Pamela Zaranek-Kuhn, RN, agreed.

Laura Bolella, RN, said the MNA ballot would make it harder for nurses to care for their patients.

“If this question passed before last year’s flu season, it would have been catastrophic. We cannot put up a “Closed, come back tomorrow” sign on our hospital doors,” Bolella said.

Importance of Autonomy 

“I am against Question 1 for many reasons. The one that stands out the most is that Question 1 decreases a nurse’s autonomy to make decisions regarding assignments. Autonomy is something nurses have fought long and hard for, and strengthens our ability to provide quality, patient centered care. We, as nurses, know what we can handle, or what is appropriate, for a patient assignment. Some days six patients is a breeze. Other days four is appropriate. Assignments are not a black and white issue based on the unit a patient is assigned to, as Question 1 makes it seem.” Sarah Freeman, RN, said. 

“Acuity is the key! Other factors to be considered include the nurse’s skill level, what’s happening on the unit, potential discharges and admissions, etc. None of these are taken into consideration in Question 1. What about covering each other’s breaks, or watching an assignment so a nurse can take a patient to a procedure? Or a nurse taking one more patient so their coworker can focus on another patient who needs a higher level of care and is waiting for a bed?” she continued. “These simple acts of teamwork will bring forth a steep penalty to the facility. Nurses know how to assess the floor, make assignments, and work together to provide quality, patient-centered care. Nursing is a highly respected and trusted profession, where nurses are currently empowered to make educated decisions regarding assignments. Question 1 will take that power away, and that’s not something I’m willing to vote for.”

Nicole, a nurse at Baystate Medical Center, talks about how the proposed mandated staffing ratios would affect Baystate Health services and staff, patients, nurses, and the public.