Many people have asked me, because I???m a nurse, about Question 1??and are getting bombarded with a lot of confusing statements.
Here is some info that may answer your questions because I want you to be informed to make an educated decision.
Nurses, the people that take care of us when we go into a hospital, wrote this ballot initiative.
They looked at the decades worth of research that shows (even though its common sense) that more nurses equals better care, they looked at the recommendations from different professional nursing organizations, and they drew on their combined centuries worth of personal knowledge and judgement and wrote Question 1.
For 20 years nurses have been trying to get this passed in the legislature, however the hospital executives and their associations 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.
California passed their safe limits law 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 I saw someone wrote).
We rank 48th out of 50 for ER waits. CA has 47% shorter ER waits than we do.
Their healthcare premiums are lower than ours. And again, most importantly, CA patients are safer and receive better care.
Is this ???one size fits all???? No. Nurses wrote this and nurses know all patients are different. So the law sets different limits in different units and specialty areas.
Is this a rigid mandate? No. Again, nurses wrote this and nurses know that patients conditions change. So this initiative stipulates that each hospital in each unit must develop a tool to measure the sickness (or acuity) of each patient.
So that a nurse can asses a patients condition and have the control and flexibility to make sure that patient can receive more individual care if they need it.
Remember these limits are a ceiling, not a floor.
Hospitals can always go below them.
Will patients be turned away or have to wait longer? No. Patients can not be turned away and ambulances can???t be diverted in MA. Wait times will DECREASE, not increase.
How? Because there will be more nurses in the ER and also on the floors. So the ER nurses can see patients faster, patients who need to be admitted will be able to go to a bed upstairs quicker because the hospitals will not have to close beds since they decided they weren???t going to put enough nurses on. And, nurses will be able to discharge patients safer and faster, opening those beds up for admissions and transfers.??
Is this really a problem? Right now, nurses have no say in staffing. If they feel a patient is too sick and should get more care or they need help and ask for it, they are most often told ???do the best you can, that???s just the way it is.???
This is dangerous and just plain wrong because it dismisses the nurse???s clinical judgment and doesn???t provide patients with the care they need and deserve.
This initiative empowers nurses, the ones who actually do the patient care.
Will hospitals be fined???
No fine mentioned in this initiative is automatic. If a potential violation is reported to the Health Policy commission will have the power to investigate. If they deem there was a violation they???ll inform the hospital who will have to submit a plan to fix the problem.
If the hospital continues to violate the law, the Health Policy Commission can refer the violation to the Attorney General who can choose to seek a fine in an amount from $0 up to $25,000.
Will hospitals fire non-RN staff? Hospital executives are certainly threatening that they will. But again, this was written by nurses and nurses know that healthcare is a team sport. So they wrote in protections for all non-RN staff.
They cannot fire/layoff any member of the healthcare team to meet the RN limits.
Is there time to implement this? Yes! The law will go into effect on 1/1/19.
Like all laws and initiatives, there will then be a lengthy regulatory process and the hospitals are well aware of this. This process will likely take at least 1.5-2 years. There will be ample time for every hospital to come into compliance.??
But are there enough nurses/isn???t there a shortage?
MA is one of two states (South Dakota is the other) that does not have a nursing shortage. We graduate nearly 3000 new RNs every year. We have the most nurses working part time and per diem of any state. Giving these part time nurses full time hours will, alone, create nearly 2000 new ???full time??? positions. There are plenty of nurses.
But hospitals say they can???t hire enough nurses right now?
It???s not that they can???t, they won???t.
New nurses apply for jobs and don???t get hired. They offer very few full time positions (so as to not pay benefits, much like many corporations do these days) and nurses don???t want them. And nurses don???t want to work in the unsafe current conditions.
The average new grad only lasts 3 years at the bedside (when they can even get hired) because of safety issues and burnout.????
Aren???t nurses divided on this? No. Nurses want this. But hospital executives are running a well funded and deceptive campaign to make it look like this is a nurse vs. nurse issue. Really this is nurses vs. hospital executives. The MA Health and Hospital Association is financing the ???No??? campaign and are on pace to spend more money than the casino industry did on their ballot campaign a few years ago.
Yet they claim they can???t afford safe staffing. If they just invested that money in patient care, this wouldn???t even be on the ballot.
I think that covers everything. I know this is long but it???s worth your time to read. This effects all of us. We???ll all be patients one day.
It???s really a matter of trust.
Do you trust the nurses, the ones who do their best to give you the best care they can despite being stretched to the breaking point? Or do you trust the hospital executives who only care about the bottom line?
#Yeson1
Evelyn Finn