How Should I Vote? (Question 1)

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Massachusetts Question 1, the Nurse-Patient Assignment Limits Initiative, is on the ballot in Massachusetts as an indirect initiated state statute on November 6, 2018.

A yes vote supports establishing patient assignment limits for registered nurses working in hospitals.

A no vote opposes establishing patient assignment limits for registered nurses working in hospitals.

Question 1 was designed to establish patient assignment limits for registered nurses working in hospitals. Limits would be determined by the type of medical unit or patient with whom a nurse is working, and the maximum numbers of patients assigned determined by the limits would apply at all times except during a public health emergency as declared by the state or federal government. The measure would require these patient limits to be met without reducing staff levels, such as service staff, maintenance staff, or clerical staff.

A YES VOTE would limit the number of patients that could be assigned to one registered nurse in hospitals and certain other health care facilities.

A NO VOTE would make no change in current laws relative to patient-to-nurse limits.


https://ballotpedia.org/Massachusetts_Q ... tive_(2018)

Does this also apply to CNAs?

I said “not sure” but I lean toward yes, vote for the limits.

RNs are in short supply everywhere, so it might be tempting to overload the ones an employer has. Especially if the RN is good at their job. And then that would discourage people from going into nursing, because they’d be walking into a draining job. Some nurses might drag their feet, because doing a better job means more work.

My vote no consideration would be that it might limit the amount of patients a place gets to take in, instead of encouraging the place to hire more nurses.

For YES:

The Committee to Ensure Safe Patient Care argued, "When RNs have too many patients to care for, we see a dramatic and dangerous impact on safety and patient outcomes. Study after study shows that there is an absolute need to set a maximum limit on the number of patients that can be assigned to each registered nurse in order to avoid serious complications, mistakes, and preventable readmissions. Recent studies have shown that patients in Massachusetts receive less time with their nurses, resulting in higher rates of complications and readmissions and longer wait times than in California."[14]

For NO:

Amanda Stefancyk Oberlies, CEO of the Organization of Nurse Leaders, stated, "Make no mistake: this proposal threatens the high quality of care we provide patients. It will force many hospitals to reduce critical services and will dramatically increase emergency room wait times. This measure will prevent nurses and doctors from being able to use their best judgment in times of crisis."[15]

For YES:

Kate Norton, a spokesperson for the Committee to Ensure Safe Patient Care, stated, "Outside of ICU, there are no laws or standards in existence for the number of patients assigned to nurses, and there are no requirements for hospitals to provide an adequate level of nursing care in the emergency department, medical-surgical floors, maternity units or psychiatric units. That’s dangerous, pure and simple."[15]

For NO:

Elizabeth Lydstone, a nurse on the Massachusetts Perinatal Team, wrote "We strive to staff according to the AWHONN (Association of Women's Health, Obstetric and Neonatal Nurses) staffing guidelines specific to labor and delivery and all of maternal child health, and in dire situations we need all hands on deck. This law would hinder our ability to navigate a crisis. If we violate the ratios in favor of safety, our organization will be charged a huge fee. Instead of focusing on the needs and acuity of our patients, we would need to be fixated on achieving an arbitrary staffing number dictated by law. Nurses will second-guess themselves when alarms sound; instead of jumping into action, and there may be delays."[25]

Last chance to advise me — I'm going to do the "early voting" thing tomorrow.

You should vote Democratic!

And you should have voted for Hillary.

The first one looks like it would hurt nurses, let them see fewer patients, and reduce their pay.