Bad bed shape in Massachusetts
Bad bed shape in Massachusetts
Massachusetts has some of the best medical care in the world, but a measure on the ballot next month could begin its erosion by increasing costs and reducing access. The culprit is the Massachusetts Nurses Association.
Question 1 would limit the number of patients assigned to each registered nurse in state hospitals. For example, in pediatric, medical and surgical units, a nurse does not treat more than four patients. Patients considered in non-stable condition in critical or intensive care units would have their own specialized nurse, as well as mothers in labor and those under anesthesia.
The nurses' union affirms that these rigid proportions will improve the quality of hospital care, which is already excellent. Massachusetts medical care ranks second in the nation, according to the Commonwealth Fund's 2018 scorecard. The state has some of the best hospitals in the world, including Massachusetts General and Brigham and Women. The state has 122.4 nurses for every 10,000 residents, much more than the national average of 89.6.
California is the only state that has imposed similar proportions from nurse to patient. But the Massachusetts Health Policy Commission, an independent state agency, examined research on the California health system and found that "there is no systematic improvement in patient outcomes after the implementation of proportions."
The quotas for question 1 go beyond those of California. The proportion of patients per nursing would be closer, without exemptions for rural hospitals. California granted the hospitals several years to be introduced in the fees, but hospitals in Massachusetts would have to comply by January 1 or face fines of up to $ 25,000 for each violation.
To fulfill the new mandate, Massachusetts hospitals would have to add up to 3,101 additional full-time nurses, according to the Health Policy Commission. The proportions would create an artificial shortage of nurses, increasing salaries and overtime. The Health Policy Commission estimates that the annual costs of Question 1 could increase to $ 949 million per year, and that is "likely to be conservative." The voting initiative leaves hospitals with little space to cut back elsewhere, explicitly stating that they have to meet the new ratios "without reducing their level of nursing, service, maintenance, administrative, professional and other personnel."
The highest medical bills would be a result, although another way to meet the proportions would be to limit patients. Boston Medical Center, the most active trauma and emergency service provider in New England, estimates that Question 1 would force it to treat 100 fewer patients in the emergency room each day and give birth to 800 fewer babies each year. More than 60 medical surgery beds would disappear. The Sturdy Memorial Hospital of Attleboro warns of the longer wait in the emergency room, while nurses refrain from providing care to meet their proportions.
"I never want to go into work and I have to decide whether or not I can legally treat my patients," says Sturdy Memorial nurse Meghan Aldrich. "If Question 1 is approved, I will constantly face a moral dilemma: violate the law and provide care outside of my relationship, or let a patient suffer."
Ms. Aldrich's comment points out the contradiction between a nurse's duty to patients and the nurse's union agenda to fill their roles with new members. Massachusetts is not a state of right to work, so more nurses means more members and more mandatory fees. The vast majority of hospitals in Massachusetts are private or non-profit, mitigating the effect of the Supreme Court Jano sentence against coerced quotas. Voters, almost all future patients, have every reason to reject Question 1.
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