Question 1 sparks controversy among hospital employees

The UDems held a debate on the Massachusetts ballot question

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Question 1 sparks controversy among hospital employees

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By Abigail Charpentier, News Editor

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A debate on Massachusetts ballot Question 1 hosted by the University of Massachusetts Democrats drew in over 50 people to the Campus Center on Wednesday evening.

According to the Massachusetts Secretary of State website, “This proposed law would limit how many patients could be assigned to each registered nurse in Massachusetts hospitals and certain other health care facilities. The maximum number of patients per registered nurse would vary by type of unit and level of care.”

Additionally, “The proposed law would require a covered facility to comply with the patient assignment limits without reducing its level of nursing, service, maintenance, clerical, professional and other staff,” the site states.

The debate was between Baystate Franklin Medical Center nurse Donna Stern who argued “yes” for Question 1 and Cooley Dickinson Hospital Director of Community Health and Government Relations Jeff Harness who argued “no.”

Harness, who has been in health care for 35 years and at Cooley Dickinson for 29 years, received a graduate degree in public health from the University in 1991 and has a background in inpatient mental health. He started off the debate with his opening statement, first touching upon the fact that Cooley Dickinson would need to hire 50 more nurses if this question passes, which would be difficult to do.

“If we are not able to recruit enough nurses, we are not going to be able to admit as many patients as we currently can without breaking state law and risking, perhaps, a fine for that,” Harness said.

Harness then went into how the timeline for implementation is unclear. He stated when California had a similar piece of legislature passed, there was a five-year phase-in; however, no such time period is listed in Question 1, and the question only uses Jan. 1 as a date.

He also referenced a Health Policy Commission report from earlier this month, highlighting that California, which has had this regulation in place for about 15 years, has had “likely no systematic improvement in patient outcomes.”

Stern, a graduate of UMass College of Nursing, has been a full-time bedside nurse for over 13 years, currently at Baystate Franklin, and has been in health and human services for over 25 years. She started her opening statement off with a question to the audience.

“Why would bedside nurses ever write a bill that would close programs, put hospitals out of business and charge you more money?” Stern asked. “It just doesn’t make sense and there are absolutely no facts to support that argument.”

She then argued that people are only admitted to hospitals when they are “very, very sick” and nurses’ ability for around-the-clock monitoring is dependent on how many patients they are caring for. She said nurses are responsible for patients’ safety every minute they are in the hospital and the best way to help patients is by giving more time to them.

Stern responded by citing several independent studies that show what happens when nurses take care of too many patients at once.

“High rates of hospital-based infections, high rates of hospital readmission, high rates of medication errors and death,” she listed.

The first question asked to Harness and Stern was how patient limits are set and if they were arbitrary.

Stern responded that the limits are based on over 20 years of scientific research on how each unit is affected. She works on a psych unit and said that all of the research and the outcomes of California have shown that she should not have more than five patients at a time.

“Right now, I have no control over how many patients I care for at one time. And the difference between taking eight patients versus five, I can’t tell you how different it is and how dangerous it is and how unnecessary it is. It is preventable,” she said.

Harness referenced the same Health Commission Policy report as earlier, explaining a bar graph that shows every state and their ratios of nursing hours per patient day and Massachusetts is doing better than California and better than the national average.

“If we pass Ballot 1 and mimic the California mandate, we would already exceed,” Harness said.

Other questions asked included the average number of patients, where the problem existed, how much discretion nurses have, the current ICU law and the successes and failure in California.

To end his argument, Harness talked about how Cooley Dickinson came very close to closing in the late 1980s. The hospital ended up with 72 hours of cash in hand, meaning on a Monday, they didn’t know if they would be able to fulfill payroll on Thursday. Since then, the hospital has made an “amazing comeback, has a really solid facility with multiple locations and made great investments in technology and programs.”

“I’m proud of what we’ve accomplished and what we have… We generally have a reputation for high-quality nursing and for being well-staffed. We are now affiliated with Mass General, one of the best hospitals in the country, and as a small community hospital, we are now able to deliver innovation to you and access of programs to our small community in a way that is really rare for a small community hospital,” Harness said. “Question 1 jeopardizes all of that – moves resources in the wrong direction. I know supporters of Question 1 say that’s a scare tactic – I believe Donna actually believes that. I don’t. I’m scared for our future.”

Stern finished her argument by saying, “It’s true, I’m exhausted, but it’s because I’ve been at work since 7 a.m. and work on an inpatient log psyche and there’s not enough staff before I came here.”

“All nurses want to do is safely take care of you. That’s it. That’s all we want to do,” Stern said. “And the fact that we are not given what we needed on a daily basis to do our jobs the way we were trained to do is appalling and unacceptable.”

The full debate can be viewed on the UMass Democrats Facebook page.

Although the UDems have endorsed “yes” for Question 3, the Gender Identity Anti-Discrimination Veto Referendum, they will not endorse a side for Question 1, as they too are divided on the issue.

Abigail Charpentier can be reached at [email protected] and followed on Twitter @abigailcharp.