Why We Oppose Question 1: McLean Nurse Shares His Perspective

By Christopher A. Richard, BSN, RN

September 28, 2018

In November 2018, Massachusetts residents will vote on ballot Question 1, a proposed law that would limit how many patients could be assigned to each registered nurse in Massachusetts hospitals and certain other health care facilities. This will be devastating for behavioral and mental health facilities. Concerned by the negative impact that this proposed law would have on overall patient care, McLean has come out publicly in opposition to Question 1.

Reasons behind this opposition are detailed in a recently issued statement from McLean Hospital and a white paper prepared by the Massachusetts Association of Behavioral Health Systems. McLean nurses are also speaking publicly about why they oppose Question 1. We will be featuring these narratives during the weeks leading up to Election Day voting on November 6, 2018.

As a nurse who knows many other nurses in many different systems, I understand the stress and strain that understaffing causes. I have worked in the field for 20 years and have felt the crush of being asked to do too much and not feeling able to give the best care to my patients. Mandated staffing levels may help a percentage of this problem, but it doesn’t solve everything. In fact, this ballot question will cause harm.

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Watch Christopher A. Richard, BSN, RN, talk about his thoughts on Massachusetts Question 1

Where will we get all the nurses? If this ballot question passes, there will be an instant need for over a thousand nurses across the state. Some will have us believe that all the nurses who have left the field dissatisfied will return to working the floors. I know some of these nurses, and staffing is not why they retired early or left the field—they didn’t like the work. Will it really be better for them if they are floating to all units in their hospital? Will they really be happy if they are doing more personal care assistant or mental health specialist work? I don’t think so.

Some say that we will have room for all the new graduate nurses who can’t find jobs in hospitals currently. Is this really what we want? Entire shifts of nurses with no one having more than three months experience is not safe. Who will be in charge? Which of these nurses will handle the complicated emergency that takes experience to handle? Would such a scenario make patients and their families happy?

Emergencies happen throughout the day and night. Imagine a bus crash outside your local ER that happens in the middle of the shift. The previous shift has left the building, and there are insufficient personnel available to increase staffing in the ER. Where do the patients go? Can you imagine turning away patients because of the staffing law?

We need to vote “no.” We need to get our neighbors to vote “no.” We need to get everyone to vote “no.” It may have taken 15 years before the Massachusetts ICU bill passed in 2014, but it was thoughtful and caused no harm. I believe that the Question 1 proposed law, however, would cause harm.

Christopher A. Richard, BSN, RN, is the nurse manager of the Alcohol, Drug, and Addiction Inpatient Program at McLean Hospital, which provides short-term, acute addiction care including detoxification.

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