Why We Oppose Question 1: Patient Care Services Leader Shares Her Perspective

By Linda M. Flaherty, RN, PMHCNS-BC

October 3, 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.

I have spent my entire career as a psychiatric nurse, providing clinical care as well as serving in administrative roles. In my current role, I am focused on providing an environment that supports our staff to partner with patients and families to provide care that is compassionate, safe, and effective. I believe that passing Question 1 would make that mission harder, not easier.

Linda M. Flaherty, RN, PMHCNS-BC
In her role as senior vice president for Patient Care Services, Linda M. Flaherty, RN, PMHCNS-BC, works to help McLean offer care that is compassionate, safe, and effective

One significant impact would be a critical reduction in access to care.

There is already a nursing shortage in Massachusetts, particularly for psychiatric nurses. It is projected that more than 1,000 beds at behavioral health facilities statewide would need to be put out of service—a 38% reduction in services—because of an inability to hire enough nurses to meet the mandated nurse-to-patient ratio. McLean’s projected nurse shortage would be more than 80 full-time employees, with the most dramatic shortage being for nurses on the night shift. If Question 1 is voted in and implemented, McLean would likely need to close a significant number of inpatient beds.

Access to care would also be affected by increased costs to patients. An independent study has projected that the staffing proposal would add more than $1 billion to Massachusetts health care costs in the first year alone. Health care consumers would have to help defray that massive increase through higher taxes, copays, and out-of-pocket spending.

The proposed mandate would also have a significant impact on health care providers outside of the psychiatric community. Under this law, for instance, hospitals without enough nurses on duty would have to turn away patients, even in emergency rooms.

Passing Question 1 would have profound negative effects on our hospital’s ability to care for patients and their families. I plan to vote “no” on Question 1.

Linda M. Flaherty, RN, PMHCNS-BC, is the senior vice president of Patient Care Services at McLean Hospital.

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