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 and other staff 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.
Some call Question 1 “good for nurses.” I don’t. I am a 39-year veteran of this profession. I have dedicated my life to being a caregiver and an advocate. My belief in the transformative power of nurses and nursing care cannot be overstated. My “no” on Question 1 is informed by experience and my belief in nursing.
Nurses are the group of professionals most trusted by the public. People trust nurses because we advocate for their health and safety, which are inextricably linked. Nurses are highly skilled in assessment and decision-making. We assess people, data, and environments. We have thoughtful, well-reasoned discussions with multidisciplinary teams and with patients.
Our evidence-based, culturally competent decisions promote health and safety. This includes decisions we make about staffing. A nurse who is creating an assignment must understand the needs and acuity of patients as well as the skills and strengths of the nurses available to provide patient care. Ratios factor in staffing decisions, but ratios are only one of many important variables.
Staffing decisions are clinical decisions, and these decisions should be made by those with clinical training and experience. They are not bureaucratic decisions to be made at the state level. These decisions should not be based on scare tactics, fallacies, or opinions of interest groups. Establishing mandatory patient ratios is not consistent with evidence-based practice, and Massachusetts should not limit a nurse’s ability to provide safe patient care by adopting a policy that has no evidentiary basis of support. To do this tells nurses their experience and skills don’t matter, nursing judgment isn’t valuable, and evidence-based practice isn’t important.
A “yes” on Question 1 is a vote of non-confidence in nurses. A “yes” on Question 1 denies the ability of nurses to advocate for themselves and their patients.
I’ll vote “no” on 1 because I have the utmost confidence in nurses. I hope you’ll join me.
Maria T. Olivier, MSN, RN, is formerly the nurse director of the Dissociative Disorders and Trauma Inpatient Program, and currently a professional staff development specialist for McLean’s Department of Nursing, where she provides support and education for nurses throughout the hospital.
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