November 13, 2018
By Tony Sjodin and Alex Tang
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As we reflect on the national effects of the U.S. midterm elections, The Musket is taking a look at decisions made closer to home. Massachusetts recently voted down Ballot Question 1, which would have placed a limit on the number of patients a nurse can have. Two of our writers discuss the implications of that decision.
WE SHOULD HAVE SAID YES!
A yes vote for this ballot question would have had a positive impact on both patient care and working conditions for nurses.
High nurse workloads actively worsen patient care. A study conducted by a variety of nursing schools and affiliated organizations found that the likelihood of a patient surviving cardiac arrest decreases by five percent for each patient added to a nurse’s workload. A patient limit would have saved lives.
Similarly, another study shows that for each additional child patient added to a nurse, the likelihood of the child’s readmission to the facility for common conditions increased by 11 percent. For basic surgeries, this rate skyrockets to 48 percent. Without the implementation of the patient limit, the impact on children and their families will be unimaginable. This should matter more than cost: a patient’s well-being comes before the profitability of a hospital.
Additionally, nurses face impossible burdens. With growing nursing shortages, especially in rural areas, nurses have simply been asked to take on too much. A universal limit was the only way to force hospitals to hire more nurses, mitigating some of the strain on current nurses.
The ballot measure received approval from students at LHS.
“The ballot is the only effective way to improve patient care,” Angelique Pham, a sophomore, said.
If hospitals truly prioritized their patients over their bottom line, the ballot would have been implemented.
WE MADE THE RIGHT CALL!
Although the “yes” campaign raised valid concerns about the current system, a “one-size-fits-all” change was never the solution.
Question 1 was the most expensive ballot initiative this fall. Several studies done by the Massachusetts Health Policy Commission indicate that the initiative would cost between $674 to $946 million dollars each year. State and federally funded health programs would have seen dramatic increases in operating costs, a change that would have the greatest impact on hospitals with patients on Medicare and Medicaid.
“Economically speaking, nurses benefit greatly if you were to answer yes because the demand for nurses would increase and therefore their wages will increase. However, as time goes by, wages will return to normal, but there will just be more people in the market. If you say no, it’s more beneficial for everyone else,” Sean Wu, a senior and first-time voter, said, before the election.
Even if there were an increase in the quality of patient care, the initiative would have caused closures in small hospitals throughout the state.
“My mom is a doctor. Small hospitals would close with lack of patients and this would be dangerous for people who need emergency care,” Isaac Ostrow, a freshman, said.
Proponents of Question 1 argued that its implementation would increase patient safety and quality of care. But research on the topic from California, in which mandatory nurse-to-patient ratios were implemented in 2004, is inconclusive. Hospital workers have reported little noticeable improvement in the quality of care that patients receive.
California’s legislation differs in that it imposes less strict ratios, whereas the proposed legislation in Massachusetts had inflexible ratios created without the input of state officials.
As the No on 1 campaign coalition said, “While improvements can always be made, this ballot question is the wrong prescription for patients and would force dramatic cutbacks across our entire healthcare system.”
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