I am the chief nurse executive at the Martha’s Vineyard Hospital and will be voting no on ballot question 1.
I am the chief nurse executive at the Martha’s Vineyard Hospital and will be voting no on ballot question 1. I have been a nurse since 1976 and have worked full time at the Martha’s Vineyard Hospital as a staff nurse and a nurse manager since January of 1979.
Martha’s Vineyard Hospital is a unique organization. Our nurses receive top scores in patient satisfaction surveys and MVH is scored one of the top critical access hospitals nationwide. Our nurse to patient ratio on the acute care unit rarely exceeds those which would be mandated by the nurse staffing ratio ballot.
I understand why people feel that staffing ratios should be helpful to nurses and the patients they care for, but the reality is that the staffing ratios will not help at MVH. The proposed law is very rigid, it speaks to meeting the ratios “at all times,” even during meal breaks. If the staffing ratio passes, there will be a negative impact on the way in which we take care of our Island patients.
Recruitment and retention for nurses at MVH is difficult, housing is a challenge for all. When necessary, we use agency and temporary staff to cover the open position until we can fill a position or the staff member comes back from leave. If we need to compete with other hospitals in the state for these interim nurses, it is unlikely we will be successful due to the demand that will be created across the state.
Nurses would not have the option to go above their ratios under any circumstances other than a “state or federally declared public health emergency.” For context, the Boston Marathon bombing was not declared a public health emergency. In fact, there have been exactly four public health emergencies declared in Massachusetts since 1970. On an Island with few local resources to help with mass injuries, this can be catastrophic.
Care at MVH will be affected in truly palpable ways. Some examples:
• Patients will likely see longer wait times and ambulances will not be able to drop patients off if nurses are already at the maximum patient load without incurring the fine of $25,000 per violation.
• Elective surgical procedures may be rescheduled if the nurses on the inpatient unit are already at maximum ratio and additional nurses are not available to work. • Transfers from Boston hospitals to our skilled nursing facility program may not be accepted or will be delayed. • Discharges for our patients will be affected. Currently patients may be discharged later in the day for their convenience allowing us to take in a new patient while the soon-to-be discharged patient waits. If doing so will make the nurses assignment greater than four patients, those patients may be discharged and made to wait elsewhere or the patient waiting for admission may need to stay in the emergency department, adding to delays in accepting more patients in the emergency department. You can see the ripple effect.
These are real examples of how we will be impacted here at MVH. Take it from a nurse who knows.
Vote no on Question 1.
Carol Bardwell
Vineyard Haven
Comments
Carol Bardwell’s recent
Helen Green West TisburyCarol Bardwell’s recent letter to the editor regarding Question 1 included a number of inaccurate details, so I am writing in reply to clear some things up for our local voters.
It should first be noted that Question 1 is not “rigid.” If passed, it will set a safe MAXIMUM limit on the number of patients that can be assigned to a nurse at any one time. This works the same in daycare centers, as there is always a maximum limit on how many children can be cared for at one time by a single teacher.
There is no rigidity in Question 1 because the law allows for nurses’ assignments to be improved upon should a patient require more urgent, specialized care. The decision regarding this type of improved-upon care (beyond the maximum limit) will be dependent upon the creation of an “acuity tool,” which nurses and managers will develop collaboratively. We know that this process, and the resulting tool, will work because we did the same thing three years ago when safe patient limits in all ICUs became law. I am happy to report that we at Martha’s Vineyard Hospital have not had one problem with that ICU law and MVH has not received one fine.
What nurses are asking for with this law are reasonable staffing limits that will help our patients stay safe and recover fully. These limits were not randomly made up by the nurses who wrote Question 1. They are based on two decades worth of research proving that specific limits based on hospital unit and a patient’s acuity improve patient outcomes. With that in mind, I found it worrisome that one of the points Ms. Bardwell used in her article was that, if this bill passes, patients’ “elective surgical procedures may need to be rescheduled.” I can report firsthand that Martha’s Vineyard Hospital was cancelling elective surgeries long before this ballot question. How can having more nurses on staff not make that better? The same common sense argument can be made about ER wait times.
The endless threats about unit closures, the shuttering of services, the diversions of ambulances, and ER backup are just that: threats and scare tactics manufactured by the hospital industry, which has long put profits ahead of patients.
But safe patient limits will end that vicious cycle, and will result in better care and outcomes for all patients. That is why the voters of Martha’s Vineyard should vote “Yes on 1.”
Helen Green RN
Chairman Martha's Vineyard Hospital Massachusetts Nurses Association local Bargaining Unit
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