Linda Condon. Handout

As a registered nurse for 36 years I have often been asked by friends and family members, what is the most important thing to know to be safe in the hospital? My answer is, it depends on how many other patients your nurse is expected to care for at one time.

I love the responsibility that comes with what I do -- not much else compares to the unspoken agreement of trust between a patient and his or her nurse. When I am assigned a safe number of patients, I have the time to use my nursing knowledge to evaluate their condition, to make moment-by-moment decisions on how to respond to their condition, and the time to teach them what they need to know to recover from their illness.


As a nurse working in a busy emergency department, having a safe patient assignment level is critical. In the emergency department, your nurse is the first clinician you will see, and the only clinician responsible for your care throughout your visit. At any given time, we may have a full waiting room, as well as ambulances on their way or waiting in our ambulance bay. Some patients may be experiencing subtle symptoms of stroke or heart failure, one might be an infant with a dangerously high fever, one might be a patient suffering a psychotic break or in withdrawal from opioid addiction, and those in ambulances might be suffering severe trauma from a car crash or a gunshot wound.

In my world every minute counts, and every new patient assigned to my care decreases the time I have to spend with each patient. Massachusetts patients experience some of the longest emergency room wait times and highest rates of readmission in the nation, according to research.


Fortunately, health care advocates are proposing a ballot measure, the Patient Safety Act, which will set a safe patient limit for nurses in all areas of the hospital including the emergency department. That would allow my patients to receive the care and attention they need to be safe. That’s why I am advising all my friends and family to please support these proposed patient limits.

NO

Allison Conlon

Registered nurse; manager of care progression at South Shore Hospital

Allison Conlon. Handout

I am a registered nurse at South Shore Hospital, and I oppose the rigid, government-mandated nurse staffing ratio proposal that the Massachusetts Nurses Association is pushing to place on the state ballot in November.

We have some of the best hospitals in the nation, with consistently high outcomes in every category. It makes no sense to override the professional judgment of nurses who are charged with managing caregiver teams with strict, uniform state standards. The way we staff our units is complex; we make decisions based on each patient’s individualized treatment plan and every nurse’s skills and experience. Collaboration between nurses is critical, allowing us to adapt to changing circumstances and make real-time decisions about patient care -- often in life-or-death situations.

The strict, uniform standards required under this measure would supersede the hard-earned professional judgment of nurses, and instead potentially presents them with a moral dilemma: Do I care for a patient who needs me and break the law, or do I comply with the mandated ratio and turn the other cheek? As a nurse who has dedicated my life to providing care for my patients, I hope to never have to ask myself this question.


Beyond these concerns, the measure would cost the health care system more than $800 million each year -- according to the Massachusetts Health and Hospital Association -- and those costs would be passed on to our patients. Because the ballot question prevents hospitals from reducing non-nursing staff, their only remedy to save costs would be to eliminate entire service departments. Important health care priorities, like providing opioid treatment, mental health services, and pre- and post- natal care, will be the first on the chopping block. Some hospitals would have to close their doors entirely. We have already experienced one closure in Quincy -- it is not an experience any community wants to repeat.

At the end of the day, this measure is a nightmare scenario. Patients would suffer through longer wait times, services would be eliminated, nurses would no longer make their own staffing decisions, and hospitals would close. How can we possibly consider a policy that will erode our health care system and hurt our patients?

(This is an informal poll, not a scientific survey. Please vote only once.)

As told to Globe correspondent John Laidler. He can be reached at laidler@globe.com.