Nurses Decry Ratio Bill at State House Hearing

Last Monday, April 30, approximately 180 opponents of government-mandated nurse staffing ratios attended a hearing on ratio legislation before the Joint Committee on Public Health.

Among the 20 who testified against two ratio bills from a nursing union were frontline RNs, nurse managers, healthcare researchers, behavioral health experts, and a hospital’s chief medical officer.

“I can’t even begin to imagine how a code blue or multiple code blues would work under this mandate without breaking the law,” said Amy Underwood, an R.N. at Cooley Dickinson Hospital. “The rigid mandates will not work in an ever-changing hospital environment where patients’ needs and conditions can change within seconds.”

The nursing union, which represents less than one-quarter of the RNs in Massachusetts, has proposed a ratio question for the November statewide ballot. Since the ballot question process in Massachusetts offers the legislature the opportunity to weigh in, all proposals slated for November are filed as legislation and a public hearing is required.

At Monday’s hearing nurses explained to committee members that ratios do not help nurses but actually take autonomy on patient care decision from them. Nurse managers described how patient care decisions are made, how they change from minute to minute, hour to hour, and are based not on a specific number of patients per nurse, but on the education and skill set of the nurse, patient acuity, availability of other care team members, and more.

“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?” said Allison Conlon, R.N., from South Shore Hospital.