VOTE YES

I am writing to strongly encourage others to VOTE YES on Question 1 on Election Day, 11/06/18. A YES vote will support the Massachusetts Nurse’s Association’s (MNA) Ballot initiative for SAFE PATIENT LIMITS. I have had three salient perspectives from which to consider this ballot.

First, I am an experienced nurse whose nine years of work in hospital settings included being a charge nurse in medical surgical and orthopedic departments and being a member of a cardiac intensive care unit team. That gave me a perspective over 30 years ago about what it was like to be an RN in SAFE hospital settings.

Secondly, I subsequently became a Board Certified Advanced Practice Nurse and worked in clinic settings as a Psychiatric Clinical Nurse Specialist (and LICSW) before establishing my current private practice. That work especially over the past ten years has given me a perspective not only of the diminishing quality of care due to understaffing in some clinic settings but also of the alarming decline in safe care in many hospital settings. That perspective grew primarily out of my work with medical professionals employed in hospitals who sought my help (including RNs, MDs, respiratory therapists, CNA s, those in middle management and other hospital employees). The most pervasive concern of RNs and others has been the difficult bind of wanting to do their jobs well but being unable to manage the at times impossible numbers of patients who deserve quality care. Unfortunately, most hospitals are now run as a business. Too often the bottom line is profit. However inadvertently, there is either insufficient administrative awareness or concern or understanding of the need for RN s and others in the trenches to be adequately staffed to handle the individual, unexpected, and often complex care of patients. The business model of staffing does not account for that. When complexity of care rises or unexpected crises or too many admissions occur, related understaffing of nurses (and others) gets beyond heart wrenching. It becomes dangerous, even, at times, deadly for patients. The psychological and physical consequence to the hospital employees include significant anxiety, panic attacks, depression, stress-related medical conditions, and, in patient cases where understaffing was the primary cause of death, out right trauma. Many nurses and other employees relay constructive efforts to address these concerns at higher administrative levels but are often not heard and/or are intimidated. Ironically, the consequences to the hospitals where understaffing and failure to listen are a major problem are related lawsuits and the loss of competent nursing and other staff most of whom are well intentioned, caring, albeit burned out providers. Nurses, doctors, others are leaving their jobs, even their professions because “First do no harm” is impeded by understaffing and other corporate constraints. Previously, hospitalized patients and family members of those who have been harmed are also among those who have sought my help. Many have experienced life-altering physical losses. All of the above problems and more are reasons why nurses are raising their voices to the critical need for safe patient limits.

Finally, I also have a patient perspective. I have been significantly impacted by the consequences of unsafe patient limits related to corporate driven health “care.” I have had two emergency hospital admissions during which I both experienced and witnessed poor and, in several instances, dangerous care due to understaffing. I believe most of the nurses and other providers/staff were well intentioned but overwhelmed by their efforts yet inability to meet the complex demands of too many patients. Some openly voiced this. Yet, despite their efforts, the consequences to patients were, without question, at times potentially life-threatening.

Thus, given my professional and patient perspectives, I am voting a strong YES on Question 1. It’s another step towards recognizing and undoing these times of corporate management and going back to QUALITY PATIENT CARE. While there will be some increase in cost for some hospitals (though not nearly what has been advertised), it will be a lot less costly than the lawsuits that can occur as a result of unsafe staffing And, far more importantly, there will be far better patient outcomes and fewer deaths. PLEASE VOTE FOR SAFE PATIENT LIMITS. IT WILL SAVE LIVES.

Marsha Hood, RN, APRN-BC, LICSW
Rehoboth, MA