NCH Urges Island Community to Vote No on Question 1


Massachusetts Ballot Question 1 would mandate nurse staffing ratios for all patients at all times in all hospitals. We all support our nurses and value the amazing work they do for our patients. But this ballot question, while well-intentioned, would have severe unintended consequences and is the wrong way to address the issue of patient safety.

Independent Cost Analysis

Hear from NCH Leaders on the Ballot Question

“The creativity and flexibility that are necessary to run a hospital 30 miles at sea would be outlawed under ballot question 1, and NCH would be forced to follow a one-size-fits-all mandate that requires small hospitals like us to staff at the same level as Boston teaching hospitals that have up to 1,000 beds and much more complex patients.”

“We all want good nurse staffing and, quite frankly, good staffing for all our departments, but we do not need the government telling us what to do. We want that autonomy and flexibility to make these decisions on our own, not a one-size-fits-all mandate that would devastate health care in Massachusetts, especially our tiny hospital.”

“I’m not a nurse but I work with them all day long, I am married to a nurse and my daughter is a nurse. I feel that Question 1 is an attempt to impose on all hospitals artificial staffing patterns which can be better managed by collaboration between hospital administration and the nursing administration. There is no “one size fits all” way to handle nursing staffing patterns.”

Boston Globe Editorial

Vote ‘no’ on Question 1. The nurse staffing ratio is wrong for Mass.

“Making medical staffing decisions at the ballot box is an inherently suspect idea. And hyperbolic ads aside, Question 1 would probably have costs and consequences for access to care: adding up to $1 billion a year in expenses, hurting community hospitals, reducing the number of psychiatric beds, and sidelining other caregivers. The question’s proponents need to demonstrate to voters why they should accept those risks.

They haven’t. In fact, there is no conclusive evidence that a nurse staffing law will lead to better care. And without clear evidence, a yes vote on Question 1 represents too much of a gamble for a health care system that is already considered one of the best in the world.

Walk into a hospital, you’ll find an alphabet soup of health professionals: RNs (registered nurses), MDs (doctors), PAs (physicians assistants), LPNs (licensed practical nurses), LCSWs (licensed clinical social workers), MAs (medical assistants), physical therapists, mental health counselors, and the list goes on. Under current law, hospitals have ample latitude to hire the staff mix they believe can deliver the best care to patients at the lowest cost.

Question 1 would, over time, alter the makeup of those teams, leading to relatively more registered nurses — and relatively fewer of everyone else. RNs in Massachusetts hospitals make about $90,000 on average, and the hospitals would need to hire about 2,286 to 3,101 more of them, according to the only independent analysis of Question 1, which was released earlier this month by the state’s Health Policy Commission. The ballot question states that hospitals would be prohibited from meeting the staffing requirements it would impose by “reducing its level of nursing, service, maintenance, clerical, professional, and other staff.” But laws can’t prevent turnover and attrition, or alter budgetary realities. If providers are required to hire more nurses, it’s reasonable to fear they’ll let staffing in other job categories slide, including professionals like physical therapists and social workers.

Shedding other professionals to free budget space for more nurses would have consequences for patients.”

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