Voting on Question 1 (Massachusetts Ballot Measure)

BCP1578

Forum Ride Along
1
0
1
Hi all,

I've seen various nurses I've talked to and some are voting Yes and others are voting No. Based on a commercial I've seen saying we should vote No with EMT's "holding the wall" waiting for patients to be seen. Anyone have any insight or input on Question 1? This pertains to voting on Nov 6th in the ballot. Would love to hear everyone's opinion. Thanks!
 

cprted

Forum Captain
385
181
43
In what jurisdiction in this measure being proposed? Perhaps a link would help generate some discussion.
 

Jim37F

Forum Deputy Chief
3,177
1,765
113
You should vote the same way you're voting for the ConAm and the ConCon on the ballot...
 

hometownmedic5

Forum Asst. Chief
682
538
93
I believe this refers to Massachusetts.

My vote is NO on 1. Clearly and inarguably this issue needs to be addressed, but this proposed action isnt the answer and will be almost immediately deleterious to the state, its healthcare system, its healthcare workers, and the people seeking its services.
 

Alan L Serve

Forum Lieutenant
226
40
28
This is a question on the ballot in the Commonwealth of Massachusetts.

The nurses union has pursued this action as they are the ones who are caring for the sick and injured.

They have been told to "do more with less" by the CEOs and corporate executives who run their hospitals.

They are fed up and despite trying to negotiate for many years they got no where.

Therefore, they turn to the People and tell the people,

"We are the nurses who will care for you. Don't you want there to be enough of us to give you the care you need? Our overlords don't want that. Do you?"

It is truly a no-brainer.
 

Summit

Critical Crazy
2,251
802
113
The hospitals that are notorious understaffers will probably respond to those ratios by immediately terminating all CNAs and Techs as those ratios are more slightly tighter than California's state nursing ratios.

My vote is NO on 1. Clearly and inarguably this issue needs to be addressed, but this proposed action isnt the answer and will be almost immediately deleterious to the state, its healthcare system, its healthcare workers, and the people seeking its services.
Explain how?
 

Peak

ED/Prehospital Registered Nurse
350
186
43
I doubt that this would increase offload times for EMS. Typically the primary issue for EDs is bed space, especially when surging, rather than nursing resources; especially so in higher volume EDs.

I think that it's a bit crazy that they think the feeders and growers need to be 2:1, level II and even some level III babies can be safely tripled (and they are only getting 30 minutes of cares ever 3 hours anyway).

The problem with mandates are that they are minimums, and often are still not based for safety especially in critical care units. If we have a kid on ECMO they are potentially a 1:3, we may have one nurse running pump and one to two actually caring for the kid. According to that law we could staff one nurse to a fresh post-op heart.

That being said the reality is that most hospitals are going to staff to the bare minimum, just like private for profit EMS does. The number one cost hospitals have is nursing department staffing (although this is also what they are mostly billing for). I remember training at a county hospital and the med/surg nursees having often had 7-8 patients each, and distinctly thinking about how I would never want to be a patient at that hospital and how unsafe it was.

Like @Summit said hospitals will likely respond by reducing nursing assistants and techs. Generally total care is considered to be safer than primary or team nursing so I don't necessarily think that this is bad for patient safety, it is also much more costly for the hospital and why most systems avoid it. Keep in mind that total care is the primary staffing model for ICUs and most pediatric hospitals. While total care is more expensive hospitals in California also saw a reduction in the number of occupational injuries so I think the costs may be more of a wash than the hospitals let on.

The reality is that EDs are not being overwhelmed with sick patients, but rather those who don't or can't go to primary care as well as the failed mental health system. Increased waiting room and offload times are a symptoms of this, and nursing taking on more patients isn't going to increase safety or provide for more efficacious care. As the local proliferation of urgent cares and free standing EDs developed our ED saw a drop in our daily census, but have have seen a substantial increase in average acuity (this is not a promotion of free standings, I think they are the epitome of what is wrong with our healthcare system).

I guess you should ask yourself if you were a medical patient in the hospital, or for the patients you bring in, would you want to have your nurse available for your care, charting, and coordination of care for 6 hours a day or a small fraction of that?
 

Remi

Forum Deputy Chief
Premium Member
3,793
2,427
113
This is a question on the ballot in the Commonwealth of Massachusetts.

The nurses union has pursued this action as they are the ones who are caring for the sick and injured.

They have been told to "do more with less" by the CEOs and corporate executives who run their hospitals.

They are fed up and despite trying to negotiate for many years they got no where.

Therefore, they turn to the People and tell the people,

"We are the nurses who will care for you. Don't you want there to be enough of us to give you the care you need? Our overlords don't want that. Do you?"

It is truly a no-brainer.
It's king of cute that you think the nurses unions are pushing this because of concern for the patients.

This is a terrible bill. It will improve ratios and create more jobs for RN's in some places, which is the real reason behind it.

But it will also cause unnecessary diversions and ultimately hospital closures. No question that there are places that simply won't be able to afford it.
 

Alan L Serve

Forum Lieutenant
226
40
28
It's king of cute that you think the nurses unions are pushing this because of concern for the patients.
My dear friend,
Remi,
The MNA is the largest nursing union in the entire Commonwealth. I am the King of Cute.

This is a terrible bill. It will improve ratios and create more jobs for RN's in some places, which is the real reason behind it.
My dear friend,
Remi,
I do think the goal of this ballot question (not a bill) is to improve ratios and create more RN jobs.
That is what is needed,
Remi.

But it will also cause unnecessary diversions and ultimately hospital closures. No question that there are places that simply won't be able to afford it.
My dear friend,
Remi,
This can be easily fixed by reducing the highly inflated salaries that executives of the hospital corporations earn and redirecting that money toward nurses and clinical care.
 

Remi

Forum Deputy Chief
Premium Member
3,793
2,427
113
My dear friend,
Remi,
This can be easily fixed by reducing the highly inflated salaries that executives of the hospital corporations earn and redirecting that money toward nurses and clinical care.
This is a common misconception among people who know nothing about hospital economics and just want an easy blame instead of actually learning about and thinking through the problem.

If all it took to keep a hospital open was to reduce the salaries of the executives, then why have almost 100 rural hospitals closed over the past decade with 700 hundred more identified by CMS as being at-risk of closing (not to mention the many more who have had to cut services like OB and mental health programs)? Do you think the hospital board members, state hospital associations, licensing agencies, and other stakeholders just didn't think of that? Are you that much smarter than all them?

What percentage of a small, rural hospital's budget do you think is made up of "highly inflated salaries of executives"?

You do realize that patient satisfaction is a key performance metric that pays for executive salaries, right? And also that RN staffing ratios are consistently shown to be the main driver of patient satisfaction? So then explain why, if all hospitals had to do was hire more nurses in order to make their patients happy and increase reimbursement, that they haven't done so on their own.

Healthcare is incredibly complicated. There is no stupid easy fix like "just make the hospitals do it" or "just pay your executives less". That's some hopelessly naive thinking.

This is a self-serving ballot measure that is meant to strengthen the RN lobby in MA, with no thought or care to how it will ultimately affect access to care. And it's an easy sell to people who don't know any better because who doesn't want more RN's per patient?

You might get your ballot measure passed and if you do, over the next few years staffing ratios will increase in the larger hospitals that can absorb the cost. But you WILL also lose at least a couple entire hospitals, as well as services at others.
 

Alan L Serve

Forum Lieutenant
226
40
28
This is a common misconception among people who know nothing about hospital economics and just want an easy blame instead of actually learning about and thinking through the problem.

If all it took to keep a hospital open was to reduce the salaries of the executives, then why have almost 100 rural hospitals closed over the past decade with 700 hundred more identified by CMS as being at-risk of closing (not to mention the many more who have had to cut services like OB and mental health programs)? Do you think the hospital board members, state hospital associations, licensing agencies, and other stakeholders just didn't think of that? Are you that much smarter than all them?

What percentage of a small, rural hospital's budget do you think is made up of "highly inflated salaries of executives"?

You do realize that patient satisfaction is a key performance metric that pays for executive salaries, right? And also that RN staffing ratios are consistently shown to be the main driver of patient satisfaction? So then explain why, if all hospitals had to do was hire more nurses in order to make their patients happy and increase reimbursement, that they haven't done so on their own.

Healthcare is incredibly complicated. There is no stupid easy fix like "just make the hospitals do it" or "just pay your executives less". That's some hopelessly naive thinking.

This is a self-serving ballot measure that is meant to strengthen the RN lobby in MA, with no thought or care to how it will ultimately affect access to care. And it's an easy sell to people who don't know any better because who doesn't want more RN's per patient?

You might get your ballot measure passed and if you do, over the next few years staffing ratios will increase in the larger hospitals that can absorb the cost. But you WILL also lose at least a couple entire hospitals, as well as services at others.
My very dear friend,
Remi,
When you take an introductory economics course
and learn about budgets
such terms as “gross” and “net”
we shall continue this enlightening
conversation.
 

Remi

Forum Deputy Chief
Premium Member
3,793
2,427
113
My very dear friend,
Remi,
When you take an introductory economics course
and learn about budgets
such terms as “gross” and “net”
we shall continue this enlightening
conversation.
“Take an economics course” says the person who thinks that a union-backed initiative is motivated by concern for patients and that all we have to do is cut executive salaries in order to pay for everything.

I knew you wouldn’t be able to answer my questions.
 
Last edited:

Alan L Serve

Forum Lieutenant
226
40
28
“Take an economics course” says the person who thinks that a union-backed initiative is motivated by concern for patients and that all we have to do is cut executive salaries in order to pay for everything.

I knew you wouldn’t be able to answer my questions.
My dear friend,
Remi,
I am here for you
should you wish to chat.
 
Top