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OP-ED: Lawrence General Hospital Emergency Center to Suffer Under Question 1

(Editor's note: The following article was submitted by Lawrence General Hospital.)

Lawrence General Hospital announced today their opposition to mandated nurse staffing ratios, citing the devastating impacts these rigid government requirements would have on their ability to provide emergency care to patients.
Slated to be Question 1 on the ballot this November, these unnecessary and unfounded staffing requirements will dramatically increase emergency room wait times and delay life-saving services in hospitals across the state.
“We are a very busy Level III Trauma Center, caring for nearly 68,000 patients a year— approximately 1,500 of those being trauma patients,” said George Kondylis, MD, Chief of Emergency Medicine at Lawrence General. “We are seriously worried about the quality of care we will be able to provide if Question 1 passes. Mandated nurse staffing ratios will not allow our nurses to use their professional judgement to make life or death decisions. In the Emergency Center, this will have detrimental effects.”
The enormous costs and operational hurdles associated with the nurse staffing ballot question will increase wait times in the Lawrence General Emergency Center by 40-50 percent for patients who need to be admitted, and non-urgent patients can expect to wait 60 percent longer than usual to be seen.
A majority of patients would wait an average of three hours to get into an emergency bed if this is passed. Question 1 would also disproportionately affect behavioral health patients who will board in emergency rooms across the state if this ballot question were to pass. On average, Lawrence General currently has a range of 6-12 psychiatric patients per day boarding in its Emergency Center. This number could easily double when Question 1 causes behavioral health bed reduction. There are no exceptions to this mandate, even in the event of an unexpected influx of patients – such as a multi-car crash or large fire.
According to an independent study by MassInsight and BW Research Partners, mandated nursing staffing requirements would exacerbate the current nursing shortage and cause emergency department beds to close in community hospitals across the state.
The ballot question would require that hospitals across the state, no matter their size or specific needs of their patients, adhere to the same rigid nurse staffing ratios within all patient care areas at all times.
The petition does not make allowances for rural or small community hospitals, holding them to the same staffing ratios as major Boston teaching hospitals.
“As an emergency room nurse for 16 years and SDC/PACU nurse for two years, my vote is no on Question 1,” said Lawrence General’s Melissa Browne, RN, BSN, CEN. “I believe in safe nurse patient ratios, but Question 1 is not contributing to the solution, it is adding to the problem.”
 The ballot question is opposed by the American Nurses Association - Massachusetts, Emergency Nurses Association - Massachusetts Chapter, Organization of Nurse Leaders, Infusion Nurses Society, Massachusetts Association of Colleges of Nursing, Academy of Medical-Surgical Nurses’ Greater Boston Chapter, the Western Massachusetts Nursing Collaborative, the Massachusetts College of Emergency Physicians, the Massachusetts Medical Society, the Massachusetts Health and Hospital Association, the Massachusetts Council of Community Hospitals, the Conference of Boston Teaching Hospitals, and other healthcare and business leaders across the state. 

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