Massachusetts Elections Dividing our Healthcare Industry

It’s officially voting season. Three questions will appear on all ballots in Massachusetts during the November 6, 2018 State Election. Question 1 on the Massachusetts ballot is highly controversial among the healthcare industry… but why?

Question 1: Patient-to-Nurse Ratio

Question 1 on the 2018 Massachusetts State Election ballot is causing an uproar among nurses, administrators, unions and the hospital industry. The proposed law would limit how many patients could be assigned to each registered nurse in MA hospitals and other healthcare facilities. The maximum number of patients would vary depending on the type of unit and level of care required. This proposed law would not be required only during public health emergencies as declared by the state or federal government.

There will also be associated inspections, with possible fines on hospitals that violate these ratios. Civil penalties can reach up to $25,000 per violation, as well as $25,000 for each day a violation continued. The proposed law would prohibit discipline or retaliation against any employee for complying with the assignment limitation. Facilities would be required to post notices explaining the patient limits and how to report violations. Violating the posting requirement could result in a civil penalty between $250 and $2,500.

Voting Yes

Massachusetts voters who Vote Yes would be “siding” with the proposed law, limiting the number of patients assigned to one RN in hospitals and healthcare facilities. This would require hospitals and healthcare facilities to meet these patient limits without reducing staff levels. The Committee to Ensure Safe Patient Care, supported by the Massachusetts Nurses Association, are supporting a Yes Vote for Question 1 because they believe the limits will not only allow nurses to spend more time with patients, but dramatically increase patient safety, reduce mistakes and readmission of patients.

Voting No

Massachusetts voters who Vote No would be “against” the proposed law, supporting no change in current laws relative to patient-to-nurse limits. The Coalition to Protect Patient Safety, supported by the Massachusetts Health and Hospital Association, are supporting a No Vote for Question 1 because they believe the limit will increase patient wait times, force hospitals to cut back on services and hire more nurses, and even shut some hospitals completely down.

Why are Nurses Divided on the Issue?

Some may think nurses who are voting No are satisfied with their job and their staffing requirements. Their patient loads may not be overwhelming and they may not have seen negative patient outcomes as a result of high staffing ratios. But, those voting No may see the hiring and operational costs associated with the law. They may also like having the extra overtime as a result of a short staff. On the other hand, nurses who vote Yes may have multiple, unstable patients at once, feeling overwhelmed in their job. They may see multiple negative patient outcomes as a result of high staffing ratios. But, those voting Yes may see the result of increased patient safety. They may see that their employer or hospital has the resources for more nurses, but spend it on paying for daily overtime shifts.

Will the Proposed Law Pass?

Unfortunately, there’s no right answer on whether to Vote Yes or No. According to a poll conducted by WBYR of 500 registered nurses, 48% said they will Vote Yes, 45% will Vote No, and 7% were undecided. There’s no way to predict if the proposed law will pass based on these statistics. But, participating in the 2018 Massachusetts State Election is the only way your vote will matter.

OccuMed of New England is aware of the proposed law and the compliance concerns associated with the issue. Please visit for updates.