To the Editor:
I am a physician and the President of the Medical Staff at UMass Memorial – Marlborough Hospital. I am a pulmonologist and critical care physician and the director of the Intensive Care Unit at the hospital. I am voting NO on Question 1. The medical staff at the hospital is also in full support of voting NO on Question 1.
In 2014, strict ICU nurse ratios went into effect in Massachusetts. The impact at Marlborough Hospital was significant. We were forced to close two of our ten ICU beds to comply. The cost of hiring nurses to staff our ten ICU beds under this new law was prohibitive. Caring for sick patients from our community became a challenge. Patients were transferred to other hospitals when we were unable to meet the rigid ICU staffing law. These are patients who would have been well cared for in our ICU. Mandated nursing ratios do not take into consideration the medical condition of other patients in the unit, the skill and expertise of the nursing staff, the availability of other caregivers such as respiratory therapists, aides and other physicians in the hospital.
I, along with my medical colleagues at the hospital, fear mandating ratios across the entire hospital will have a similar negative impact on our ability to meet the needs of our patients. We have already experienced this in the ICU on a much smaller scale. What other services will the hospital have to eliminate to implement the rigid staffing ratios? Patients will have to travel far from home for medical care when their local community hospital cannot meet the proposed staffing laws. This will result in increased costs for patients, families who need to travel to visit loved ones, and the overall health care system.
Recent research has shown that the ICU nurse ratio law did not improve outcomes as intended but rather resulted in adverse consequences such as transferring patients and delaying care. Mandating ratios in all hospital units may have a similar result. We can expect long wait times to be seen in an emergency department and delayed admissions to a hospital bed.
Kimberly Robinson, MD, MPH
President of the Medical Staff
UMass Memorial – Marlborough Hospital