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Analysis

Will They or Won't They? Massachusetts Voters to Decide on Nurse Staffing Ratios.

By Jennifer Thew RN  
   November 02, 2018

On Tuesday, Massachusetts voters will face a ballot question on mandating nurse-to-patient ratios.

Nurse staffing ratios are one of the most hotly debated issues within the nursing profession. Those in favor say the limits improve patient safety and care. Those against them say ratios don't account for patient acuity and would create a financial burden on hospitals and healthcare systems.  

Now the public gets to weigh in on the issue. On Nov. 6, Massachusetts voters will face ballot Question 1, which would implement nurse to patient ratios in hospitals and other healthcare settings. The ratios vary according to the type of unit and level of care provided.  

The Massachusetts Nurses Association supports the law, while hospitals, health systems and some other nursing professional organizations oppose it.

Both sides have pumped millions of dollars into the debate.

Voters seem to be split on the issue as well.

According to an October 25 to 28  WBUR poll,  58% of voters say they are against Question 1. This is a change from September when respondents to a previous WBUR poll were more evenly split with 44% in favor, 44% against, and 12% undecided.

Massachusetts is not completely unfamiliar with nurse-patient staffing ratios. In 2014, Massachusetts passed a law requiring 1-to-1 or 2-to-1 patient-to-nurse staffing ratios in intensive care units, as guided by a tool that accounts for patient acuity and anticipated care intensity.

However, an analysis by physician-researchers at Beth Israel Deaconess Medical Center found those regulations were not associated with improvements in patient outcomes.

Should the law pass, Massachusetts will join California as the only other state to require this level of mandatory ratios. In California, the law supporting ratios was passed in 1999 and was then rolled out in a staggered fashion until it was in full-effect in 2004.

Will mandatory ratios become a reality for those in the Baystate? That will be known, most-likely, in just a few short days.

Jennifer Thew, RN, is the senior nursing editor at HealthLeaders.


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