Guest Column- Joseph Casey

Published on October 20, 2018

Trust in your Hospitals, Nurses, and Medical Professionals to Provide Safe Care—Not a Mandated Ratio

By: Joseph F.X. Casey, President and Chief Executive Officer of Sturdy Memorial Hospital

Joseph Casey President and CEOFor the first time in over 100 years, Sturdy Memorial Hospital has taken a stance on one of the questions that you, a Massachusetts resident, will be asked to vote on.  As an organization, Sturdy Memorial Hospital is adamantly opposed to Question #1, not just because of the costs that will strain the entire health care system of Massachusetts, but because of the impacts that this proposed bill could have on our patients, our community, and our ability to continue to provide care as we have since 1913.

As a community hospital, every employee, from leadership to those on the front lines of care share the same mission, that is, to provide high quality, safe patient care to each and every individual that comes through our doors. Accomplishing this mission takes teamwork and flexibility to adapt to the ever changing demands that running a successful hospital requires today. As a locally controlled, nonprofit hospital, we benefit from having few layers of administrative burden to implement necessary and impactful changes. We encourage our nurses and our medical providers to bring forward recommendations to enhance patient care. We assess these recommendations and, if appropriate, plan for any changes in our budgets. We work to allocate funds so that they are used in a manner that benefits our patients, our employees, and our health care community as a whole.  

When it comes to staffing, a one size fits all ratio simply does not make sense for our culture at Sturdy. We are proactive with our staffing, and work together with our leadership team, managers, and our frontline nurses to address concerns from our units. We watch the trends in our hospital, the ebbs and flows of volume and the changes in acuity of our patients. We do our best to plan accordingly; however, health care is fluid and requires quick thinking and flexibility to address in the moment issues that arise. Rigid ratios have no place in how we provide care at Sturdy.

Our staffing at Sturdy is not dictated by administrators. It is through the collaborative efforts of our managers and nurses by which staffing decisions are made, and together they weigh many factors that relate to patient assignments. They look at the acuity of patients on the floor; anticipated admissions, discharges, and transfers; and most importantly, they make decisions based on the skill and experience of the nurses to ensure safe patient care.

We support safe staffing for our nurses. Our nurses are extraordinary professionals who commit themselves to providing the highest quality of care to our patients each and every day. We recognize that this ballot initiative is challenging for them, and respect all of their views on the issue.  We know that during times of unexpected influxes of patients, they are asked to go above and beyond to ensure our patients receive the best care.  And through collaboration with each other and every other member of our care teams, they are able to accomplish this. We recognize that they are the backbone of our health care system and place value in their ability to use their professional judgment.

As a community hospital, we want to know that we are truly making an impact on the lives of our patients, that the programs and services we offer have a profound effect on the health and wellness of our communities. We do this by assessing the needs of our patients as well as the health care needs of the residents in the communities we serve, and allocating funds to meet those needs. For Sturdy, this means that in this fiscal year, we are allocating more funds to address the growing concerns of behavioral health and the opioid crisis in our communities. We want to continue to be able to provide health care in this need-based manner. We do not want to reduce access to programs and services, or delay investments in the latest advances in medical technology. But unfortunately, this may become a stark reality for Sturdy and many other hospitals in the state. Yes, we are and have been fiscally responsible, but we are not immune to the devastating impacts that the passage of Question #1 would have throughout the state.

In closing, the ballot question is challenging to understand. It sounds well intentioned at first glance, but has significant consequences for health care in the commonwealth of Massachusetts and right here in our local community. There are very real concerns that Sturdy, along with other hospitals in Massachusetts have regarding the potential passage of Question #1. None of us want to see reduced access to care, the closing of vital programs and services, and gridlocks in our emergency rooms. But, these are the realities we may face if Question #1 passes.

I ask that you trust in your hospitals, and your professional nurses to treat you and your family to their fullest capacity based on experience, skill, and knowledge – not through a mandated ratio. Thank you for taking the time to become an informed voter on this important issue.

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