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| Troubling bill on nurse staffing |
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Author: Editorial Publication: Berkshire Eagle |
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May 26, 2006 - There are bad bills and there are worse bills, and the bill that passed the House Wednesday requiring a minimum level of nurse staffing to care for hospital patients is a bad bill that perhaps staved off a worse one. If this bill is destined to become law, we hope the Senate will fine-tune it further, to offer protection for Berkshire hospitals that will suffer greatly under the burden of regulations their larger Boston-area hospitals may be able to shrug off. Everyone wants what is best for patients, but the issue is more complex than indicated by simplistic television advocacy ads in which an overworked nurse confides to her colleague that a mistake she made could have killed a patient. Like the infamous "Harry & Louise" ads that helped doom the Clinton administration plan for health care reform, these ads, common to the airwaves the last couple of weeks, do a disservice by appealing to emotion when what is needed are facts. The fact is that hospitals trying to stave off a red ink bath, such as North Adams Regional Hospital, which lost $6 million last year, need flexibility in staffing based on patient workload. They need the flexibility of employing licensed practical nurses and nurses aides instead of registered nurses for some tasks. The bill takes away this flexibility. Without it, and facing a $3,000 fine per violation, the financial viability of small hospitals will be threatened, which is not only to the detriment of patients but to the entire community. The bill passed Wednesday partially takes into account the considerable disparities among hospitals throughout the state by offering the possibility of a hardship waiver of the nurse-patient ratios from the Department of Public Health. Representative Chris Speranzo, a Pittsfield Democrat, said yesterday that while his efforts to include a geographic waiver as well did not succeed, he was assured by bill co-sponsor Representative Martin Walsh that "geographic isolation" would be a factor in considering waivers. One of three Berkshire legislators to vote for the bill, Representative Speranzo expressed certainty that if the bill was defeated, the "Draconian" Massachusetts Nurses Association bill that included no protection for small community hospitals would then have been passed. If the Senate is determined that Massachusetts become the second state to regulate nurse staffing it should at least put into writing a geographic waiver for small hospitals with fluctuating patient loads and the perennial funding challenges that go with a rural location. Better yet, the Senate will return to square one and debate whether government has any business telling hospital officials how to do their jobs. |