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November 12, 2013

Nurses seeking limit on patients

METHUEN — Several nurses set up shop near the School Street entrance of the senior center here last month, catching visitors for their signatures for a ballot initiative that would limit the number of patients a nurse can have at one time.

The proposal, which could reach the ballot for next year’s gubernatorial and midterm Congressional election, would limit many nurses in hospitals to four patients at a time. Critical care and intensive care nurses and emergency room nurses would be limited to fewer patients, depending on those patients’ conditions.

Hospitals and hospital groups oppose the proposal, saying it reduces flexibility by binding their hands in providing care and could jack up already high medical costs in the state.

“There is no limit to the number of patients a nurse cares for,” said Karen Higgins, a staff nurse at Boston Medical Center and a member of the Massachusetts Nursing Association, which was collecting signatures here Oct. 22. “You could have four (per nurse) or you could have eight.”

The petition would cap at four the number of patients most nurses, including emergency, pediatric, medical and surgical, according to a copy of the initiative. Intensive care or critical care nurses could only have one patient, or two if the patients’ conditions are stable. Emergency room nurses would have between one and four, depending on the patients’ conditions.

Donna Kelly-Williams, president of the Mass. Nurses Association, said in many situations four patients per nurse is ideal, but hospital and provider consolidation has led to a higher ratio.

“More patients are being assigned to nurses,” she said, adding the trend has been getting worse over the last five years.

Lynn Nichols, president of the Massachusetts Hospital Association, said in a statement that the group opposes assigning ratio limits because “patient care is best determined by the care-giving team at the bedside, not by a government-set fixed formula. Patient care staffing decisions should always be based on the best interest of the patient – not a number. Nurses don’t treat numbers, they treat people. Hospitals shouldn’t be required to staff by numbers, either.”

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