ER Doctor: No on Ballot Question 1
By GuestDear Editor:
I am an emergency physician with over 25 years of experience. A yes vote on Question 1 will prevent me from providing safe, quality, and expeditious care for you and your loved ones!
This is not about projections of cost or the availability of nurses to meet the proposed ratios. My concern and focus is how the bill will affect the emergency department and the obstacles we’d face in providing the quality patient care expected of all emergency physicians.
The bill places limits on how many patients a nurse may care for and is based on perceived criteria of how sick the person is. Nowhere in the bill does it explicitly state physicians will have a say in determining what “is sick and not sick.” The rigid criteria within the bill define what “sick” means. To me, the most concerning of all the criteria written in the bill is allowing an “urgent non-stable patient” to wait up to one hour to be seen. “Non-stable” patients need immediate attention!
The sponsors of this bill will have you believe that lower nurse ratios mean a safer environment for patients. None of their mentioned studies actually demonstrate this. What is well known in the medical literature is the most dangerous time in the emergency department for a patient is when care is being transferred from one healthcare professional to another. As written, this bill will create a situation where the transfer of care between nurses will increase due to the constant switch in ratios caused by continued changes in patient acuity (sickness level) — a part of the everyday complexity of our emergency departments. With more transfers of care between the nursing staff comes an inevitable increased risk of medical errors and potential sub-optimal care to the patient!
When you come to my emergency department, you become my patient. I, as along with the very dedicated nursing staff and the ancillary services, want to provide the absolute best care possible. But we cannot predict or control the volume or the level of illness we see. We accept that on some days, the volume and acuity can bring us to a near breaking point. When it happens, we band together, elevate our game, and still provide the safest and best care this profession has to offer. Providing strict nurse-to-patient ratios will not only prevent us from utilizing our internal resources as we deem appropriate, it will force us to play Russian roulette with patients’ lives as we try to determine what “urgent non-stable” patient can wait an hour before being seen.
In summary, please allow me to continue to provide the safe, quality, and outstanding care citizens in Massachusetts have come to expect from their emergency departments and emergency physicians. Vote ‘No’ on Question 1.
Daniel Muse, MD
Signature Healthcare
Short URL: https://www.thecantoncitizen.com/?p=43724
Posted by Guest
on Oct 26 2018. Filed under From One Citizen to Another, Opinion.
Both comments and pings are currently closed.
