As an engineer I spent much of my working career documenting job duties with production goals for employees. It is a thankless job which earned me the ingenious but unflattering nickname of Alan No-paycheck.
Question 1 in the Massachusetts Voters Information Book (patient to nurse limits) is written quite like a union proposal at a contract negotiation. In my past, such a proposal would have been discussed completely and modified to the satisfaction of union and management and then voted upon by the employees. After agreement and implementation, there are rules in place to address areas of concern that may develop.
The write-up in Question 1 suggests simply to install the changes as documented as-is without discussion or procedures to modify such procedure should this become necessary. It becomes law.
It is not too hard to see the dangers in such a move. Several that come to mind:
Are there enough nurses available to satisfy these rules?
How can changes to these rules be made after implementation?
How much of a problem will absenteeism be?
And, of course, how much will all of this cost?
Tack onto this the potential for “creeping change” in medical procedures. As improvements are made, the time requirements for nurses per case can go down. A real example, my dad had a polyp removed by a cut through his gut which took weeks to heal. Now polyps are removed as a standard part of a colonoscopy with no extra healing time required. But I see no system to adjust staffing change rules that the nurses have documented.
This is too much of a risk to take for the intended goal of patient safety. And it may not even achieve the goal.
Alan Owseichik
Greenfield