I am the chief nurse executive at the Martha’s Vineyard Hospital and will be voting no on ballot question 1. I have been a nurse since 1976 and have worked full time at the Martha’s Vineyard Hospital as a staff nurse and a nurse manager since January of 1979.

Martha’s Vineyard Hospital is a unique organization. Our nurses receive top scores in patient satisfaction surveys and MVH is scored one of the top critical access hospitals nationwide. Our nurse to patient ratio on the acute care unit rarely exceeds those which would be mandated by the nurse staffing ratio ballot.

I understand why people feel that staffing ratios should be helpful to nurses and the patients they care for, but the reality is that the staffing ratios will not help at MVH. The proposed law is very rigid, it speaks to meeting the ratios “at all times,” even during meal breaks. If the staffing ratio passes, there will be a negative impact on the way in which we take care of our Island patients.

Recruitment and retention for nurses at MVH is difficult, housing is a challenge for all. When necessary, we use agency and temporary staff to cover the open position until we can fill a position or the staff member comes back from leave. If we need to compete with other hospitals in the state for these interim nurses, it is unlikely we will be successful due to the demand that will be created across the state.

Nurses would not have the option to go above their ratios under any circumstances other than a “state or federally declared public health emergency.” For context, the Boston Marathon bombing was not declared a public health emergency. In fact, there have been exactly four public health emergencies declared in Massachusetts since 1970. On an Island with few local resources to help with mass injuries, this can be catastrophic.

Care at MVH will be affected in truly palpable ways. Some examples:

• Patients will likely see longer wait times and ambulances will not be able to drop patients off if nurses are already at the maximum patient load without incurring the fine of $25,000 per violation.

• Elective surgical procedures may be rescheduled if the nurses on the inpatient unit are already at maximum ratio and additional nurses are not available to work. • Transfers from Boston hospitals to our skilled nursing facility program may not be accepted or will be delayed. • Discharges for our patients will be affected. Currently patients may be discharged later in the day for their convenience allowing us to take in a new patient while the soon-to-be discharged patient waits. If doing so will make the nurses assignment greater than four patients, those patients may be discharged and made to wait elsewhere or the patient waiting for admission may need to stay in the emergency department, adding to delays in accepting more patients in the emergency department. You can see the ripple effect.

These are real examples of how we will be impacted here at MVH. Take it from a nurse who knows.

Vote no on Question 1.

Carol Bardwell

Vineyard Haven