We don’t seem to be having much luck talking national politics. We have rigidified our views in these areas, so there is no conversation possible. Nonetheless, there is stuff to talk about and a lot of is hits much too close to home.

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Each state has its own unique ballot questions. While these issues are statewide, the subjects involved affect many places not only in this country but worldwide. While no two places have precisely the same issues, many problems are similar enough. The states watch each others’ ballot issues — both on how they are fought and to see how the solutions do or don’t work.

This year, Massachusetts is trying to vote on government-mandated Nurse Staffing Ratios for hospitals. The Nurse’s Union put the issue on the ballot because nurses in many hospitals are greatly overworked. Not only are the nurses exhausted and underpaid, but tired, harried nurses make mistakes. Some of them are fatal.

According to a recent study by Johns Hopkins, more than 250,000 people in the United States die every year because of medical mistakes, making it the third leading cause of death after heart disease and cancer. — Feb 22, 2018

No one could reasonably argue that nurses are not overworked. Except for Intensive Care Units where nursing ratios are tightly controlled, Massachusetts does not have mandatory nurse-to-patient ratios. In the U.S., the only state that has state-mandated ratios is California.

From inside looking out at UMass Memorial Hospital

The problem is, that Massachusetts doesn’t have enough nurses. Forget, for a moment, whether or not the hospitals could afford to hire enough nurses. We don’t have them to hire.

Almost anyone who wants to go into nursing can get a full scholarship. The shortage of nurses has been an issue for many decades. Nursing was a popular choice for women when I was a kid, but by the time I was an adult, women were beginning to think that if they were going to do the work, they might as well become doctors.

In an attempt to get a better grip on the subject, we had a conversation with our doctor. Garry figured he probably had a pretty good sense about it.

He thought for a while, then he said “It would probably mean closing at least 200 hospitals around the state … most of them in areas like this one where we don’t many hospitals.” Rural areas have very different issues than big or even medium-sized cities.

There’s the fundamental problem.

Milford Hospital from the Dana-Farber

Nurses — when we have recent graduates — want to begin careers in places where salaries are better (who doesn’t?), facilities are more advanced, and there are reasonable opportunities for professional growth. They don’t choose little hospitals in the middle of Worcester or Hampden counties.

“The hospital closures would,” our doctor commented, “make it very hard to find places to put patients.” Like me, I thought.

It’s not that he doesn’t think nurses are overworked. We all think they are overworked. I don’t think that’s even an issue. The problem is (1) where are we going to get all those nurses, and (2) how are we going to pay them?

What’s the answer? We are missing approximately 13,000 nurses. If we vote for government mandated nursing ratios, will the government also provide the nurses and money to pay them? A lot of hospitals are operating on a shoestring already. It wouldn’t take much to push them over the edge.

We have the same problem with teachers, police, firefighters, and medics. They work hard and they don’t get paid well. We are short of libraries and librarians and a lot of other things, too, like functional railroads and bridges that won’t collapse. Roads that urgently need paving.

It’s not like we don’t know about the problems. It’s just that we can’t always fix them by passing laws. There are secondary and tertiary problems that result from “just pass the law and work it out afterward.”

In rural areas — like ours  — if you close one hospital, there’s a very good chance there will be no place to go if we get sick or have an emergency. Boston is more than 70 miles away through very heavy traffic. Some of our “local” hospitals are not places you’d want to be if you had a serious problem.

As I am coming to realize in our personal lives, you can’t always fix the problems. Even when you know what the problems are and what needs to be done, that doesn’t mean you can make it happen. Unlike the federal government, states can’t just raise the deficit.

Putting aside all of our national problems, we still need to bang our heads together and figure out sensible solutions to problems that face us personally.

When you live in the country, these problems are at least twice as difficult to manage as they are in Boston. Hospitals are big business in Boston — and yet even there, they are merging many of the biggest and best facilities to stay solvent. Or nearly solvent.

Out here, we don’t have many hospitals. They have already closed most of the smallest ones. Unlike Boston where they make their budgets by giving parking tickets to any car that pauses too long at a stop sign, we have to live on property taxes that are already very high … too high for many of us. We don’t have enough police and if there’s a big fire, all the towns have to get together to fight it because no town has enough professionals

We have a Fire Chief, but firefighters are 90% volunteers. And some of the smaller valley towns don’t have a fire department at all. Uxbridge has a pretty good fleet of fire trucks and a new firehouse in town … but we don’t have a professional staff. For this, we — and our nearby neighboring towns — depend on volunteers.

But sick people? We have a plenty of them.

For more information, see Nurse staffing ratios: What is the 2018 Massachusetts ballot question all about?

Categories: #Health, #Photography, Election, Hospital, UMass Memorial

Tags: #Photography, Ballot Questions, Election, Marilyn Armstrong, not everything is political, Nurse-to-Patient Mandatory ratios