📷 Local nurses Elise Wilson and Tracy DiGregorio attended a forum on ballot question 1, Thursday, Oct. 25 at Southbridge Town Hall. Both expressed opposition to the ballot question as written. Nurse Marie Ritacco and member of the Massachusetts Nurses Association presented arguments in favor of question 1.
By Sarah Champagne, Managing Editor
SOUTHBRIDGE – In the upcoming midterm election, Massachusetts voters will choose elected officials at the state and district levels. Throughout the state, voters will also have the opportunity to voice their opinion on three ballot questions.
Question one, which sets nurse-to-patient staffing ratios in health care settings, has seen vigorous public debate, with visible advocacy on both sides of the debate. Question Two would establish a citizens’ commission “to consider and recommend potential amendments to the United States Constitution to establish that corporations do not have the same constitutional rights as human beings.” Question Three would either repeal or maintain protections of transgender and other gender non-conforming individuals in public places.
A forum to discuss the three ballot questions was held in Southbridge Thursday, Oct. 25, at the town hall in McMahon Council Chambers. Town Councilor Gus Steeves had set up the event and moderated the discussion. Consistent with the amount of public attention each question seems to receive, two speakers presented opposing sides of question one, but only one speaker was available for both question one and question three. Polls indicate that the last two questions will show less division among voters and that both questions may pass in the affirmative.
At the forum, Tracy DiGregorio presented the “vote no on question one” point of view and Marie Ritacco argued the “vote yes” argument. Both women are registered nurses. DiGregorio works for Harrington Healthcare and Ritacco works at St. Vincent Hospital in Worcester. Ritacco arrived with fellow nurses of The Massachusetts Nurses Association (MNA), which is in strong support of this law.
DiGregorio provided an opening statement listing problems with the law as written and the expected impact on smaller community hospitals, in particular. Her argument, along with other opponents of ballot question one, is that the nurse-to-patient ratios and the associated fines written into this law will impede the ability of nurses and supervisors to adapt to conditions in real time at hospitals and that the law would treat health care settings in a “one size fits all” manner. DiGregorio used the example of leaving her work area to take a patient for a test or scan. When she leaves her assigned work area, even briefly for tasks related to patient care, her work unit would be subject to fines up to $25,000 for dipping below the legislated nurse to patient ratio. Those opposed to question one have argued that even meal breaks would cause a dip in nurse staffing ratios, subjecting health care facilities to tens of thousands of dollars in fines for each incident.
DiGregorio also argued that the law as written is an unfunded mandate; it requires an increased financial commitment from hospitals and healthcare facilities, but it does not offset the cost of implementation. She also suggested that the mandate could not be carried out, considering a pre-existing shortage of nurses.
“This bill sets us up for failure and that failure boils down to patients,” DiGregorio said.
DiGregorio also countered the argument, sometimes given by her fellow opponents of the ballot question, that patients needing immediate care would be turned away from health care facilities that are unable to accommodate more patients without violating the staffing requirements of the new law. DiGregorio argued that the expected tension between breaking the (new) law and providing care someone with immediate medical need is unfair to nurses and to health care managers. Turning a patient away in the emergency room would be illegal, but potential nurse staffing mandates would also create illegal staffing levels when an unpredictably high number of emergency room visits happen.
“No, I am not going to turn anyone away. Can’t do it, wouldn’t do it. But it’s unfair for the government, for the MNA or anyone to make me choose between taking care of a patient and breaking the law,” she asserted.
DiGregorio expressed satisfaction with her work at Harrington Healthcare and remarked that current nurse to patient ratios at Harrington work well for her and her colleagues. She said staff takes a collaborative approach to patient care and problem-solving; the staff that is present can work together to adapt to the number of patients and their level of need at any given time.
“This is going to change the way we nurse. I don’t want to do that. I don’t want to have to work around a rigid law,” she argues.
Marie Ritacco then had her turn to give an opening argument in favor of question one. Ritacco argued that the law, as presented and supported by the Massachusetts Nurses Association, gives control over patient care back to the nurses who are directly involved in care.
Ritacco claimed that hospital executives have poured excess money into a “vote no on question one” campaign, which they could have put into higher staffing levels. She also argued that executive salaries are exorbitant and that hospitals have paid “millions upon millions of dollars to keep up the charade.”
“They are not poor. They can make better choices,” she said of hospital executives, who she claims hold back money that could be put into nursing salaries for their own financial benefit. Ritacco alleges that hospitals or healthcare executives have access to millions of dollars in tax havens and “offshore accounts” in places like the Cayman Islands which would be better used to increase nurse staffing.
Ritacco listed several ideas found in public discussion of question one that she says are “myths.” The myths included that the law will cost too much, that hospitals will close and cut services that it represents government-run care and that the law will create longer wait times or cause patients to be turned away by facilities already at the maximum staffing level.
Another myth that Ritacco listed was that “the majority of nurses are saying to vote no.” Ritacco said that the majority of the nurses who oppose question one are those that are nursing directors or nurse executives and who are not in touch with the average day of a floor nurse.
“They may have a nursing license, but they are not caring for you,” Ritacco claimed.
During the question and answer portion of the forum, Ritacco said that extra money for hiring could come from reducing or eliminating capital expenses such as “buildings, waterfalls, expensive executive suites.”
DiGregorio responded that “At our hospital, we don’t have exorbitant executive salaries, we don’t have fountains. And this bill treats us like we do.”
Despite disagreement over the ballot question, DiGregorio remarked that, “Those of us who vote no, we’re against the bill, not the concept” and that “We are probably closer in our thoughts than we are different, but we are looking at it different ways.”
After the forum for question one, speakers arguing in favor of questions two and three provided their arguments on those ballot questions.
Kim Wass argued in favor of a “yes” vote on question two, which would initiate “a citizens commission to consider and recommend potential amendments to the United States Constitution to establish that corporations do not have the same constitutional rights as human beings and that campaign contributions and expenditures may be regulated.”
Wass said that those in favor of a yes vote on question two expect it to pass and that polls indicate that the majority of Massachusetts residents support creating the commission. The commission will research how money has influenced politics. She described the issue as a “bipartisan or nonpartisan issue that crosses over the divide.”
She estimates that the goals of the commission would take a significant amount of time to complete, but that the lenght of the process assures that the democratic process works. The related national initiative would require two-thirds of states’ approval.
Jackie Ryan of Southbridge spoke on the issue of question three, which would either confirm or reverse a current statute prohibiting discrimination on the basis of gender identity in public spaces. Ryan is the chair of the Southbridge School Committee and is transgender herself. She related her experience as a transgender woman and described why voters should “vote yes” on question three.
Ryan countered a frequent argument of those opposed to question three, which is that bathroom access for transgender individuals in line with their identified gender would make women and children vulnerable to attacks. Ryan cited research saying that there has been no instance of this type of attack or increased danger to any group in public settings.
Ryan said that this line of thinking was “trying to find a solution to a problem that doesn’t exist” and that access to bathrooms and the right to be served in public places such as restaurants is about “maintaining dignity and respect.”
“The key is dignity and respect for transgender individuals,” she said, adding that if protections are reversed by ballot question three, “I can be told I won’t be served and that seems antithetical to what Massachusetts stands for.
Ryan commented that she would have enjoyed a discussion with someone representing the opposite side of the debate on question three and that the increased dialogue would have been useful to public discourse.