My hospital is one of only three “critical access” hospitals in the state, and the proposed nurse staffing law poses a great threat to how we successfully care for our community. Being a critical access hospital means that Athol Hospital is in a rural community where community members would significantly suffer if they had to travel outside the area for basic inpatient health care.

Rural hospitals like ours provide crucial jobs. If, or when, a hospital closes, doctors leave the area. Were this to occur, a lack of conveniently located care would place a huge burden on all members of our communities and loved ones. For example, if someone needs to be admitted for end-of-life care and the proposed law were in effect, the patient would likely be sent an hour or farther from their hometown. It would be incredibly difficult for the patient’s family to be present for their last days. In a rural setting, there is a lack of public transportation to tertiary care hospitals and not everyone has convenient transportation.

If there were a serious bus accident on Route 2 during peak leaf peeping season, we’d call that a civil disaster. We’d have all hands on deck. In an unexpected crisis, where do you find nurses with emergency room experience? We simply don’t have the ability to call on those resources because they do not exist. We would be unable to afford the new staffing mandate, and, like most rural hospitals, we struggle to recruit as it is.

Hospitals would have to cut inpatient services and inpatient beds, meaning more patients would be held up in the ER, which would also be struggling to staff in accordance with this arbitrary mandate. It would feel horrible to have four stable patients (the proposed limit) and know that an ER patient is waiting for an admission bed. As an experienced nurse, I would say “send them up!” As a nurse I know I can, but the law would say I can’t. This law would take away the power to make real-time decisions about nursing practice at the bedside, without regard to the abilities of the nurse.

It would be terrible to have to tell a community member, “we have an empty bed, but we can’t take you, it’s against the law.” Or, ” I’m sorry, we are a designated critical access hospital, but we can’t grant you access.”

I was a bedside nurse for 20 years, and at one time a member of the union pushing this law. I understand how at times, the bedside nurse’s job can be difficult. However, I think that concerns at individual hospitals should be handled with internal resources and nurse leaders. A blanket law is not the answer because each situation is unique.

Hospitals should come up with their own staffing and acuity plans because the union does not represent the majority of Massachusetts nurses. The union’s rhetoric frightens our communities and encourages animosity instead of problem-solving. I urge you to vote “No” on 1 in November.

Nancy J. Mallory, RN, BSN

Director of Nursing Athol Hospital