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Mass. Sees Increase in Emergency Room Visits, Nurses Assoc. Wants to Limit Patient Numbers

Massachusetts Medical Society

Emergency room visits have increased over the past year in Massachusetts, and now the state’s Nurses Association wants to limit the number of patients they handle.

The Massachusetts Medical Society recently released its 2013 Public Opinion Poll, which found emergency department use increased six percent, as 31 percent of those surveyed say they visited the ER in the last year.

Seventy-three percent of people said getting access to the care they needed was “not difficult,” which is down 5 percent since last year, but still much higher than the 57 percent of those polled in 2008, following the extension of health insurance coverage to state residents in 2006. Medical Society President Doctor Ron Dunlap says rural areas like the Berkshires have a large patient-to-primary care provider ratio.

“There are pockets in the state of communities where’s there is a really severe shortage of providers," Dunlap said.  "So that when you have insurance and you don’t have a primary care doctor you go to the emergency room.”

Massachusetts Nurses Association President Donna Kelly-Williams says limited access to primary care directly relates with increasing hospital visits.

“What we're seeing a decrease in the number of preventable care visits to primary care physicians, and more just in-time-of-crisis health care seeking, which is what brings patients to the emergency room," said Kelly-Williams.

The association has filed a ballot initiative to set a maximum limit on the number of patients a nurse can care for at one time. The Patient Safety Act would also require hospitals to adjust nurses’ assignments based on patient needs. Michael Leary is the Director of Media Relations for Berkshire Health Systems and says a rigid nurse-to-patient ratio doesn’t address the patient’s needs.

“We feel that ongoing care is best determined by our care-giving team and not a government mandated formula," said Leary.

Leary says despite the statewide increase in emergency room visits, levels at Berkshire Medical Center have remained static, and the number of primary care providers is increasing in western Massachusetts.

“We don’t feel we're seeing any kind of an increase in the number of patients who may go to the emergency department if they're unable to see their primary care physician immediately,"  said Leary.

Nurses Association spokesman David Schildmeier says they haven’t been able to get the nurse workload issue through the state government in past years because the hospitals are such strong lobbyists.

“The nurses have decided to go to the ballot, directly to voters because the reason is conditions in hospitals are getting worse every day," Schildmeier said. "Every day we wait for this to be passed someone is  suffering in a bed somewhere not getting the nursing care they need.”

The initiative needs 70,000 signatures by November to get to the state legislature. From November 2013 to June 2014, state lawmakers can act on the initiative, but if they don’t, the Nurses Association would need to get an additional 15,000 signatures next summer to get it on the November 2014 ballot. Schildmeier says the public supports the issue and hopes the current push can bring an end to it.

“We’ve had a number of votes to strike and we’ve had strikes by unionized nurses over this issue," he said. "Nurses shouldn’t have to go on strike to get a hospital to do what they should do anyway.”

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