Margaret McRae

Nurses bring a vast body of knowledge and expertise to every health care setting, and they support patients and their communities throughout the continuum of life and care.

Nurses make a difference by influencing and shaping health care policy decisions that ensure all people have access to high-quality, affordable patient care. Their skill to do this is based on the foundation of nursing — the nursing process.

Core to the delivery of care is the ability to assess, plan, implement and evaluate the conditions and needs of their patients. This includes determining the best nursing assignment to meet patient needs. The nursing process allows nurses as professionals to make decisions about staffing that takes in account the unique needs and acuity of each patient.

Currently, there is a bill, LD 1639 — “An Act to Address Unsafe Staffing of Nurses and Improve Patient Care” — that, if passed, would have a detrimental effect on this most trusted profession and the patients and communities they serve.

LD 1639 removes nurse autonomy to make the necessary decisions to provide safe, effective, quality care. It essentially reduces every patient and every nurse to just a number by mandating nurse-to-patient ratios. These ratios are not evidenced-based and do not take into account the patient as an individual.

Supporters of this bill make reference that this will cure the nursing shortage.


Establishing ratios won’t create more nurses, but it will limit access to care.

When hospitals are unable to meet these ratios, their only option will be to reduce bed capacity and turn away patients in order to meet the regulations. In order to have more nurses, efforts need to focus on workforce development and addressing the capacity at our educational institutions.

Supporters also claim that mandated ratios will improve quality. There is no evidence to support that claim. Currently, the health care provided in Maine is recognized as being in the top quartile in the country for quality and safety. In contrast, California, the only state with mandated ratios, sits in the bottom quartile for quality and safety.

Being a nurse with over 40 years of experience, having held certifications in both critical care nursing and emergency nursing, I relied on the skills I developed and my capacity to use the nursing process to best meet the needs of my patients. Over the course of my career, I have been fortunate to have the ability to collaborate with the health care team and not reduce the patients I cared for to just a number.

Senate and House representatives must oppose LD 1639 so that health care organizations can continue to provide access to care that our communities need.

Margaret McRae of Lewiston is a vice president for ambulatory patient care services with MaineHealth Medical Group.

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