National Nurses United

6 N A T I O N A L N U R S E W W W . N A T I O N A L N U R S E S U N I T E D . O R G J A N U A R Y | F E B R U A R Y 2 0 1 6 MASSACHUSETTS M assachusetts emergency depart- ments are bursting at the seams. In recent years, the loss of mental health treatment beds and the strain of an opiate epidemic have combined to leave EDs across the state understaffed and overburdened. That was on the minds of Massachusetts Nurses Association leaders this fall when Gov. Charlie Baker made a legislative proposal to combat the state's addiction problem. A provision in the governor's bill would have allowed doctors to commit patients with substance abuse issues for up to 72 hours without a court order. To nurses on the frontlines of healthcare, the proposal was alarming. In response, MNA leadership gathered with experts in addiction, ethics, and law to discuss the opioid bill. At a board of directors meeting in December, nurses from across the state talked to direc- tors from the American Civil Liberties Union of Massachusetts and members of the MNA's Center for Ethics and Human Rights. Among the conclusions reached was one nurses know all too well: The state and private- sector facilities need to open more beds for those suffering with mental health conditions and addiction. The MNA has proposed legisla- tive solutions to this problem, including a bill that would create a pilot program to reopen beds at Taunton State Hospital for the care of patients with mental illness outside of hospital emergency departments. The MNA is also advocating strongly for the Patient Safety Act, legislation that would require safer staffing in all hospital units. Nurses and other healthcare profession- als reached out to the public with their concerns and the governor's 72-hour hold provision was ultimately removed from the opioid legislation working its way through the State House. "The bottom line is our state and our nation are failing to provide appropriate care and services for those suffering from mental illness and addiction, and the proposed use of hospital [emergency departments] as a dumping ground for these vulnerable patients is not only bad policy, it is a disservice to those most in need," MNA Pres- ident Donna Kelly- Williams, RN told a GateHouse News Service reporter, whose article was published in news- papers across Massachusetts. Linda Condon, an emergency nurse at Morton Hospital in Taunton and MNA board member, was quot- ed widely as saying the governor's 72- hour hold provision would be "disastrous throughout the state." State Rep. Denise Garlick, a past president of the MNA, spoke against the provision on the floor of the House, leaning on her experi- ence as a registered nurse. As the proposal was being debated, nurs- es' arguments were bolstered by new state data showing that Massachusetts emergency departments saw a 24 percent increase in mental health and substance abuse patients from 2010 to 2014. Karen Huskins, a registered nurse who has worked at Good Samaritan Medical Center in Brockton for 15 years, told her daily newspaper, The Enterprise, that on a recent Sunday nearly 30 percent of the emergency department beds at her hospital were being used by behavioral health patients. "Two nurses and 10 beds were tied up with patients who needed specialized care," Huskins said. "Their rooms needed to be cleared of potentially dangerous equipment, they needed proper medication and, in some cases, around-the-clock observation. It requires a lot of staff time and takes nurses away from other patients in the ED." In the end, concerns about hospital staffing made the difference. Sen. Jennifer Flanagan, co-chair of the House-controlled committee that rewrote the governor's bill, told the State House News Service that the 72-hour hold was removed from the legisla- tion because of the limited capacity of hospi- tals to handle an influx of patients battling addiction. —Joe Markman Nurses stave off ill-conceived hold provision of opioid bill Solution to open more mental health and addiction recovery beds, not warehouse in ERs NEWS BRIEFS

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