"Massachusetts Voters Reject Nurse Staffing Standards" (In the News, February) discusses the rejection of the proposal known as "Question 1," which would have mandated nurse-to-patient ratios in hospitals based on the type of unit and the level of care. It was unfortunate to read about the rejection of this proposal.

As an RN, I for one would have been 100% in favor of the proposal. Working on any hospital unit can be overwhelming when you feel bogged down with too many tasks and not enough time in your shift to accomplish them. This can affect decision making and leads to nurse burnout.

A nurse who is feeling overwhelmed at work is less likely to provide adequate care to her patients. As health care providers, we take oaths to put patients' needs before our own, but at what cost to ourselves? The Massachusetts Nurses Association was correct in stating that the proposal would enhance patient outcomes. I would argue that patient safety alone would have been reason enough to approve the proposal.

The article mentioned the Massachusetts Health Policy Commission's estimates that the approval of "Question 1" would have required the hiring of up to 2,624 additional nurses, creating an increased annual cost of up to $949 million. These figures are rather large, but they do not change my mind about the need for standardized staffing ratios. The figures pale in comparison to the number of patients whose lives would be positively affected by nurses not feeling overwhelmed by their nurse-to-patient ratios while working their shift.

Janyll Joaquin, RN

New York, NY