A nurse from Berkshire Medical Center helped deliver signatures Wednesday to a 17th-floor office in downtown Boston, joining members of health, education and labor groups seeking a law they say will improve the safety of hospital patients.
Of the more than 100,000 signatures dropped off with a sense of drama at the Secretary of State's Office were 4,275 gathered in Berkshire County over the past two months.
As contract negotiations continue between registered nurses and the Pittsfield hospital, one of the main disputes from those talks is now a step closer to being decided by voters next November.
A spokesman for Berkshire Medical Center said rigid rules on nurse staffing would be costly without improving care for patients and would have "unintended consequences to hospitals and the communities they serve."
Members of the new Committee to Ensure Safe Patient Care deployed an ambulance and gurney to wheel signatures to a news conference on the steps of the Statehouse, then to Secretary of State William Galvin's office in the McCormack Building at One Ashburton Place.
The Patient Safety Act, as backers call it, would set minimum staffing levels for registered nurses in Massachusetts. From now until November, the Legislature has the option of taking up the measure.
But if lawmakers do not act and proponents meet other requirements, voters will decide the issue after what's expected to be a vigorous campaign for and against the new rules.
Harley Keisch, a 10-year nurse in BMC's critical care unit who is on leave, helped lift the signatures onto a counter in Galvin's office. He also is a member of the committee overseeing the statewide ballot campaign.
"A lot of work went into collecting those signatures," Keisch said by phone from the Statehouse area. He and other members of the Massachusetts Nurses Association, which supports the ballot question, fanned out across Berkshire County from September into early November collecting signatures. They visited grocery stores and shopping centers. They say they found willing residents at the Lenox Apple Squeeze event Sept. 23-24.
"The thing that was remarkable for me was how supportive people were," Keisch said of collecting signatures in support of the ballot measure. "People seemed to get it right away. I think people get it very intuitively."
Michael Leary, spokesman for Berkshire Health Systems, said Wednesday the hospital and the union remain far apart on the best way of ensuring patient safety and quality of care.
"The MNA and the hospital have fundamentally different views on how to manage nurse staffing levels," he said in a statement in response to questions about the ballot measure.
"BMC has relied upon a flexible team approach that takes into consideration the whole care team — including nurses, but also physicians, LPNs, nursing assistants, technologists, respiratory and other therapists, social workers and support staff," he said.
The hospital's approach, Leary said, has been adapted from recommendations produced by the American Nurses Association.
"Through legislative mandate, the MNA wants to replace the approach that has worked well for the BMC community with an inflexible, numerical formula that disregards most of the healthcare team and the constant changes in patient care needs," he said.
If the question reaches the ballot, residents of Massachusetts will hear plenty of arguments for and against in the months ahead.
Sarah Roberts, a 36-year-old Pittsfield nurse working nights on BMC's critical care step-down unit, joined the signature-collection drive.
"We were out and about in the community, really putting our feet to the pavement," she said. "Without having the proper staffing, it feels like it's all hands on deck all the time."
Most people Roberts and others approached for signatures were receptive to the proposal, she said.
"This really felt like we were putting the people first," she said.
One man she asked was cool to the idea.
"He said, 'It's all about money for you guys, isn't it?'" Roberts recounted. She said they talked and she argued that the measure is a way to advocate for patients.
"He ended up signing," Roberts said of the man.
Keisch, of Richmond, said that in his conversations with prospective voters, people seemed receptive to the idea of minimum staffing levels.
"Every nurse — really, every patient in the hospital — gets a good look at how hard-pressed nurses are to deliver good care. We're stretched pretty thin."
"I think for most people it's pretty easy to understand ... that you can't be in two places at the same time," he said of nurses.
Donna Stern, a union board member and leader of the bargaining committee for RNs at Franklin Medical Center in Greenfield, said the union is excited to move toward putting the staffing question to voters.
"It's an enormous accomplishment. It's validating, because it wasn't hard to get those signatures," said Stern, who spoke to striking nurses in Pittsfield at a rally Oct. 3.
"People were like, 'I get this.'"
She acknowledged that voters will hear from opponents of the ballot measure. The union's goal, she said, will be to make its case on staffing face-to-face with voters and "inoculate" voters against the other side's argument.
"I don't believe that's going to be a heavy lift," she said.
Hospitals will argue that new rules will make an already complex system of assigning nurses for patient care virtually impossible to handle.
Leary said BMC is "thoroughly committed to patient quality and safety" and notes that the hospital has been lauded for its care by national organizations.
The Pittsfield hospital and nurses have held two bargaining sessions since a one-day strike and four-day lockout in October.
Talks will continue Dec. 20, both sides say, after meetings Nov. 14 and Nov. 28.
At the Nov. 14 session, the two sides discussed a union proposal related to security in the workplace.
Leary said that when the issue of security came up, the hospital provided a presentation to members of the union's bargaining committee on its approach to safety.
Joe Markman, a union spokesman, said bargaining committee members were pleased to engage in that discussion with the hospital. But the focus has now shifted back to staffing and health insurance coverage, he said.
"The nurses would be glad to settle it before Christmas," Markman said. "It would be great for everybody."
Leary said the hospital has made what it views as a fair offer to the nurses, whose contract officially lapsed at the end of September 2016. Though the pact was canceled before the October strike, most of its terms remain in effect.
The hospital, Leary said, "remains hopeful that an agreement can be reached at the next scheduled sessions."
Larry Parnass can be reached at firstname.lastname@example.org, at @larryparnass on Twitter and 413-496-6214.