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Advocates for and against a ballot question that would set strict limits on the number of patients assigned to nurses working in hospitals tangled in a tense radio debate on Monday.

Donna Kelly-Williams, the president of the Massachusetts Nurses Association, which wrote the measure, said the proposed law would protect patients, is backed by studies and nurses, and also just makes plain sense — urging voters to say yes on Question 1.

“Think about it: Do you want to be one of four patients or one of eight patients if you’re in the hospital?” she asked.

But Nancy Gaden, the chief nursing officer of Boston Medical Center, said Massachusetts already has some of the best hospitals and patient outcomes in the country and warned the proposed law would squeeze hospitals, increase wait times, and lead to “tragic unintended consequences”. She pressed people to vote no on the Nov. 6 referendum.

One of the most intense exchanges on the WBUR-FM radio program came after a call from a local EMT who mused that emergency rooms might need many, many more nurses to deal with a potential surge in patients.

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Gaden said no matter how much a hospital plans, in any given hour there could be a stream of patients walking and being wheeled into the ER, and the “rigid” limits would mean a nurse wouldn’t be able to help a patient coming in from an ambulance or the waiting area.

Kelly-Williams vociferously disputed that assertion.

“Absolutely no nurse at any time would ever refuse to care for a patient, Nancy,” the union leader shot back. “Never ever ever! If patients are at the door, the nurses will care for that patient.”

Kelly-Williams said if it meant moving patients around to different parts of the hospital, then staff would make it happen to facilitate patient care — care that is “the way they are supposed to be seen when they show up to a hospital.”

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If a nurse has the full number of patients allowed under the law, but there’s a new patient who they need to see, Gaden replied, it creates an untenable situation.

“I can’t ask nurses to break the law,” Gaden said. “I think it puts them [in] terrible moral distress.”

The debate aired live on WBUR-FM and on other venues, and was moderated by WBUR reporter and host Deborah Becker and Boston Globe reporter Priyanka Dayal McCluskey. It was hosted by WBUR-FM, the Globe and UMass Boston’s McCormack Graduate School of Policy and Global Studies.

Early voting began Monday and will continue until Nov. 2.

Polls have found support for Question 1 slipping.


Joshua Miller can be reached at joshua.miller@globe.com