The Berkshire Eagle reports the chief of emergency medicine at Berkshire Medical Center says passage of a nurse staffing ballot question next month could force the hospital to keep patients on hold in ambulances or its waiting rooms, unable to accommodate them as quickly as it does now.

Dr. Michael McHugh joined a chorus of doctors and administrators at BMC speaking out against Question 1 on the Nov. 6 ballot.

But advocates of the question say mandatory staffing ratios for registered nurses in all areas of hospital operations, including emergency departments, will improve care for patients.

And they say first responders will join a public event Thursday in Boston, prepared to press their belief that care will improve under the measure, with shorter wait times in emergency departments and a better flow of patients within hospitals.

In such departments, the ballot measure would require specific nurse-to-patient ratios depending on the condition of the person receiving care — from a maximum of one patient in critical care or intensive care units to five patients listed in "non-urgent stable" condition.

McHugh said he believes the measure would lead to patient delays in getting emergency care, including time spent in waiting rooms while hospital teams monitor and adhere to set RN staffing ratios.

If an ambulance cannot discharge its patient promptly, due to delays getting into emergency departments, those vehicles would not be ready to free up space on medical and surgical floors by taking patients who need transport to other facilities.

The emergency department at BMC handles 50,000 patient visits a year, according to spokesman Michael Leary. The hospital has said it would need to hire the full-time equivalent of 125 RNs to meet terms of the proposed law.

It’s estimated the cost to the institution to comply with the law would be $23 million,

McHugh said he believes the referendum would force the hospital to rely solely on RNs in the emergency department, squeezing out nurses' aides and other staff who normally take on duties for which RN training is not required.