BOSTON, MA – Although a ballot question proposing stricter nurse-to-patient ratios was defeated in the Massachusetts midterm elections in November, hospitals are taking initiative by addressing a more sinister problem: the asshole-to-nurse ratio.

Dr. Ivory Tower, who practices in the emergency department at a busy downtown hospital, says the measure was inspired by the number of patients they see who are absolute dicks.

“You can’t imagine the number of a**holes we see a day,” Dr. Tower explains. “Most people don’t realize that Massholes need medical care too – and unfortunately, we’re the safety net hospital that can’t refuse patients, no matter how ridiculous their complaints are.”

Dr. Tower notes that their patients come from all over the world, so the department is exposed to rudeness from all cultures.

“I once had a lady curse me out in another language because I refused to give her Dilaudid for her UTI,” Dr. Tower recalls as he shakes his head. “When I asked if she could be pregnant, she threw her slipper at me. I’m told this is a cultural gesture of respect in her culture.”

Dr. Tower then excused himself to attend to a healthy young patient with two years of intermittent mild back pain.

Emergency department nurse Darlene Dontryme explains that the move to smaller asshole-to-nurse ratios is long overdue.

“I can easily take care of four sweethearts, like those adorable little old ladies and their hip fractures,” she says, “But I can only take care of a maximum of one asshole per shift. It takes time for me to explain that, no, you cannot leave to have a smoke while you’re having active chest pain.”

Our conversation was interrupted by a patient screaming for a turkey sandwich.

“He came in for nausea and vomiting,” she notes, rolling her eyes and grabbing some stale graham crackers instead. “He thinks I didn’t see him sneak McDonald’s into the room.”

Not everyone is on board with the change, however. Gastroenterology fellow Dr. Yolo Scope is worried that his measure could lead to an unnecessary influx of inpatient consults.

“I want to make things clear,” Dr. Yolo Scope states, sipping his fourth coffee of the day as his pager continued to frantically beep. “A common misconception is that, while we all have assholes, there is no actual cure for being an asshole. So… please, for God’s sake, stop consulting us.”

Nineteen year nurse Ayam Fedup says that tighter asshole-to-nurse ratios is an excellent start, but as the next step, he would like to see improved asshole-resident-to-nurse ratios.

“We all know patients can be assholes, but residents are also oftentimes assholes,” he explains. “I personally would like to see a one asshole resident to nurse ratio. That way, we don’t have to waste our time hammer paging every fresh resident who acts like a know-it-all. We can redirect our energy elsewhere.”

Dr. Tower could not be reached for final comment, as he was busy a patient who had self-cauterized a nosebleed by sticking an enflamed paintbrush up his nose.