NOTES ON NURSING

AHRQ Seeks Comments From Patients to Help Develop Patient Safety Reporting System   There is a growing body of evidence that many adverse medical events go unreported in current systems.  One important reason for this reporting gap is that most reporting systems do not presently accept or elicit reports from patients and their families. AHRQ recognizes that the unique perspective of health care consumers could reveal important information that is not reported by health care providers. NOTE: Comment deadline is July 8, 2013

On the Wings of a Nightingale  Today I ran into a Mexican restaurant to grab a quick lunch, and as I ate my meal I came across a table of nurses wearing hospital scrubs. As they chatted amongst themselves I thought about the many nurses my family has interacted with over the last five years, and I found myself filled with such appreciation for what these amazing women and men do for us.

HEALTH CARE

Is Self-Rationing of Medications a Good or a Bad Thing?  In America, the conventional wisdom is that we don’t ration health care. But we do, and there’s no better example than patients rationing themselves when it comes to the medicines they take.

Research Forgotten by Budget Cuts   The N.I.H. funding is cut 5 percent, or $1.55 billion this year, across the board. That means 700 fewer research grants are approved and 750 fewer patients will be admitted to its clinical center. The longer the automatic cuts go on, the worse it will get; medical breakthroughs are rarely instant. They take years and build on previous studies and experiments.

LABOR UPDATES

Union Membership Decline Boosts Corporate Profit at Workers’ Expense   “It’s a zero sum game: whatever is not going to workers, goes to corporations,” Kristal said. “Union decline not only increased wage gaps among workers, but also enabled capitalists to grab a larger slice of the national income pie at the expense of all workers, including the highly skilled.”

The 2013 legislative session ended last week with some significant improvements and changes to policies that affect nursing, health care and working families. In addition, with the change in legislative majorities to DFL control of the House and Senate, we did not have to fight off threats like Right to Work legislation, deep cuts to programs, or the Interstate Nurse Licensure Compact.

Safe Staffing

We made major progress toward our goal of minimum standards for nursing care in acute care hospitals. Our bill for a Department of Health study of the correlation between nurse staffing and patient health outcomes was signed into law by Governor Dayton. We are confident this study will validate what nurses have been saying for years: patients suffer when staffing is inadequate.

The bill will also require hospitals to report their staffing levels on a public website, which will provide transparency for the public.

Nurse Practice Act Changes

Governor Dayton signed into law a bill clarifying the scope of practice of Licensed Practical Nurses. The measure goes into effect on August 1. SF1016 was crafted after years of discussions between MNA, the Licensed Practical Nurse Alliance and the Board of Nursing. The final product clarifies and strengthens the Nurse Practice Act for both LPNs and RNs. Specifically, the law clarifies the definitions of assignment, delegation and unlicensed assistive personnel.

The Board of Nursing has committed to conducting education sessions for nurses on this issue. We will alert you when those opportunities are scheduled.

State Employee Contract

Last session the contract for over 700 MNA nurses in state facilities, agreed to by both management and employees, was voted down by the Republican-controlled legislature after continued attacks on public employees. During this legislative session the same contract was approved by the House and Senate and signed into law by Governor Dayton. Nurses at state facilities will see a 2 percent raise retroactive to this year.

Budget and Taxes

Minnesota now has a budget that invests in our future and protects the health of seniors and working families, while making the tax system fairer.

The top 2 percent of wage earners will pay about 2 percent more in taxes, which will raise $1 billion dollars; cigarette and other tobacco taxes will go up, which will raise another $600 million and hopefully convince some to quit; and the state will close corporate tax loopholes, which will raise $424 million.

Doing all that meant the Governor could sign an $11.2 billion health and human services budget bill, which includes a 5 percent rate increase for nursing homes next year-of which over half will go to workers who care for our seniors-along with another 3.2 percent increase by 2016.

MNCare will continue to provide high-quality affordable health care for working families in 2014 and beyond, making Minnesota the ONLY state that is continuing a public health coverage program in 2014 that will be able to transition to the Basic Health Plan option under the Affordable Care Act (ACA) in 2015. Basic Health Plan financing offered through the ACA means our state budget will see significant savings starting in 2015.

Patients will benefit from improvements to MNCare including elimination of the $10,000 hospital cap, lower premiums and elimination of the waiting period to get on the program. Expansion of Medicaid will add health care coverage for 35,000 low-income people.

You are invited: Legislative Wrap-Up Briefing

Come learn more about the legislative session, including more in-depth information about the staffing study, at the MNA Legislative Wrap-Up Briefing.

WHEN: Tuesday, June 11, 4:00 – 5:30 pm

WHERE: At the MNA office in St. Paul, 345 Randolph Avenue, Suite 200, St. Paul 55102 or via webcast

This event is for MNA members only and requires an RSVP. Please contact Eileen Gavin at eileen.gavin@mnnurses.org and let her know if you plan to participate in person or online. (Online participants will need an RSVP code to join the event.)

NOTES ON NURSING

Night Shift Workers More Likely to Develop Type 2 Diabetes  ”It is surprising that just a single night shift can significantly impair glucose tolerance and increase insulin levels,” said Christopher Morris.

National Health System May Bring In Police Officers to Deal with Acute Nursing Shortage   A local forum has discussed the possibility of drafting in assistance from Police Scotland and the Red Cross.  Two months ago it was announced that 30 nursing posts had to be filled as soon as possible at the hospital.

New Law Raises Fines for Assaulting Nurses   Much like law enforcement, health care can be a very dangerous job. The Bureau of Labor Statistics reports more than 2,000 nurses nationwide were assaulted, and eight were killed while on the job between 2003 and 2009.

LABOR UPDATES

Not All College Degrees are Created Equal    For instance, the unemployment rate for recent college graduates in nursing was the lowest at 4.8 percent, while recent graduates in information systems, concentrated in clerical functions, were the hardest hit with an unemployment rate of 14.7 percent.

Cities across the state are grappling with what to do about synthetic drugs.  Staffers at public shelters in Duluth have caught more than 100 people smoking, snorting, or injecting synthetics in the past year even though city council members have battled with a local head shop to halt sales.

On Friday, Minnesota Attorney General Lori Swanson and a special Committee on Controlled Substances and Synthetic Drugs will meet to develop some recommendations.

City and state leaders have fought again and again to stop these drugs that ER nurses and physicians say are turning people into zombies.  The trouble is, every time they outlaw a substance, the substance changes and becomes legal again.

Swanson and House Speaker Paul Thissen, who appointed the committee, are have spearheaded the efforts to help communities stop the legal sales of synthetics.  Duluth state representative Erik Simonson, who calls synthetic drugs a “real threat,” is heading up the committee.

Lawmakers are looking for nurses and community members who can show the magnitude of the problem of synthetic drugs on Minnesota’s hospitals and cities.  Thissen hopes the public will be able to demonstrate the effects of abuse of prescription drugs as well.  A strong turnout will urge the rest of the legislature to enact a statewide solution next year.

The meeting will begin at 2 p.m. June 7 at the Sheraton Hotel.  More meetings are scheduled for in Brainerd and on the Iron Range, and the committee is expected to issue report with recommendations next February.

NOTES ON NURSING

In Australia, Nurses Fight for Patient Ratios   “You’re less likely to have the nursing hours you need the further you are from the city,” Miss Telfer said.

NSW Midwives Issued “Cease and Desist” on Patient Limits Despite Shortages      ”We accept there is a shortage of midwives out there but management needs to understand that not only are staff at Nepean exhausted, they are deeply concerned that health care is being compromised. They have reached their limit and cannot continue on in this way.”

HEALTH CARE

The $2.7 Trillion Medical Bill   In many other developed countries, a basic colonoscopy costs just a few hundred dollars and certainly well under $1,000. That chasm in price helps explain why the United States is far and away the world leader in medical spending, even though numerous studies have concluded that Americans do not get better care.

Hospital CEOs See Double Digit Pay Hikes   A recent survey by Equilar, an executive compensation data firm based in Redwood City, Calif., found that — for the fourth time in five years — health care chief executives commanded the highest pay packages last year among publicly traded companies.

Violence Against Women is a Serious Public Health Problem   IPV and domestic violence figures among the top ten global causes of years of life lost due to premature mortality and disability. The consequences of IPV are far reaching, insidiously destructive and have a widespread negative socioeconomic impact.

Trapped in a Hospital Bed  But one number sent a murmur through the auditorium anyway: 43 minutes. That’s the median time a hospitalized elderly patient spends standing or walking daily, Dr. Brown and her colleagues reported in 2009.

LABOR UPDATES

Scores of Workers Die in Chinese Poultry Plant Fire    Explosions and fire tore through parts of a poultry plant in northeast China on Monday, killing at least 119 people in one of the country’s worst factory accidents in recent years.

OpEd:  Reaching Milestone of Working Women Still Finds U.S. Last Among Rich Nations in Supporting Working Families     After 50 years, shouldn’t we stop debating whether we want mothers to work and start implementing the social policies and working conditions that will allow families to take full advantage of the benefits of women’s employment and to minimize its stresses?

NOTES ON NURSING

MNA OpED:  Law Change Will Benefit Patients   (originally published in the New Ulm Journal)  Everyone who’s a patient in a hospital, who might be a patient in a hospital, or who cares about somebody in a hospital will be grateful that the Staffing Plan Disclosure Act was signed into law on May 9.

A Shared Concern:  Flight Attendant Fatigue Poses Safety Risks   Flight attendants exhausted from long hours and little rest have forgotten to engage or disarm emergency chutes, failed to properly stow baggage and carry out other safety duties. The federal government says the risk of mishaps may have increased as airlines cut rest periods to save money.

HEALTH CARE

Minnesota Ranked Best State for Seniors   Hoping to jump-start a discussion about the well-being of America’s rapidly-growing aging population, the United Health Foundation on Wednesday published the first comprehensive state-by-state analysis of senior health across the nation.

How Health Care is Learning from Lawsuits   New evidence, however, contradicts the conventional wisdom that malpractice litigation compromises the patient safety movement’s call for transparency. In fact, the opposite appears to be occurring: the openness and transparency promoted by patient safety advocates appear to be influencing hospitals’ responses to litigation risk.

Originally posted in the New Ulm Journal: http://www.nujournal.com/page/content.detail/id/534962/Law-change-will-benefit-patients.html?nav=5004

Everyone who’s a patient in a hospital, who might be a patient in a hospital, or who cares about somebody in a hospital will be grateful that the Staffing Plan Disclosure Act was signed into law on May 9.

Rep. Joe Atkins (DFL-Inver Grove Heights) and Sen. Jeff Hayden (DFL-Minneapolis) authored a bill that provides for consumer transparency of hospitals’ nurse staffing plans. In addition, the Department of Health will study the correlation between nurse staffing and patient outcomes, with a final report due in January 2015.

Starting in January of 2014, patients will be able to see how many nurses care for them on a public website at www.mnhospitalquality.org/default.aspx Hospitals will be more transparent, and patients will make wiser decisions on where they have a procedure and where they can expect to make the best possible recovery.

We have a right to know this information because the healthcare industry as a whole operates behind a brick wall of secrecy. For example, the federal government recently released a report showing huge differences between what different hospitals charge for the same procedures. Sometimes, even doctors and nurses don’t know what kind of care to expect as patients at hospitals. That’s why transparency in patient care is so important. Hospitals that operate consistently with regard to patient safety should be recognized and those that cut corners to save money must also be singled out.

Throughout the legislative session, nurses told legislators that because there is no minimum staffing standard, they frequently can’t answer the call button or give a patient his or her medication on time. That’s not easy for nurses to admit. Nurses are hardwired to care for people. They stretch themselves to the limit to ensure no patient is forgotten. This law is a first step in allowing patients to choose where they get their care based on how many nurses will take care of them. Patients should check the website periodically to see how their local hospitals are doing, and if the hospitals aren’t reporting their staffing levels, they should tell their lawmaker that we all have a right to know who’s taking care of us.

Linda Hamilton

President

Minnesota Nurses Association

NOTES ON NURSING

Expert Affirms Nurses’s Warnings About Electronic Health Records System   At a meeting of the Marin Healthcare District board on May 14, a group of Marin General nurses told the board problems with the new computer system were diverting them from their patients and causing errors, such as sending orders to the wrong patients. One nurse reported that a patient had received a medication to which he was allergic.

Worst Times to be Admitted for Heart Attack.  Hint: Involves Nurse Staffing   It’s possible that staffing issues at hospitals during these times are part of the problem; patients who come into the hospitals just before the weekend and late at night may see fewer nursing staff members and this could contribute to less attention that may impact care.

LABOR UPDATES

High-End Health Plans Scale Back to Avoid “Cadillac Tax”   Companies hoping to avoid the tax are beginning to scale back the more generous health benefits they have traditionally offered and to look harder for ways to bring down the overall cost of care.

WalMart Workers Launch First-Ever “Prolonged Strikes”  Organizers expect retail employees in more cities to join the work stoppage, which follows the country’s first-ever coordinated Walmart store strikes last October, and a high-profile Black Friday walkout November 23.

In Thief River Falls, Plenty of Demand for Workers But No Room for Them   Two big employers have made the city an oasis of job growth. Now housing and schools are trying to catch up.

HEALTH CARE

Krugman:  The Obamacare Shock   Yes, it does look as if there’s an Obamacare shock coming: the shock of learning that a public program designed to help a lot of people can, strange to say, end up helping a lot of people — especially when government officials actually try to make it work.

Put Nurses in the Spotlight This Summer

Attention MNA Members

The summer months offer a great opportunity for nurses to enhance our visibility as an organization and a profession. We encourage you to connect with the public by participating in area events in your local community.  Think of booths at the county or local fair, a 4th of July parade, organized sports tournaments, community festival or any fun activity that allows nurses to proactively advocate about issues that directly impact patients and families who might need our care.

MNA will provide giveaways and message banners. You need to organize the onsite crew and handle all other arrangements.

Check the events calendar in your area, and submit your request using the online form or emailing Jan Rabbers

470 Registered Nurses at Mankato Mayo entered contract negotiations today as a united group determined to address troubling staffing issues at the hospital that members believe put patients at risk. Lead MNA negotiator David Nachreiner reflected the views of the mass of responses the team collected from colleagues throughout the hospital as he read the Opening Statement. “My colleagues and I approach these negotiations with one primary focus.   We believe our patients – our families, friends and neighbors of this community – face unnecessary risk when they require the services of this hospital.  They face that risk primarily due to inadequate staffing and poor planning.  The nurses of this bargaining unit are very concerned about the staffing shortages we experience every day.  Each of us receives about five texts a day requesting us to pick up shifts.  How can that be safe?  Especially when we’ve already worked 8, 9, 10 or 12 hours.  Ladies and gentlemen, hoping nurses will respond to relentless texts is not a plan. “The lack of devotion on the part of this administration regarding safe staffing only creates a dangerous environment to people of our community when they at their most vulnerable.

Signing in for colleagues who wanted to join the Negotiating Team in spirit.

“To retain the quality RN workforce this community deserves – to make Mankato a destination Medical Center of its own – requires commitment and the power of collaboration.  Unfortunately, we are troubled by recent actions that minimizes the mutual trust you hope for, exemplified by the unilateral changes made in health insurance benefits without input or consideration of impact to nurses. “It’s time these negotiations bring a fair and positive agreement that rewards our dedication, our skill and our professional knowledge. It’s time we combine our expertise to reach an agreement that will recruit the best of the best and keep the finest of the finest. We are confident that fair wages, robust insurance and most of all, ethical staffing plans developed in partnership will lead to the quality care our community expects and values. “Have no doubt, you will find my colleagues and I are fiercely united in our positions – we hope you join us for the sake of our patients and neighbors.”