NOTES ON NURSING

More Proof:  Heart Patients Survive with Better Nurse Staffing    “This finding suggests that the correlation between cardiac arrest incidence and case survival was partly attributable to the hospital factors in the model,” the authors write. A hospital’s nurse-to-bed ratio and geographic region correlated with the greatest shift in the relationship between incidence and survival.

Hero Nurse Protects Newborn from Tornado   Miraculously, all the staff, patients and families survived the storm.  That includes nurse Cheryl Stoepker, who used her own body to protect a newborn she’d delivered barely an hour earlier.

LABOR UPDATES

UMass Nurses Poised to Strike if Today’s Negotiations Fail   Nurses at UMass Memorial’s University Campus are staging the 24-hour strike to draw attention to what they call deplorable patient conditions.

Median CEO Pay Rises to $9.7M in 2012   CEO pay, which fell two years straight during the Great Recession but rose 24 percent in 2010 and 6 percent in 2011, has never been higher. Meanwhile, Pay for all U.S. workers rose 1.1 percent in 2010, 1.2 percent in 2011 and 1.6 percent last year – not enough to keep up with inflation.

The hand-wringing and the vote-counting are over.

Governor Mark Dayton speaks to MNA Nurses

Minnesota finally has a budget that protects the middle class, invests in our future, and protects the health of seniors.

It was no mean feat.  The Governor and the legislative leaders had to hold fast to the right priorities through threats of filibusters, add-on amendments, and even talk of businesses exiting the state.

Governor Mark Dayton and legislative leadership had to rectify years of imbalanced budgets and re-invest in state programs that had been long ignored.  In summary, 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 go up, which will raise another $600 million and hopefully convince some to quit; and they found money in the couch cushions too by closing corporate tax loopholes, which raises $424 million in business tax write-offs.

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-much of that goes to workers who care for our seniors-along with another 3.2 percent increase by 2016.  While some proposals saw health and human services losing $150 million, this investment ensures seniors will receive good quality care and their care-givers will be better paid for their priceless work.  That keeps experienced nurses and care-givers protecting our seniors.  Nurses at state facilities will also see a 2 percent raise retroactive to this year.

Legislative leaders needed to re-right the boat after eight years of no new taxes has denied Minnesota the ability to move forward and placed the middle-class in a squeeze from all their other taxes going up, including local property taxes, school levies, and other referenda.  With a stable base of revenue coming into the state, Minnesotans should be able to count on their health, their children, and their seniors continuing to be cared for without worrying what the next year will bring.

HEALTH CARE

Is the Future of American Health Care in Oregon?   “The governor has a notion that you can move away from medical billing and towards a more flexible approach to health-care spending that makes more sense for the community,” John McConnell, a health economist at Oregon Health and Science University, is telling me. Then he stops. “You’ve heard the air conditioner story, right?”

Medicaid Opposition Underscores States’ Health Care Disparities   Republican opposition in many statehouses to expanding Medicaid next year under President Obama‘s healthcare law — opposition that could leave millions of the nation’s poorest residents without insurance coverage — will likely widen the divide between the nation’s healthiest and sickest states.

Minnesota Health Care Program Cuts Costs for the Poor   Many other states are simply cutting medical assistance funds or moving patients into private managed-care health plans in hopes of saving money. But Minnesota is exploring new options like Hennepin Health in which the state contracts directly with county or medical providers who have banded together to provide care for a certain number of patients — giving them greater control of medical assistance dollars and, in turn, more freedom to innovate and focus on preventive care.

LABOR UPDATES

Twin Cities’ Rise in Suburban Poverty Among Highest in Nation   The Brookings Institution on Monday will release a study ranking the Twin Cities area among the nation’s top 10 major metropolitan areas for the speed at which suburban poverty is rising. Its analysis says the number of suburban Minnesotans living in poverty more than doubled between 2000 and 2011.

Health and Human Services

As we near the end of the session, the major budget bills are nearing completion. The details of the Health and Human Services Finance omnibus bill are still being decided, but the basic framework cuts $50 million from the HHS budget, not the $150 million originally planned. At the same time, it makes significant increases (3.25% in 2014 and 3.2% in 2015) to long term care, 75% of which will be mandated to go to workers’ wage increases. This is a major victory for workers whose wages have been frozen for years.

The HHS omnibus bill also includes funding to keep the Willmar state treatment facility, which had been slated for closure, open to continue providing much-needed services.

Tax Plan

The biggest news this week was that the House, Senate and Governor reached an agreement on a tax plan. The plan will make historic investments in education, job creation, balance deficit, and property tax reform. The wealthiest 2% of Minnesotans, with household incomes over $250,000, will pay a new higher tax rate of 9.85%, much closer to the rate middle-class and working families pay. The bill also closes corporate tax loopholes and expands the sales tax on non-consumer items. Finally, it raises cigarette taxes by $1.60 per pack, which MNA supports as the most effective public health measure to discourage youth smoking.

With the funds raised by the tax bill, the state will fund all-day kindergarten and early childhood education, freeze higher education tuition, reduce property taxes by $400 million, invest in job creation initiatives, and erase the budget deficit.

The Mayo Clinic expansion in Rochester (the “Destination Medical Center” project) will also be included in the new tax plan.

Minimum Wage

The House passed a minimum wage increase from $6.15 to $9.50 an hour, and the Senate passed an increase to $7.75 an hour. The House and Governor have said they wouldn’t accept the small increase made by the Senate, but Senate leadership has indicated that they will not be able to pass an increase any higher than $7.75, putting any increase in minimum wage this year in doubt.

MNA supports an increase in the minimum wage because it will lift many families out of poverty and will stimulate our economy. Please use the Grassroots Action Center to contact your Senator TODAY and encourage them to raise the minimum wage to $9.50 an hour indexed to inflation. Study after study shows that raising wages speeds economic recovery, increases productivity, and reduces turnover for small businesses. That income goes directly back into the local economy to improve communities. A bill to raise the wage to $9.50 would help more than a half-million Minnesotans put food on the table and pay their bills.

State Employee Contract

The contract that includes over 700 MNA nurses at multiple State of Minnesota facilities passed its final legislative hurdle last week and now is waiting for the Governor’s signature.

Legislative Wrap-Up

Come learn about the impact of the legislative session on issues related to nursing practice, health care policy and finance, and the state budget.

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

Federal Report Shows Wide Disparity in Nursing Supply   The U.S. Nursing Workforce Report issued by the Health Resources and  Services Administration National Center for Health Workforce Analysis predicts continuing shortages as more than 500,000 RNs are expected to retire within the next seven years.

HEALTH CARE

One-Third of Patients Willing to Change Doctors to Save Money Respondents also were asked how much money they would need to save annually to make that switch. Thirty-four percent thought keeping down out-of-pocket insurance costs was more important than retaining their doctors.

Angelina Jolie:  My Medical Choice   It has got to be a priority to ensure that more women can access gene testing and lifesaving preventive treatment, whatever their means and background, wherever they live. The cost of testing for BRCA1 and BRCA2, at more than $3,000 in the United States, remains an obstacle for many women.  Related:  Jolie’s Procedure Shows Harsh Choices Women Face   The $3,000 cost of the screening test may be an “obstacle for many women” without health insurance,

California Hospital Charges are 4.5 Times Their Cost    The hospital industry typically seeks to dismiss reports on the massive disparity between its costs and charges insisting that few actually pay the “list” price, and insists the charges are “random” when in fact there are distinct patterns in the pricing practices.   Related:  Miami Hospitals Plan to Release More Cost Data    Once a closely-held competitive secret, hospital prices are beginning to shake loose from the grips of healthcare executives in the wake of last week’s unprecedented move by the federal government to publicly share what hospitals bill Medicare for the most common diagnoses and treatments.

LABOR UPDATES

Record Debate Yields Victory for Care Workers’ Unionization   An all-night, 17-hour debate prompted by furious GOP opposition ended with a victory for unions seeking to organize care-workers on Wednesday.

Candidate Forms Are Due June 15.

MNA members, be involved in making decisions and directly working towards advancing the goals and mission of MNA as established by the House of Delegates.

Submit your name for one of the many elected offices listed on the Call for Candidates Form. Many different opportunities are available that could reflect your passion – from collective bargaining and organizational governance, to education and practice-specific work or governmental affairs.

Nominations for the offices listed on page 1 of the MNA Call for Candidates Form will be accepted until 5:00 p.m. on June 15, 2013.

You must sign the form and submit via one of the following methods:

1. Mail or bring to the MNA office 345 Randolph Avenue #200, St. Paul, MN 55102
2. Fax 651-695-7000
3. E-Mail Julie.Kinsel@mnnurses.org

The Call for Candidates Form is located on the Member Portal and may be completed on line, but then must be printed out, signed, and returned by one of the above methods.  You can also download all forms and explanations from the Spring 2013 issue of the Minnesota Nursing Accent, here.

In accordance with the MNA Board of Directors policy (also available on the Member Portal), there will be no write-in candidates on the ballot.

If you have any questions regarding the election, please contact either Samantha Riazi or Julie Kinsel.

The election timeline has changed since the last election cycle. Please make note of the dates.

2013-2014 ELECTION TIMELINE

NOTES ON NURSING

Angels Fund Set Up for RNs and Co-Workers Lost in Limo Fire   This year’s Nurses Week was sadly darkened by the death of two RNs and three other caregivers in a tragic limousine fire on the San Mateo Bridge in the San Francisco Bay Area.

UMass Nurses Will Strike Over Poor Patient Care Conditions    After posting more than $88 million in profits, UMass Memorial Medical Center has slashed its nursing and support staff in the last two years.

LABOR UPDATES

Dairy Queen Offers Grads Their First Job – Without Pay    Edina-based Dairy Queen is giving new college grads the chance to shill for its Orange Julius brand.

North Dakota Leads Nation in Rate of Worker Deaths   North Dakota had a workplace fatality rate that was more than three times greater than the national average and more than five times greater than Minnesota’s rate.

HEALTH CARE

Health Care Plan Needed for End of Life   Never in human existence has dying been more complicated. Before the onset of modern medicine, most people died quickly from an acute event such as trauma or the effects of infection. Today most deaths are a slow process of decline.

The Skyhigh Price of Chemotherapy:  Why Do Cancer Drugs Cost So Much?  Overall, cancer drug prices are skyrocketing. Of the 12 drugs approved by the Food and Drug Administration for various cancer conditions in 2012, 11 were priced above $100,000 for a year of treatment.

Study:  Nearly One-Third of All Death Certificates Are Wrong   As to why doctors were reporting inaccurate causes of death, it actually appears to be a weirdly bureaucratic reason: Three-quarters said the system they use in New York City would not accept what they thought to be the real cause of death.

The Mayo’s Destination Medical Center appears to be a done deal.  Hundreds of milliions of taxpayer dollars will transform Rochester into a gilded city worthy of hosting a gold standard of health care in the world, but something’s missing from all the talk – patients.

We know a little about what Rochester could look like, but it’s a lot more than we know what the Mayo could look like.  Rochester is slated to build new bridges, hotels, streets, and even a high-speed train from Minneapolis.   The DMC will create the optimal experience for patients and their families with world-class amenities to match their level of care.  That means hotels, restaurants, where patients and/or their families could enjoy lavish accommodations and entertainment while getting better.

In fact, both Minnesota Public Radio and the Rochester Post-Bulletin have reported that for more than two years, DMC was a top-secret project.  No one in the newspaper’s newsroom had even heard of the DMC, even though the P-B’s publisher was in on some of the meetings.  Evidently, a contract of confidentiality had to be signed just to be in the meeting.

The Mayo even agreed on a logo for the DMC after putting the design out to competitive bid in April, 2010-more than two years before the DMC project became public knowledge.

The Mayo has only hinted, for example, that a new $100 m tower at St. Mary’s hospital is probably first to be built as it can dovetail from a current construction project.  What kind of care will be available in this tower, we don’t know.  The Mayo receives more than $100 million in competitive peer review grants into cancer research alone, but the public amenities seem more open to discussion than any cutting edge technology.

By contrast, the Cleveland Clinic’s medical campus extols the innovation alley that’s being created to foster new technology that will bring better care to new patients.

The Mayo says 30,000-40,000 people will be hired over the next 20 years to create a world-class medical campus to compete with the Cleveland Clinics and the Johns Hopkinses of the world.  There’s no talk of whether any of those new workers will be doctors and nurses or valets and food servers.  It appears that patient satisfaction surveys have become more important than the patient outcomes and that marketing has become more marketing than medicine.

The Mayo could be a Destination Medical Center by ensuring that enough nurses and staff are hired to safely care for serious patients and promote better outcomes.  The Mayo could be a destination for innovative care by seeking out the toughest cases the medical world sees and solving those cases, regardless of the patient’s ability to pay.

There are other questions too.  Such as, will these “new” buildings include current union employees? And will agreements be in place to assure labor peace before construction begins?

But the biggest question remains, will patients make Rochester a destination without knowing what level of care they’ll receive?

Standards of Care Campaign

Yesterday, Governor Dayton signed HF588/SF471 into law after it passed its final hurdle on the first day of Nurses Week when the House took a last procedural vote on Monday.  The bill requires the Department of Health to conduct a thorough study of the correlation between nurse staffing and patient health outcomes, and mandates every Minnesota hospital to publicly report their staffing plans.

When the study is complete, we will have Minnesota-specific data to underscore the stories nurses have been telling legislators for years: that unsafe staffing is a serious problem in Minnesota hospitals. Our ultimate goal is still a minimum standard of care for patient assignments in Minnesota. To that end, we must continue to advocate for safe staffing in every hospital, every day, every shift. Continue to submit Concern for Safe Staffing forms – they do make a difference – especially to legislators who may be skeptical that inadequate staffing is a problem.

Please thank the Governor for his support of nurses and of patient safety by sending an email.

Minimum Wage

Last week the Minnesota state House passed a long-overdue increase in the state’s minimum wage to $9.50. At the current federal minimum wage of $7.25, a couple with two children would have to work 155 hours a week to meet basic needs. Families headed by minimum wage workers are stressed, and an increase in minimum wage would lift many out of poverty. Click here for more information about the minimum wage in Minnesota.

This week the Senate passed their version, increasing the minimum wage to $7.75. Neither the House nor Senate version contains a “tip penalty” (a lower minimum wage for tipped workers like restaurant servers). The House version of the bill also indexes the minimum wage to inflation, ensuring raises for minimum wage workers as costs go up in the future.

The bill will now go to a conference committee to work out the differences between the two bills. MNA supports the House position, which brings minimum wage workers closer to a living wage.

The minimum wage increase may affect you, because many MNA nurses have contract language that is tied to the minimum wage. Check your contract by logging in to the MNA member portal at www.mnnurses.org.

State Employee Contract

The contract that includes over 700 MNA nurses at multiple State of Minnesota facilities will receive a vote on the Senate floor soon, possibly today. It has already been passed by the House, and should pass the Senate and go on to the Governor for his signature.

State Budget

Leaders of the House and Senate have been in meetings with the Governor this week to work out the differences between their budget and tax proposals. Among other items, the Health and Human Services budget depends on these talks, so we will continue to monitor the process.

Marriage

Yesterday the House of Representatives voted 75-59 to allow all Minnesotans the freedom to marry, while protecting the freedom of religious institutions and clergy to practice their religion based on their values. Next, the bill will go to the Senate for a floor vote, expected on Monday, and then to Governor Dayton who has pledged to sign it into law. MNA supports the freedom to marry as an important step in ensuring equality under the law for all Minnesotans and their families.

You’re Invited: MNA Legislative Wrap-Up on June 11

Come learn about the impact of the legislative session on issues related to nursing practice, health care policy and finance, and the state budget, Tuesday, June 11, 4:00 – 5:30 pm at MNA office in St. Paul 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.)

Methodist Hospital PACU nurses recently celebrated a win that illustrates how working together and taking action can improve patient care in our hospitals.

After management denied requests for additional staff to replace nurses out on leave, Methodist PACU nurses circulated a petition and gathered the signatures of 100 percent of their fellow nurses on the unit.  They submitted the petition to the employer and within hours the employer notified MNA that they would bring in agency help to improve staffing and would post the position for a permanent replacement in the coming weeks.

“We’ve got to staff our unit.  Our contract says we’re back up calls, not first call,” said Jean Adomaitis, RN, in the Recovery Unit.  Adomaitis said they feared patient care was going to suffer and gaps in staffing would start to appear on the day shifts as tired nurses wouldn’t be able to work round-the-clock.   She said she wasn’t surprised by all the signatures and credits the unanimous consent of all the nurses to convincing management to act.

“It was almost a slam dunk,” Adomaitis said.  “The fact that everyone signed it.   They saw the whole unit, a very professional unit with lots of ICU experience.  She (nursing manager) saw all these names, and said, ‘ok, we’ll do something.’”

We are ethically and legally obligated to advocate for the safety of our patients every day, in every unit, on every shift. When our professional nursing judgment tells us that staffing is unsafe and potentially detrimental to patient health, we have to act collectively to demand better staffing. When we are denied that help the first time, we must increase the pressure on the employer until they have to respond.

The petition was Methodist PACU nurses first collective action as a unit, but other member leaders helped them out just as PACU members supported facility-wide actions in the past.  We have the collective action of the nurses who came before us to thank for our right to organize, our high standards of patient care, and the protection of our union contract. It is our responsibility to our patients and to the future members of our profession to continue that proud tradition of advocacy.