NOTES ON NURSING

HHS Secretary Sebelius Hails Nurses   National Nurses Week gives us a chance to recognize the contribution of the health care providers at the heart of our health care system.  Every day, nurses provide leadership, innovation and advocacy to meet the health care needs of Americans.

Advanced Nurses Lower Costs, Improve Care   Studies find that Advanced Practice Registered Nurses who provide preventive  care are as effective as primary-care physicians in accuracy of diagnosis and  prescription.

LABOR UPDATES

The Labor Market Won’t Be Healthy Until People Feel Like they Can Quit Their Jobs  The unemployment rate may be falling and the number of jobs rising. But there isn’t enough “churn” going on, a hallmark of a healthy job market, in which people freely move between positions.

Daily Job Death Toll:  150 Workers    The report finds that along with the 4,693 workers killed on the job in 2011 (about 13 a day)—the last figures available from the U.S. Bureau of Labor Statistics (BLS)—an estimated 50,000 workers a year (about 137 a day) die from occupational diseases. In addition, some 3.8 workers are reported to suffer job-related injuries or illnesses each year.

Battle at Kaiser Permanente is Sign of Vibrant Health Care Unions   “The old image is of a union worker being a steel worker or an auto worker but the typical person today is a teacher, nurse, firefighter or airline pilot. Nurses are one of the most unionized groups in society,” said Alex Colvin, who chairs the labor relations department at Cornell University. “This isn’t an area where unions are dying.”

HEALTH CARE

Slowdown in Rise of Health Care Costs May Persist    David M. Cutler estimates that, given the dynamics of the slowdown, economists might be overestimating public health spending over the next decade by as much as $770 billion.  Related:  Structural Changes May Be Foundation for Containment 

Same Procedure, $30K Difference in Hospital Billing   For the first time, the federal government has released the prices that hospitals charge for the 100 most common inpatient procedures. Until now, these charges have been closely held by facilities that see a competitive advantage in shielding their fees from competitors. What the numbers reveal is a health-care system with tremendous, seemingly random variation in the costs of services.

First MAT training for Mankato nurses=full house

Next time, they’ll rent a bigger room.  Maybe a movie theater.

More than 60 nurses from the Mayo Clinic Health System-Mankato showed up for trainings and organizing planning meetings to prepare for negotiations with management later this month.

Nurses showed up over two days to sign upwork with groups of 10 nurses to gather input and organize actions in the lead up to their upcoming contract negotiations through Member Action Teams (MAT).

MAT members will also be a voice of their colleagues upwards through the bargaining team so those at the table understand what’s most important for nurses in their next contract.   Nurses are driven by staffing shortages that threaten patient safety and continues to be a major issue.  Some have received more than five texts a day to pick up shifts.

“I go out and touch base with members, and they contact me,” said David Nachreiner, bargaining team chair,  “it’s an absolutely united group that’s bringing concerns to the meetings.  We all care about patient safety.”

Kris Stenzel talks to a full house.

Nurses mapped the entire hospital up floor-by-floor to ensure that no part of the bargaining unit would be left out of important bargaining news or events or would be susceptible to bad information from rumor or management misinformation.  They’ve also created a unit website that contains specific contract language and a link to email the entire bargaining unit with questions about their major issues.

“We want a safe work environment.  We want enough staff members to be able to do the job that has to be done, which is taking care of patients and to do it safely,” Nachreiner said.

They also made plans for events over the summer to show support for one another at the bargaining team during negotiations, including a family day at the Mankato Moon Dogs.  So far, six negotiating dates have been scheduled.

“We’re prepared to stand together,” Nachreiner said.

Serious talk by Mankato nurses about unsafe staffing situation

NOTES ON NURSING

Sen. Boxer Proposes Federal Regulation for Nurse-to-Patient Ratios    ”I am proud to introduce legislation that will help save the lives of countless  patients by improving the quality of care in our nation’s hospitals,” Boxer said  Tuesday. “We must support the nurses who work tirelessly every day to provide  the best possible care to their patients.”

HHS to Fund Solders-to-Nurses Program   A new program will help military veterans with healthcare experience or training  to build on their skills and abilities and earn bachelor’s degrees in nursing,  Health & Human Services Secretary Kathleen Sebelius announced this week.

Nurses Drowning in a Sea of Paperwork   Nurses are “drowning in a sea of paperwork” with more than one-sixth of the working week taken up doing non-essential paperwork, a survey suggests.

Nurses Lead the Way in Better Diabetes Outcomes  A program led by certified diabetes nurse educators helped patients titrate insulin and improve key diabetes parameters, researchers reported here.

Standards of Care/Staffing Disclosure Act

The Standards of Care/Staffing Disclosure Act (SF471/HF588), creating a Department of Health study of the correlation between nurse staffing and patient outcomes and requiring public reporting of hospital staffing, passed the Senate Finance Committee on Tuesday, and passed the full Senate on Thursday. Thanks to our Senate author, Sen. Jeff Hayden (DFL-Minneapolis), for his work on the bill. The bill will next head back to the House for a final procedural vote, and then to the Governor whom is expected to sign the bill into law.

If you would like to see how your legislators voted, the Senate roll call vote is here, and the first House roll call vote is here. More information about the study can be found in the bill’s fiscal note here.

Nurse Practice Act

Governor Dayton signed the bill clarifying the scope of practice of Licensed Practical Nurses this week. 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.

Thanks to all the nurses who participated in conversations with the Board of Nursing about this issue, and to the bill authors, Rep. Patti Fritz (DFL-Faribault) and Sen. Chris Eaton, RN (DFL-Brooklyn Center).

State Employee Contract

The contract for over 700 MNA nurses in state facilities was passed by the House two weeks ago, and now awaits a hearing in the Senate Finance Committee. Last session, the same contract, agreed to by both management and employees, was voted down by the Republican-controlled legislature after attacks on public employees all session long. This session we expect a smooth path to ratification.

Taxes

A conference committee is meeting to work out significant differences between the House and Senate versions of the Tax bills. We are encouraged both versions ask the wealthiest to pay their fair share to support public investment in our schools, roads, and health care. Both also include an increase in the cigarette tax, which will both discourage youth smoking and help pay for the public health costs of smoking.

LABOR UPDATES

CEO Pay Gap Up 1000% Since 1950    Today Fortune 500 CEOs make 204 times regular workers on average, Bloomberg found. The ratio is up from 120-to-1 in 2000, 42-to-1 in 1980 and 20-to-1 in 1950.

Worldwide May Day Rallies Thousands of low-paid workers are rallying in the streets on May Day to demand better pay and improved working conditions a week after a Bangladesh building collapse that was a grim reminder of how lax safety regulations make work a danger in poor countries.

Health Care Dominates Highest Paying Jobs (no surprise:  nurses excluded) in America   Anesthesiologists top the list with average annual pay of $232,830 as of 2012, the latest year for which official figures are available from the U.S. Bureau of Labor Statistics (BLS).

House Panel OKs Minimum Wage Hike    “Where the hell are the workers in this particular argument?” Mahoney, DFL-St. Paul, asked before the measure passed. “There used to be a compact: eight hours of work, eight hours of rest and eight hours of family. … It is time America, and Minnesota, and this world, get back to that particular attitude.”

Solidarity Forever!  Listen to the worker’s anthem by Pete Seeger

HEALTH CARE

Park Nicollet, HealthPartners to Build Clinic in Plymouth   The site of a former driving range in western Plymouth soon will be home to a 60,000-square-foot medical and dental clinic jointly run by Park Nicollet and HealthPartners.

NOTES ON NURSING

Successful Nurse-Intensive Chronic Disease Management Experiment in Jeopardy    But Health Quality Partners, with its emphasis on continuous nurse-to-patient contact, did work. Of the 15 programs, four improved patient outcomes without increasing costs. Only HQP improved patient outcomes while cutting costs.

HEALTH CARE

Austerity is Hurting Our Health    Austerity is having a devastating effect on health in Europe and North America, driving suicide, depression and infectious diseases and reducing access to medicines and care, researchers said on Monday.

Uninsured Population Swells    About 84 million were uninsured or underinsured, 3 million more than when the 2010 health law was signed and 20 million more than in 2003. About 80 million adults who had medical conditions said they chose not to see a doctor or fill a prescription because of the cost.

Bloomberg News OpEd:  What Tax Exempt Hospitals Owe Their Communities   According to a study published last week in the New England Journal of Medicine, only 5 percent of the money that tax-exempt hospitals spent on behalf of their communities in fiscal year 2009 went to public-health programs.

LABOR UPDATES

Health Care Jobs Saved Minnesota   Bottom line: Health care jobs saved our bacon in the recession. The industry continued to grow jobs during the worst economic conditions in decades.

MNA’s E & GW Commissioners stand behind HealthEast Home Care nurses

The bargaining team for HealthEast’s Home Care nurses got a boost from MNA’s E & GW Commissioners who joined them at the table on Wednesday.  The Commissioners came to show the 68-member bargaining unit and management that MNA’s 20,000 members are standing with them in their fight to achieve a first contract.

After observing negotiations over this one particular morning, it became apparent to commissioners that HealthEast administrators are playing games in the talks and hiding behind their attorney to avoid working out a fair contract.  Jennifer Michelson, chair of the E & GW Commission, said administration is disrespecting HealthEast Home Care nurses by refusing to agree to basic provisions that are part of every union contract.

“They wouldn’t even make eye contact with their own nurses.  They wouldn’t make eye contact with us,” Michelson said, “They have no intention of maintaining what nurses have now as non-contract employees.”

Nurses at HealthEast Home Care are still fighting for basic protections such as a grievance procedure with binding, neutral arbitration as well as “just cause” language that other HealthEast nurses have.

150 nurses and supporters greet St. Luke’s management prior to contract negotiations

St. Luke’s nurses approved a new contract they won after coming to a one-day, wage-only focused negotiations showing they were ready to bargain together after three years of strong member engagement.   The strength of the nurses was apparent even at breakfast.

A hearty “Good morning!” was echoed more than 150 times as Duluth nurses turned out in force in the early morning to welcome St. Luke’s Hospital negotiators to the bargaining table.  They saw nurses from St. Luke’s and from competitor Essentia St. Mary’s as well as their friends, families, fellow union members, and even kids in an impressive display of red filling the hotel hallways.  The big turnout to push for a good contract, however, started well before the day of negotiations and even back to the first day after the last contract was signed in 2010.

Three years ago, St. Luke’s nurses were able to get a Letter of Understanding that staffing issues would be addressed through a thorough review of grids to address shortages.  Nurses continued to worry that their patients were not receiving the best quality to care due to short staffing.

“We did get contract language in our last contract about staffing and ratios, but the hospital has been very slow to implement that,” said Danielle Rodgers, RN at St. Luke’s.

That got nurses talking and organizing.  Together they initiated a petition informing management that staffing levels were still putting patients at risk.  The petition was signed by 330 RNs – more than 75 percent of the unit.

Hundreds of nurses wore the Q button to show safe staffing is needed on every shift.

Nurses then began a “Q” campaign.   Duluth nurses passed out buttons to their colleagues floor by floor with the medical shorthand for “every” next to staffing to indicate every shift needs to be properly staffed.   Management noticed, but so did patients who didn’t get the lingo.

“A lot of people say ‘that’s excellent,” or “I don’t see why you wouldn’t have standards already.’” said Anna Rathbun, RN in St. Luke’s ICU, “We started the button initiative several months ago, and it stirred up unon talk before negotiations were even being thought of, and I think the fact that so many nurses are wearing the buttons showed solidarity in the hospital.”

Management responded by hiring 20 FTEs, but the message was as clear as the Q on the button-that nurses were still standing together after the 2010 contract was negotiated.

When St. Luke’s management approached nurses with a wages-only negotiations proposal, members in each department went nurse-to-nurse to explain the ramifications.

“We asked our members to vote on focused vs. traditional negotiations,” Rathbun said, “just getting the feel for what nurses felt about it and spreading the word about what’s happening-taking their temperature.”

Even future MNA members showed up to support St. Luke’s team

The strong turnout for that vote indicated that yes, nurses would be willing to negotiate wages only.  The established network that was set up to address staffing was now able to turn its efforts to bring out nurses for St. Luke’s wages.

After the “Good morning” event, St. Luke’s post-op nurse, Erin Behling, read a statement that whatever their offer, it will be considered representative of what hospitals think of nurses and the work they do. The crowd of 150 applauded Behling then filed out to let the bargaining teams go to work.

“I think it set a tone that we were not alone as a negotiating team. We were representing a much larger group that was interested and concerned about what was going on at the table,” said Kate Donovan, RN, a nurse in St. Luke’s Med/Surg unit and a three-year veteran of negotiations.

Because they kept up the pressure, nurses received 4.5 percent over three years, and the offer came less than four hours after negotiations began. That deal was ratified a week later by a majority of nurses at St. Luke’s.

“The solidarity and support of all of the unions at negotiations was absolutely crucial to get the settlement that we reached.  The sea of red was absolutely empowering to those of us at the bargaining table and gave us confidence that we would get the agreement we needed to pass,” said bargaining team member Cindy Prout, RN.

Duluth nurses plan to show up united again when Essentia St. Mary’s enters negotiations later this year.

“Duluth’s a total unit.  We’re all MNA.  We’re going to fight for patients. We’re all strong. We’re all fighters,” said Behling.

Hospital negotiators meet a sea of red prior to negotiations.

MNA members join unions, education advocates, and homeless groups to fight for the Robin Hood Tax

Washington DC’s Farragut Square turned into Sherwood Forest this weekend as 2,000 Robin Hoods rallied for a Wall Street Tax to pay for healthcare, medical research, and education.

Fifteen MNA members joined union nurses from Massachusetts, DC, and across the country to demand President Obama and Treasury Secretary Jacob Lew to implement the “Robin Hood Tax,” a transaction fee on stock trading that could generate $260 billion for the needs of the middle class.

MNA members Peter Danielson and Katie Skipton join 2,000 people in Farragut Square

“We have seen the devastation of our patients at the bedside,” said Bernadine (Bunny) Engeldorf, RN, Vice-President of MNA, “we discharge our patients to the streets because some people are picking between healthcare and paying the mortgage.”

“As nurses we can be advocates for patients because we see first-hand how the economy has affected our patients,” said Katie Skipton, RN, from Bemidji.

Buses full tourists in DC for the cherry blossom season saw nurses put on a flash mob as they rallied for an hour with other unions and more than 140 organizations, including ATU and Public Service International.  Then they marched from the square to the White House to the US Treasury Building carrying giant puppets of wealthy Wall Street bankers.  Nurses were also trying to get the attention of G-20 finance ministers and dovetail on the introduction of the “Inclusive Prosperity Act,” HR 1579, which was introduced by Rep. Keith Ellison (D-MN).

“If you can’t be strong enough to go to work, it affects your mental health,” Engeldorf, a mental health nurse, said, “we’ve had people actively suicidal because they can’t get a job.”

“We do our best to get patients healthy and get them home,” Kipton said, “but once they leave the hospital no amount of care or education will help them keep their house.”

Besides the rally, Minnesota MNA members met with the staffs of Minnesota Congressional members Betty McCollum, Colin Peterson, Keith Ellison, and Rick Nolan.

MNA members gather after the Robin Hood Tax Rally

NOTES ON NURSING

Nurses Fight State by State for Minimum Staffing Laws   Legislatures in at least seven states and the District of Columbia are trying to answer that question as they debate bills that would require hospitals to have a minimum number of nurses on staff at all times.

Ruling:  MI Hospital Cheated Nurses Out of Proper Pay   McLaren Lapeer Region improperly cut the wages of 51 registered nurses and must pay them tens of thousands of dollars in back pay, an arbitrator has ruled.

LABOR UPDATES

Minnesota’s Pay Equity Laws Have Bridged Gap for Women   Fifty years after Congress passed the Equal Pay Act, women still make less than men. Except in Minnesota. For public employees, there is no pay gap. It didn’t happen by accident.

Reeling Elsewhere, Labor Poised for Minnesota Gains    As economic changes batter organized labor nationwide, eroding its membership and political power, Minnesota has emerged as one of the few places where unions are faring well.

HEALTH CARE

Senate Unveils Mayo’s Destination Medical Center Plans   Rochester residents would be allowed to serve on the authority board overseeing Mayo Clinic’s Destination Medical Center plan under a Senate plan unveiled Monday.

U.S. Hospitals Send Hundreds of Immigrants Back Home    Hundreds of immigrants who are in the U.S. illegally have taken similar journeys through a little-known removal system run not by the federal government trying to enforce laws but by hospitals seeking to curb high costs.