What Nurses Really Want

When Nurses Week rolls around each May, our employers predictably trot out the pizza parties, free lunch totes, and all manner of cutesy promotions and prizes to show how much they “appreciate” and “value” us registered nurses.

But National Nurses United RNs are not so easily fooled, nor bought off. Our nurse members, and the activist nurses we are allied with around the world through Global Nurses United (GNU), always use Nurses Week as an opportunity to remind the public about what nurses really want and what we stand for as patient advocates.

We don’t want doughnuts and free pens; we want safe staffing ratios so that we can actually care for our patients the way they deserve, workplaces without violence, and lift teams and equipment to save our backs. We stand for a just healthcare system for all that eliminates the profit motive from providing people with what we consider a human right, so we oppose privatization of services and the starvation of public health services and the public sector. We know a healthy planet means healthier people, so we stand for a world not reliant on the burning and extraction of fossil fuels.

“We have a slogan in NNU, ‘Save one life, you’re a hero. Save 100 lives, you’re an RN,’” said RoseAnn DeMoro, executive director of NNU. “Yet too many hospitals treat this as a moment to give nurses balloons or candy while seeking to drive down patient protections and nurses’ livelihoods every other day of the year. Let’s honor nurses every day by once again treating hospital care as a caring, public service, not just another Wall Street-type institution.”

Leading nurse and healthcare union organizations in 11 countries across the globe held coordinated actions that week to highlight global efforts to improve patient care protections, oppose cuts in healthcare services, and stop the erosion of nurses’ workplace and living standards that are under attack in many countries.

In the United States, NNU held rallies in Washington, D.C. on May 12 to urge passage of mandatory, minimum nurse-to-patient ratio legislation and to call on the federal Veterans Administration to stop the bullying of registered nurses. Nurses also lobbied Congress in support of legislation to mandate minimum nurse-to-patient ratios across the country and for full collective bargaining rights for nurses employed at the Veterans Administration. California and Minnesota nurses used Nurses Week as a chance to lobby legislators in support of various bills to protect patients.

“We are here today to celebrate international nurses’ day.But more importantly, we’re here to take action as nurses to make our values as nurses a reality—values of caring, compassion, and community,” said Touko Leuga, a registered nurse in the medical/surgical unit at MedStar Washington Hospital Center, the largest hospital in the District of Columbia.“It’s time for the DC Council to step up by moving forward on the Patient Protection Act. The health of our patients depends on it.”

Australian nurses, through the New South Wales Nurses and Midwives’ Association and the Queensland Nurses Union, pushed for safe staffing ratios in their country through demonstrations and other public events. The Canadian Federation of Nurses Unions launched its federal election campaign May 12 with the slogan “Vote care, not cuts” to defend and shore up the country’s Medicare system. In Europe, the Greek healthcare workers union PASONOP also called for safe RN-to-patient staffing ratios to address dangerous understaffing in Greek hospitals and for better funding of the Greek healthcare system. In Ireland, the Irish Midwives and Nurses Organisation held a press conference calling on the government to restore nurses’ pay and working conditions that have been cut due to austerity measures that have defunded the healthcare system.

the healthcare system. Throughout the Caribbean and South America, registered nurses held many different actions. In Brazil, RNs met with legislators to lobby for a 30-hour workweek and held other events honoring nurses. In the Dominican Republic, the Sindicato Nacional de Trabajadores de Enfermeria visited the Dominican Congress to demand that it approve a salary increase for all public and private employees, including nurses. On May 12, multiple nurses unions held a vigil outside the National Palace to demand President Danilo Medina comply with the agreements signed since October 2013, in which health insurance is guaranteed to pensioners, transportation among others.In Paraguay, the Asociación Paraguaya deEnfermeríaheld a mass mobilization in front of the Ministry of Public Health in Asuncion on May 8 to defend the law that respects nurses’ rights and professional practice.

In the Philippines, the Alliance of Health Workers held protest actions May 7 calling for a national minimum wage, decent jobs, and a ban on contract labor.And on May 11, the union demonstrated before the House of Representatives with demands for decent jobs for nurses, better pay, and working conditions. In Taiwan, RNs joined other labor unions and marched for improved working conditions, including less overtime and better pay. ns, including less overtime and better pay.

“This great series of actions represents the dedication of nurses and other healthcare workers worldwide uniting to protect patients and the health of our nations,” said Karen Higgins, RN, co-president of NNU.

Safe Nurse Staffing

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Safe Nurse Staffing

It’s no secret: Safe nurse staffing is an issue at many hospitals.

With a rising nurse shortage and increased demand for healthcare, many healthcare professionals are watching the idea of safe nurse staffing slip even farther off into the fantasy realm.

Sure, safe nurse staffing is not an issue in every unit at every hospital, but it is a remarkable problem at far too many. Even worse, many nurses feel intimidated into keeping quiet about the issue — while also (along with their patients) bearing the brunt of the problems it causes when it comes to patient care — all for fear of losing their jobs.

In response to Alexandra Robbins’ related recent op-ed in the New York Times, titled “We Need More Nurses,” Scrubs Magazine took to their Facebook page to gather opinions about how feedback on hospital staffing conditions. Like I said above, there is definitely a taboo around discussing the problem of understaffing — and it’s even reflected in the title of Scrubs’ article sharing Facebook comments on the issue: “Let’s talk about understaffing … just don’t say ‘understaffing.’”

While taking a Travel Nursing job can certainly help address the issue of safe nurse staffing by filling a position in need, much more action and legislation is needed to solve the issues caused when nurses are stretched too thin on the job.

Who better to explain the issue and help address the problem than nurses themselves, who are in the trenches and understand the needs of their patient population better than anyone!

Scrubs’ Facebook feedback revealed that nurses were way understaffed — one even saying she had “27 [patients] at any given time.” The general sentiment was that the issue stems from upper management attempting to constantly cut costs. Ironically, some nurses touched on how the poor working conditions lead to high turnover — which, in the end, costs hospitals more money.

And sadly, we’ve all heard these kinds of stories, one nurse even said she was forced out of her job because she stood up for safe patient ratios.

Have facilities you’ve worked in maintained safe nurse staffing levels? What are some of the consequences that you and/or your patients have faced as a result of unsafe patient ratios? Please share your experiences and opinions in the comments!

CBO Finds 19 Million Would Become Uninsured If Health Law Repealed

Repealing the federal health law would add an additional 19 million to the ranks of the uninsured in 2016 and increase the federal deficit over the next decade, the Congressional Budget Office said Friday.

The report is the first time CBO has analyzed the costs of the health law using a format favored by congressional Republicans that factors in the effects on the overall economy. It is also the agency’s first analysis on the law under Keith Hall, the new CBO director appointed by Republicans earlier this year.

CBO projected that a repeal would increase the federal deficit by $353 billion over 10 years because of higher direct federal spending on health programs such as Medicare and lower revenues. But when including the broader effects of a repeal on the economy, including slightly higher employment, it estimated that the federal deficit would increase by $137 billion instead.

Both estimates are higher than in 2012, the last time that the CBO scored the cost of a repeal.

The latest report from the nonpartisan congressional watchdog and the Congressional Joint Committee on Taxation comes just days before the Supreme Court is expected to rule on the health law’s premium subsidies in the nearly three dozen states that rely on the federal marketplace. Such a ruling would cut off subsides to more than 6 million people and be a major blow to the Affordable Care Act. It could also boost Republican efforts to repeal the entire 2010 law, which would likely face a presidential veto.

Last week, President Barack Obama said nearly one in three uninsured Americans have been covered by the law—more than 16 million people.

The CBO said repealing the health law would first reduce the federal deficits in the next five years, but increase them steadily from 2021 through 2025. The initial savings would come from a reduction in government spending on the federal subsidies and on an expanded Medicaid program. But repealing the law would also eliminate cuts in Medicare payment rates to hospitals and other providers and new taxes on device makers and pharmaceutical companies.

The CBO projected that repeal would leave 14 million fewer people enrolled in Medicaid over the next decade. Medicaid enrollment has grown by more than 11 million since 2013, with more than half the states agreeing to expand their programs under the law.

By 2024, the number of uninsured would grow by an additional 24 million people if the law is repealed.

In 2012, the CBO projected repealing the health law would increase the federal deficit by $109 billion over 10 years.  It said the higher amount in Friday’s report reflected looking at later years when federal spending would be greater.

Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation.

Ask a Travel Nurse: Can I get my state license through one Travel Nursing company then switch to another?

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Ask a Travel Nurse: Can I get my state license through one Travel Nursing company then switch to another?

Ask a Travel Nurse: Can I get my state license through one Travel Nursing company then switch to another?

Ask a Travel Nurse Question:

I am a new nurse hoping to travel! I’ve recently been recruited by an agency for jobs in California, and I sent all my California license info through their recruiters and company. Now I am worried because after looking at multiple Travel Nursing sites this company has many terrible reviews. Can I get my state license through one Travel Nursing company then switch to another? I want to avoid sending all my information and fees again to the state board.

Ask a Travel Nurse Answer:

While there probably is a way for you to do that, I would not be the person to ask in accomplishing this as it is contrary to my values.

If I was receiving help from a company in getting a state license, I would not feel right in saying “thanks,” by then turning around and traveling with someone else. If you find that you do not like the benefits this company offers or have some other reason for electing to go with another company for your second assignment, no worries. But to just go by the word of others (particularly “online” others), when it comes to choosing a Travel Nursing company, in my opinion, may be a reason to proceed with caution, but not to take advantage of a company’s assistance in this way.

If you yourself paid the fees to the board, then you should not have to repay these fees or resubmit your information to the board simply for electing to travel with a different company (again, I do not know the details of your arrangement with this company). However, I can tell you that after 20 years of being a travel nurse, my last assignment was with this company and I would not hesitate to travel with them again.

This begs the question, “Why would a travel nurse, with 20 years of knowledge about the industry, choose to travel with a company with such a reputation?” The answer: I have a great recruiter at there.

You can find a negative review about ANY company out there. What defines most of the complaints is an issue such as “my recruiter told me this,” or “they promised this.” Examples that are easily combatted by having a great recruiter and getting everything in writing. No one company has a monopoly on bad recruiters. That is why I never recommend or refer nurses to companies, but rather, to great recruiters who work for the companies I trust with my travels.

I have always maintained the importance of the recruiter in the Travel Nursing equation. Quite simply, you MUST have trust in a person who is arranging job for you that may be hundreds or thousands of miles from home. They should be willing to answer all of your questions and take the time to find assignments for you that are based on your criteria.

While I’m sorry this does not answer your original question, I do hope it gives you some added perspective.

David

david@travelnursesbible.com

Congressional Bills Would Mandate Equal Coverage For Pills And IV Cancer Therapy

A bipartisan group of House and Senate legislators introduced bills last week that would require health plans to cover the growing number of oral chemotherapy pills as favorably as they do intravenous chemotherapy. But an insurance trade group says that as long as drugmakers continue to increase the prices of the oral drugs, parity legislation amounts to a “shell game” that will push up everyone’s premiums.

In recent years, states have passed oral chemotherapy parity laws at a steady clip. They’re on the books in 39 states and the District of Columbia, according to the American Cancer Society’s Cancer Action Network.

A federal law would ensure equal access across all states, says Anna Howard of the ACS Cancer Action Network.

Proponents also say the bill is needed to because private self-funded health plans that pay their employee claims directly generally don’t have to comply with state parity laws.

About a quarter of chemotherapy drugs in the pipeline are oral cancer medications, Howard says.

Similar bills that were introduced in the previous congressional session didn’t advance. It’s unclear that the current bills have any better chance.

Patients who receive intravenous chemotherapy typically pay a flat copayment (perhaps $50) for an outpatient visit. Oral chemotherapy pills are covered under a plan’s pharmacy benefit, however, where they’re often placed in higher cost tiers that may require coinsurance of 20 percent or more that for some drugs can run thousands of dollars.

Under the health law, consumers are limited in how much they can be required to pay out of pocket annually for care. (The only exception is for enrollees in plans that are grandfathered under the law.)  In 2015, those limits are $6,600 for individuals and $13,200 for family coverage.

Still, “many individuals don’t have an extra $6,600 in their bank account in order to get up to their out-of-pocket maximum,” Howard says.

The proposed bill would require plans to cover chemo pills on terms “no less favorable” than their coverage for IV chemotherapy drugs.

But with the price tag for some oral cancer drugs well into six figures for a course of treatment, consumer premiums are bound to rise if insurers have to absorb the lion’s share of a drug’s cost, says Clare Krusing, press secretary at America’s Health Insurance Plans, a trade group.

“This legislation would place an arbitrary limit on cost-sharing between medical and pharmacy benefits, forcing premiums to increase for all consumers as a result,” Krusing says.

Please contact Kaiser Health News to send comments or ideas for future topics for the Insuring Your Health column.

Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation.

Fast Track Bill Moves On to Senate, Along with Fight to Stop It.



Dear members and supporters:

We cannot thank you enough for continuing to hold your ground. The past months have seen nurses, union members, working families, environmentalists—a very broad coalition of Americans—stand together against Fast Track authority for the Trans-Pacific Partnership. We proved the power of our united voice by stalling Fast Track last week.

In the latest update, today the House of Representatives sold out to multinational corporate interests by using a series of slick maneuvers to pass Fast Track. The bill moves on to the Senate now—and so does the fight to stop it.

Want to see how your House rep voted today? Click here.

Contact your Senator to continue saying ‘No’ on Fast Track

Americans will look back on this moment—when medication costs, environmental and food safety regulations, and workers’ jobs were on the line—and remember who was fighting for public health. Thank you for standing up for millions of Americans. We will continue to keep you posted, as this risky trade agreement moves on the Senate—and we attempt at every juncture, to stop it for good.