Fairview Lakes nurses are standing up for a fair contract that ends inequities in pay between nurses in clinics and the hospital.
Fairview Lakes nurses are standing up for a fair contract that ends inequities in pay between nurses in clinics and the hospital.
The 2014 session of the Minnesota Legislature was a success for nurses and working families. Minnesota’s growing economy produced a $1.2 billion budget surplus in 2014, allowing Governor Dayton and the legislature to deliver middle class tax relief and new investments in our schools and our economy.
Minnesotans have seen remarkable progress over the past two years following some of the most productive, efficient legislative sessions in recent memory. Much of that progress will affect patients, working families and nurses.
Health and Human Services Policy Omnibus Bill: Signed into Law
The Governor signed the package of health policy bills (HF2402) into law. Several MNA priorities were included in the bill.
o Requires health licensing boards to temporarily suspend a health professional license for 30 days and complete a disciplinary investigation during that time, if they receive a report from HPSP that the regulated person has engaged in conduct that might cause risk to the public and the board has probable cause to believe their continued practice presents an imminent risk of harm to the public.
o Allows the 30 day temporary suspension to be lifted if the board does not complete their investigation by then, unless the regulated person requests a delay.
o Requires all health licensing boards to stay in HPSPS until July 1, 2015.
o Requires employers to report any knowledge of drug diversion by a regulated health professional to that persons licensing board unless the knowledge was obtained in the course of a professional-patient relationship or because of the person’s participation in HPSP.
o MNA supported this legislation to protect patient safety and to protect the privacy and health of nurses with substance use disorder who are working to preserve their licenses and careers.
o Bans the sale of e-cigarettes from kiosks and vending machines.
o Requires child-resistant packaging to prevent the dangerous ingestion of nicotine by children.
o Bans the use of e-cigarettes in publicly-owned buildings.
o Local communities can implement more restrictive regulations on e-cigarettes if they wish.
o MNA supports restrictions on e-cigarettes since the long term health effects are unknown.
Public Employment Relations Board: Signed into Law
On May 9th, the Governor signed into law a bill to establish a Public Employment Relations Board (HF3014). This legislation will create a board to decide Unfair Labor Practice (ULP) claims involving public employees, which includes many MNA nurses at public municipal or county hospitals (known in statute as Charitable Hospitals). Under current law, public employers and employees must litigate ULP claims in district court-a cumbersome and expensive process. MNA supported this bill because the PERB will create a process that saves employers and employees money and would mirror the ULP process in the private sector.
APRN Bill: Signed into Law
Governor Dayton signed into law a bill to allow Advance Practice Registered Nurses to practice to the full extent of their scope (SF511). The law gives full practice authority to Certified Nurse Midwives, Certified Registered Nurse Anesthetists, Nurse Practitioners and Clinical Nurse Specialists. Beginning January 1, 2015, APRNs will be able to practice independently. The new law limits, however, CRNA’s who will continue to require a collaborative management agreement with a physician to practice pain management.
This law represents years of work by advocates for APRNs, and MNA was proud to support this effort.
Steve’s Law: Signed into Law
Governor Dayton signed into law a bill to broaden the availability of Naloxone (Narcan) for first responders to use in cases of opiate overdose (SF1900). The bill received near unanimous support along every stage of the legislative process. Members of both parties spoke eloquently about the disease of addiction and the great promise this bill has to save lives and give individuals suffering with substance use disorders a second chance. MNA proudly supports this bill, and we applaud the chief authors, Rep. Dan Schoen and MNA member Sen. Chris Eaton, for their work on this common-sense, live-saving legislation.
Medical Cannabis: Awaiting Governor’s Signature
Sen. Scott Dibble and Rep. Carly Melin, the authors of different bills to legalize medical marijuana, announced they had come to an agreement based on the House version of the bill, but with some changes that broaden access, while tightening restrictions to prevent misuse.
This bill will be the strictest and most regulated medical cannabis law in the country. Only patients with qualifying conditions such as cancer, HIV/AIDS, and seizures will be eligible. It does not allow smoking of marijuana. Instead, patients can access approved forms of medical cannabis such as liquid, pill, or vapor. The bill creates a patient registry to monitor the use of prescription cannabis as well as to evaluate the health effects. Governor Dayton has said he will sign the bill next week.
MNA supports legislation that would provide compassionate relief to seriously ill patients.
Budget Issues: Signed into Law
The Governor signed the Omnibus Supplemental Budget bill into law. There are several portions of the bill that will directly affect MNA members. Highlights of Health and Human Services portion:
Construction Projects: Signed into Law
The Capital Investment Bonding bill to fund construction projects included several MNA priorities. Highlights include:
Minimum Wage: Signed into Law
For the first time in a decade, Minnesota’s minimum wage is set to increase. An estimated 325,000 hard-working Minnesotans will get a raise to $9.50 by 2016 (HF2091). The minimum wage will be indexed to inflation in 2018 to keep up with the cost of living. MNA supported this effort because poverty is a public health as well as an economic issue.
Synthetic Drugs: Signed into Law
The Governor signed a bill prohibiting the sale of synthetic drugsinto law. MNA members actively advocated for tougher prohibitions on synthetic drugs and were vocal supporters of the bill. We thank Representative Eric Simonson for considering MNA’s input as he worked to protect both the public and medical personnel affected by those under the influence of synthetic drugs.
Women’s Economic Security Act: Signed into Law
The Governor signed into law the Women’s Economic Security Act(WESA) on Mother’s Day. The WESA is the most significant women’s rights legislation in years.
The Women’s Economic Security Act:
MNA supported this legislation.
Sweeping changes underway in the nation’s health care delivery system that expose hundreds of thousands of patients to severe risk of harm are the focus of a major new national campaign by the nation’s largest organization of nurses announced today.
An unchecked proliferation of unproven medical technology and sharp erosion of care standards are rapidly spreading through the health care system, far outside the media spotlight but frighteningly apparent to nurses and patients, says National Nurses United.
In response, NNU has launched a major campaign featuring radio ads from coast to coast, video, social media, legislation, rallies, and a call to the public to act, with a simple theme – “when it matters most, insist on a registered nurse.” The ads were created by North Woods Advertising and produced by Fortaleza Films/Los Angeles.
To watch the new videos and hear the radio ads visit www.insistonanRN.org
Or click below:
Key features of the new threat to patient safety include:
Digitalized care – experimental, unproven medical technology put patients at risk
Hospitals and other healthcare industry giants are spending billions of dollars on medical technology sold to the public as the cure for everything from medical errors to cutting costs. But the reality is proving to be far different, warns NNU.
Bedside computers that diagnose and dictate treatment for patients, based on generic population trends not the health status or care needs of that individual patient, increasingly supplant the professional assessment and judgment of experienced nurses and doctors exposing patients to misdiagnosis, mistreatment, and life-threatening mistakes.
Computerized electronic health records systems too often fail, leaving doctors and nurses in the dark without access to medical histories or medical orders. The Office of the Inspector General for the Health and Human Services Department has reported widespread flaws in the heavily promoted systems. Telemedicine and robotics marketed as improved care deprive patients of individualized care so essential to the therapeutic process central to healing.
The face of future health care – a world without hospital care
Cutting costs is now seen as the prime directive in health care. Unwilling to reduce their profits or limit excessive pricing practices, the means to limiting expenses in the healthcare industry is by restricting or rationing care.
Insurance companies do that by denying claims or setting out-of-pocket costs so high Americans lead the developed world in skipping care when they need it because of the price. Hospitals, especially those that are also insurance companies, like Kaiser Permanente, or linking up with insurers through the new Accountable Care Organizations, restrict care by cutting patient services, limiting hospital admissions, or discharging still very ill patients to clinics, nursing facilities, or home, all settings that have fewer staff and regulations. Hospitals overall, have profit margins of 35 percent for elective outpatient services, compared to just 2 percent for inpatient care.
Nurses every day see patients denied admission who need hospital care, held on hallway gurneys in emergency departments, or parked in “observation” units. Observation is the latest fad in large part because Medicare reimbursement penalties for patients re-admitted within 30 days for the same illness do not apply if the patient was discharged from an observation unit.
The ascendance of profits while reducing access to professional nursing care
Hospital industry profits are at a record high – some $64.4 billion in 2012, according to American Hospital Association data. Kaiser Permanente, which is the model for many of the industry trends, just reported first-quarter profits of $1.1 billion, up nearly 44 percent from a year ago.
Yet, as one of the new NNU radio ads notes, many of those hospitals are spending their profits and patients’ health care dollars “on everything but quality patient care” – on technology, Wall Street investments, buying up other hospitals, while cutting the staff of bedside registered nurses, “the health professionals most critical to your care and safety.”
Inadequate, unsafe staffing is proliferating through the nation’s hospitals, even as hospitals shift care to other settings leaving the patients able to get in, and stay in hospitals, facing often perilous care standards. Just one example of many, in a report released May 12, Washington, DC nurses cited 215 incidents of severe understaffing, including life-threatening events, in District hospitals the past 15 months. RNs in DC and several states are pursuing safe staffing legislation.
‘Behind every statistic a patient exposed to unnecessary suffering’
“The American health care system already lags behind other industrialized nations in a wide array of essential health barometers from infant mortality to life expectancy. These changing trends in health care threaten to make it worse,” said NNU Co-President Jean Ross, RN. “Behind every statistic is a patient, and their family, who are exposed to unnecessary suffering and risk as a result of the focus on profits rather than what is best for individual patient need.”
“What we are advising every patient, every American to do is stand up and be heard,” said Ross. “When it matters most, insist on a registered nurse.”
MNA Legislative Update May 2, 2014
Public Employee Relations Board
A bill to establish a Public Employee Relations Board (HF3014) was passed by the full Senate on Monday. This legislation would create a board to decide Unfair Labor Practice (ULP) claims involving public employees, which includes many MNA nurses at public municipal or county hospitals (known in statute as Charitable Hospitals). Under current law public employees must litigate ULP claims in district court-a cumbersome and expensive process. The PERB bill would create a process that saves employers and employees money and would mirror the ULP process in the private sector.
Many nurses contacted their senators last week asking them to oppose attempts to remove Charitable Hospitals from the bill, and we are pleased to report that an amendment to exempt those facilities failed. Another amendment to delay implementation of the PERB for Charitable Hospitals for one year also failed.
The companion bill was already passed by the House, and, next week, we anticipate the House will vote to concur with the Senate version of the bill, which would then go on to the Governor for his signature.
Sen. Kathy Sheran’s bill (SF511) to allow Advance Practice Registered Nurses to practice to the full extent of their scope was heard on the Senate floor. Her bill would give full practice authority to Certified Nurse Midwives, Certified Registered Nurse Anesthetists, Nurse Practitioners and Clinical Nurse Specialists. The bill allows APRNs to practice independently, but does limit CRNA’s who will continue to require a collaborative management agreement with a physician to practice pain management.
The bill passed unanimously, and we anticipate the House will vote to concur with the Senate language, which MNA supports over the House language.
The bill to legalize medical marijuana prescribed by a physician for certain serious medical conditions (SF1641) passed the Senate State and Local Government Committee on Tuesday then passed Judiciary without recommendation on Wednesday. The Senate Health and Human Services Finance Division amended the bill today to prohibit smoking medical marijuana, but would still allow “vaping,” the inhaling of fumes through a charged liquid vaporizer.
On Thursday, Representative Carly Melin and House leadership announced a new medical marijuana proposal (SF2470) that would pave the way for clinical trials for patients with qualifying conditions such as seizures, cancer, HIV/AIDS, and glaucoma. Because the bill prohibits smoking marijuana for medicinal purposes, law enforcement is neutral; they have opposed other bills that allow smoking as well as other methods of using medicinal marijuana.
Today the House Rules Committee is hearing the compromise bill introduced by Rep. Melin. As of this writing they have not yet concluded their hearing.
MNA supports legislation that would provide compassionate relief to seriously ill patients.
Health and Human Services Policy Omnibus Bills
The Senate and House omnibus Health and Human Services Policy bills have been taken up by a conference committee to work out differences between the two. The bills both include language that MNA supports related to the Health Professionals Services Program and health professionals with substance use disorders.
Supplemental Budget Bills
The House and Senate are also working out the differences between their supplemental budget bills in a conference committee. In his supplemental budget recommendation, Governor Dayton included $11 million this year and $22 million in the next biennium to cover the cost of negotiated salary increases for staff working in 24-hour care facilities within State Operated Services and the Minnesota Sex Offender Program, which includes many MNA members. While neither the House nor the Senate has included this funding in their respective omnibus bills, we have spoken to conference committee members and about the serious consequences of not funding the State Operated Services salary supplement. We will continue to monitor the negotiations.
Nurses Week May 6-12
MNA nurses will be going to the Capitol the morning of Tuesday, May 6 for the kickoff to Nurses’ Week. We’ll meet at the MNA office at 9:00 am to carpool over to the Capitol. We anticipate the House and Senate will go into session around 10:00 or 11:00 am. As legislators enter the chambers, we will give out stickers saying “Nurses Care” then listen to speeches honoring nurses from the Galleries. Please email firstname.lastname@example.org if you can come on Tuesday morning.
MNA Government Affairs Commissioners and staff with State Representative
Joe Atkins at the Capitol on Wednesday.
MNA members of the Sanford – Thief River Falls Medical Center bargaining unit are celebrating the success of their inaugural 5k RN Run on Saturday, April 19 to raise funds for the community’s D.A.R.E. program.
Nearly 60 runners participated in the event and nurses were able to deliver $836 to the organization dedicated to drug abuse resistance education.
MNA Co-Chair Tiffany Eidelbes credited nurse organizers Kayla Knutson and Karey Johnson with imagining and executing an idea that brought a sizable crowd out for the festivities. “They did an excellent job,” said Eidelbes. “We heard several runners say it was a perfect kick start for upcoming longer runs – and it was fun!” Runners grinned to see the Easter Bunny as race starter.
Community engagement in the event is especially meaningful for the nurses as they head into contract talks with hospital management. “People asked good questions about how the union contract helps us protect our patients,” said bargaining unit Vice Chair, Amber Hawkins. She believes it was an opportunity to provide good insight and background that will result in support down the road. “The event helped set a good tone,” added Hawkins.
The nurse group all agrees they definitely hope to repeat the event.
The 83 members of the MNA bargaining unit will begin talks with hospital management on May 14. The contract expires on July 31.
Eight months into negotiating a contract with management at Rainy Lake Medical Center (RLMC), the 27-member bargaining unit is literally seeing signs of support throughout this picturesque city that shares a border with Canada.
Over 100 signs, sporting the message “We Support Our Nurses” are being posted in shop windows; hoisted high by firefighters, paramedics and EMTs; cradled by senior apartment residents; and displayed on bulletin boards throughout the city’s commercial districts. It’s a message warmly given from the town often referred to as “America’s Icebox.” In addition, members of several other unions in the area have signed petitions of solidarity for the nurses.
RLMC management has yet to receive the message. Contract talks on Tuesday ended after the union and hospital could not come to agreement settling outstanding proposals in negotiations.
A key issue is hospital management’s attempt to force a “management rights” clause into the next three-year contract. Nurses fear the provision could lead to administrative personnel perceiving they have power to make arbitrary decisions that impact nursing practice and patient safety.
A petition, signed by 100 percent of the nurses and delivered to management in February characterized, the tactic as a “serious overreach of authority.”
“When it comes to the care we are able to give and how we can advocate for our patients, this proposal ties our hands,” said MNA negotiating team member Diane Olek. She is especially concerned about the fast-changing dynamics of health care.“ This is a contract we will have to live with and health care is changing so quickly,” said Olek. She worries that non-providers believing they can arbitrarily make unilateral decisions about nurse staffing without negotiating them will compromise the safety of patients in the hospital. “Why lock ourselves into this?”
Lisa Hay, an active union member, considers it an unacceptable concession of rights and professional nursing judgment. At a recent all-RN meeting, Hay warned her colleagues “When I looked at the management rights clause I said ‘what you take away from us, you take away from patients’.”
Those values run through the whole nurse group. “I feel 100 percent support at the table,” said MNA Co-Chair Wendy Sutch. “All of our nurses feel very strongly they want to have a voice in patient care.” She describes her colleagues as a tight-knit group and especially sees a deep river of resolve in the younger nurses. “They’re aware of what their future could be based on this contract. Everyone’s on board.”
That solidarity and community support will be on full display for RLMC management to view on Tues., May 6 when MNA nurses intend to conduct an informational picket in front of the hospital from noon – 2:00 p.m.
Minnesota legislators introduced a bill (HF2415/SF2212)to require mandatory flu vaccination for all health care workers. At MNA’s Nurses Day on the Hill on March 11, nurses raised these issues with their respective representatives and senators, including the bills’ sponsors, and brought forward enough concerns that the authors and legislative leaders agreed that the bill should not move forward this year. It is very unusual for a bill’s author to change their mind about an issue after a bill has been introduced, and, to our knowledge, this is the first MNA issue to be withdrawn in recent memory.
While MNA considers vaccinations one important public health tool and encourages nurses to consider vaccination as a means of protecting themselves and their patients, we oppose attempts to legally mandate vaccines. Mandatory vaccination alone is not sufficient to protect patients and staff and control the spread of influenza. Nurses raised these concerns with legislators:
1) Mandatory vaccination is a single pronged approach which does not apply the most effective level of protection against the spread of infection
2) Vaccines can result in illness and injuries that are not compensable by workers compensation
3) Mandatory Vaccination infringes on nurses’ rights to collective bargaining and privacy
The battle against the flu never stops, and the issue of mandated vaccinations will likely return again. MNA believes future attempts to address the spread of flu should include:
Morbidity and Mortality Weekly Report, January 18, 2013
Nurse Licensing, Monitoring and Discipline
The bills proposing changes to the Health Professionals Services Program (HPSP) and how the Board of Nursing handles nurses with substance use disorders and drug diversion are moving through the legislative process. Our priorities remain reflected in the bills – protecting patient safety, treating substance use disorder as a disease, encouraging nurses with substance use disorders to seek rehabilitation treatment, and protecting nurses’ private medical and legal information.
The conference committee working on a bill to increase the minimum wage is still hung up on the issue of an automatic inflationary increase for low-wage workers (“indexing”). While both the House and Senate negotiators agree on raising the wage to $9.50 an hour, only the House has proposed to index the wage to inflation, meaning wages for minimum-wage workers would increase based on cost of living increases.
The Senate has repeatedly rejected the concept of indexing the wage. Its latest proposal is to have the voters decide by putting the question of indexing on the ballot as a constitutional amendment. A bill reflecting that proposal was heard in the Senate Jobs Committee this morning and passed on a voice vote. It goes next to the Rules Committee.
MNA is supportive of raising the wage and indexing it to inflation to low-wage workers can catch up and keep up while lifting their families out of poverty. Low-wage workers have waited long enough, and it’s time for legislators to govern. By raising the wage and indexing future increases to inflation, lawmakers can keep politics out of the minimum wage once and for all.
Call to Action: use the MNA Grassroots Action Center to contact your senator and ask him or her to do the job they were elected to do: govern. It’s time to raise the wage and index it to inflation.
Advocates for long term care workers not working in nursing homes are seeking a 5% increase to match the rate increase nursing home workers received last session. Much like the legislation giving nursing home workers an increase, these long term care workers are also proposing that 75% of the increase be earmarked for compensation of direct care workers. In addition, the employer must come to an agreement about the distribution of funds with the union that represents the workers,if the workers have a collective bargaining agreement.
This increase for long term care workers was included in the House Health and Human Services Finance Bill, which was introduced on Wednesday. We anticipate the Senate will introduce its HHS Finance bill early next week, and we will be watching to see if the increase is included.
State Employee Salary Supplements
The Governor recommended an increase in compensation funding for the Department of Human Service’s Direct Care and Treatment State Operated Services programs and the Minnesota Sex Offender Program. The programs are experiencing compensation pressures due to negotiated salary increases, as well as increased costs of employer-paid benefits for current employees. This increase would allow the programs to meet these increasing personnel costs and continue to deliver care to their clients.
We were disappointed that the House Health and Human Services Finance Omnibus Bill did not include these funds. We are waiting for the Senate’s omnibus bill to be released next week to learn if the funds are included there. MNA is concerned about the situation, and expressing to key legislators how important this funding is to state nurses and other state employees. We will continue to monitor the situation.
Last Friday (after the MNA Legislative Update went out) the Governor signed the tax cut bill that was paid for by the $1.2 billion budget surplus. The bill cut $508 million in taxes, some of which will be available immediately during this filing season. The bill cut $230 million in taxes for middle class families, including the elimination of the “marriage penalty” an expansion of the Working Family Tax Credit, and an increase in child care tax credits for 25,000 families. The bill also includes a tax cut for students and parents for tuition and student loan interest. More information about these tax cuts is available on the Governor’s website.
The employees of Murray County Medical Center (MCMC) in Slayton, MN often refer to themselves in the collective as “family.” They are neighbors and friends who care for neighbors and friends in the most of vulnerable times. In recent years, however, circumstances for patients on some of the hospital’s shifts at the county-owned hospital became so alarming that many of those family members have left the facility. Nurses, physicians, physician assistants and others have either resigned or were forced out – some amidst the disruption of legal wrangling.
Several months ago, nurses who are also MNA Stewards surveyed their co-workers and the results pointed to the hostile environment, fears about inadequate staffing and the fact it is impossible for nurses to be two places at once due to the distance between patient care units.
Julie Lind, a member of MNA who worked at MCMC for the past six years was one of those who could no longer accept the situation. “I believe patients and co-workers were in an unsafe environment,” said Lind. “I resigned because I felt nursing ethics were being violated.” More than once Lind worked a shift alone on her med-surg unit caring for seven patients, with only one other RN in the hospital, who was two hundred feet away in the ER unit. In November, Lind herself was injured while on duty. She despairs most for co-workers who remain, however. One colleague recently hurt her back and Lind was called in to relieve her. “She was in tears. This is a registered nurse who is as good as it’s going to get,” said Lind.
Most of the former and current employees point to a common source of the problems facing the hospital. CEO Mel Snow arrived at MCMC in 2006 after questionable tenures in other health care facilities. One claim alleged he had stripped a publicly-owned hospital in Nebraska to usher it at a bargain price into the hands of Sanford Healthcare. Some speculated Snow had similar intentions for MCMC. A number of employees believe Snow surrounded himself with other managers who went along with him as he operated in an atmosphere in which bullying was not only allowed but encouraged, which fostered an environment of intimidation and fear.
It was MNA nurses who inspired a public uprising of awareness and action. During a February meeting of the County Commissioners (who also act as the hospital Board of Directors), nurses Monica VanOtterloo, Sara Lewis and Donna Thomson all spoke their truths to the admiring applause of audience members.
“I love my job,” said Lewis. “But we have a lot of concerns that we’ve brought to administration regarding safety related to staffing.” Lewis urged the Commissioners to do something, saying, “I’m very afraid.” Thomson called on the Commissioners to capture reality by conducting an employee satisfaction survey and exit interviews of those who left. She posed the concerns that reflected a majority of sentiment that night. “What’s it going to take? How many more nurses? What are we going to do if we don’t have nurses?”
Within days of the confrontation, a public Facebook page emerged, entitled “Taking Back MCMC.” Community members were on fire with discussion and ideas for next steps. Participants expressed support for all MCMC workers and even shared their own stories of suffering due to poor staffing.
On the night of a planned citizen meeting, the group learned some welcome news. Mr. Snow had delivered his own resignation to the Commissioners.
While heartened, there’s no return to complacency for MCMC providers and Murray County residents. One of the most recent posts on the Facebook page reads “try and stay positive and dwell on remaining a community who fought for safe working conditions and a county hospital. We have a ways to go, but working together got us this far.”
In the wake of Snow’s departure, there is a general consensus that remaining hospital management has a lot of work to do in order to earn back the trust of the entire staff by demonstrating that they are listening and will make the necessary changes. Employees and community members have expressed concern that, while some members of management may quietly be relieved the former CEO is gone, other managers may have been “cut from the same cloth” as Snow.
Those seeking change in the hospital culture warn that if managers are not able to learn and adapt, additional problems at MCMC will need to be resolved in order for MCMC to have a healthy workplace for attracting and retaining staff. An optimal environment for staff would be to have all of the ethical, emotional and physical support they need while they deliver outstanding patient care.
MNA nurses have made it a goal to help community members regain confidence in the hospital. They have already conducted meetings in an attempt to open the gates of communication, knowing that getting input from employees for decisions on future issues will help significantly. “We know it will take a lot for the trust to come back, but we are hopeful,” said Thomson.