Seachange Bulletin #88

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Arizona:

Under the Tucson Sun

Defying anti-union climate, Southern Arizona nurses stand up for patients, themselves

In the desert state of Arizona, the climate has been hostile for professionals trying to organize. Nurses have long searched for a way - a voice - to protect themselves and their patients. Now, a handful of nurses appear to have broken through, planting the seeds for change by creating the Southern Arizona Nurses Coalition (SAZNC). ...

Many companies using Internet to communicate with workers

Non-urgent care cited as smaller crowding factor

Australian Capital District:

ANF calls for a national nursing workforce plan

Submission to Senate Inquiry into Nursing

The Australian Nursing Federation Federal Office, in its evidence to the Senate Inquiry into Nursing in Adelaide today, has called for a national nursing workforce plan to alleviate the acute shortage of nurses in Australia. ... "Nurses are suffering because poor staffing levels do not allow them to provide quality care. This means that patients suffer too. ...

British Columbia:

Could BC be Canada's right-to-work beachhead?

Wages lower wherever open-shop laws introduced in US

When workers at a Nexfor lumber and i-joist plant in Juniper, New Brunswick, went on strike last October, it was anything but run-of-the-mill. Negotiations for a first collective agreement broke down over the employer's refusal to accept the inclusion of a union security clause and dues check-off. ... In the United States, right-to-work laws are in effect in 22 states. ... In right-to-work states, individual workers can revoke their membership at anytime and still receive the same union-negotiated benefits as their dues paying co-workers - including the right to union representation. ...

Leaked document details devastating health cuts in Vancouver

Nurses call on Campbell to start putting patients first by abandoning the policies that are forcing health authorities to rip the heart out of BC¹s Medicare system

The document spells out major cuts to acute care and to community health services

Burma:

Burma protest hits Bloomingdale's
<http://www.boston.com/dailyglobe2/083/metro/Burma_protest_hits_Bloomingdale_s+.shtml>
Benjamin Gedan, Boston Globe, March 24, 2002

NEWTON - The Commonwealth's strained relationship with Burma, a Southeast Asian nation whose military government is accused of violating human rights, was reignited yesterday at Bloomingdale's in the Mall at Chestnut Hill as 12 students from Brandeis University protested the store's refusal to eliminate made-in-Burma apparel from its clothing racks. ...

Pressure mounts on Burma's reluctant generals to satisfy clamour for reform

Observers say tentative reconciliation process risks breaking down unless there is a big step forward soon

California:

Groups Form New National Nursing Association Advocating Government-Mandated Staffing Ratios
California Healthline, March 28, 2002

Five state nursing groups have "cut their affiliation" with the American Nurses Association and have formed the American Association of Registered Nurses, an organization that is advocating government-mandated nurse-to-patient ratios, the Knight Ridder/Tribune/Tallahassee Democrat reports. The new association is "spearheaded" by the California Nurses Association, which left the ANA in 1995 and has successfully lobbied California lawmakers to establish minimum nurse-to-patient ratios at general acute care hospitals (Godinez, Knight Ridder/Tribune/Tallahassee Democrat, 3/27).  California's proposed regulations, which are subject to public hearings and could be changed, would initially establish a ratio of one nurse for every six patients on general medical floors. Eighteen months after the expected July 2003 implementation of the rules, the standard would be narrowed to 1-to-5. The rules would also set a 1-to-1 ratio for nurses and patients in trauma centers, a 1-to-4 ratio for pediatric nurses and child patients and a 1-to-2 ratio for obstetric nurses and women in labor (California Healthline, 1/23). CNA President Kay McVay said, "If you don't have ratios, we'll never be able to attract people into nursing, because it's just become so difficult to be able to do your job." The AARN includes groups that represent nurses in Maine, Massachusetts, Missouri and Pennsylvania, for a total of about 70,000 members.

Opposition to Ratios

Hospitals losing money -- major nurse shortage

200 workers rally in Oakland over threats to 'civil rights'

New Study Reinforces Recent CNA Research on Nursing Care

Nurses Seek to Join State's Largest RN Association

District of Columbia:

Medicare¹s Spin Cycle

Medicare Czar was hospital industry/Columbia flack

Dull, but factual: That's the way most Medicare information is presented to US residents. But with the entry of Tom Scully to oversee Medicare, the public may see more Medicare programs that are laundered in the world of for-profit health care, then put through the spin cycle of his organization, formerly known as HCFA. ...

Nursing Home Worker Reform Proposed

England:

Burdened nurses ready for pay fight
<http://www.thetimes.co.uk/article/0,,2-254569,00.html>
David Brown, London Times, April 2, 2002

NURSES are ready to take industrial action over pay, staff shortages and working conditions, according to a poll published yesterday. More than 94 per cent said they were prepared to take action, according to Nursing Times, which carried out the survey of 1,117 nurses. Three fifths said they would take industrial action over pay, with 14 per cent willing to act over staffing shortages. Only 5.5 per cent believed they should never take industrial action. ...

Florida:

Nursing Shortage Act wins approval

State desperate to fill positions

TALLAHASSEE -- Though several issues have illustrated division among party lines in the Legislature, there is at least one subject all members seem to share the same philosophy on: Florida needs more nurses right away. ... The act provides more than $1 million in grants to hospitals, middle schools and high schools to create programs that bring more people to the field and keep them there longer. It also expands financial incentives for nursing students and recent graduates. One of the most praised provisions makes it easier for nurses from other states and US territories to receive licenses to practice in Florida. ...

Nursing: Profession is about caring for others

Ireland:

Discussion: Nurses
<http://www.online.ie/discuss/discussion.adp?d=262370>
Ireland Online, March 17, 2002

Nurses do a great job. They are appreciated by the patients and families of patients but not by hospital management. Their working conditions and pay should be improved. Enough staff should be on duty at any given time so that patients are not put at risk and the mental and physical stress of nursing is not overloaded. Comments please ...  

Deadlock in nurses' dispute talks

Israel/Palestine:

We have had enough killing to last a lifetime
<http://www.coalitionofwomen4peace.org/Home Page/we_have_had_enough_killing.htm>
Coalition of Women for Peace, March, 2002

By now, we have had enough violence to last us forever --
Enough terrorism,
Enough revenge,
Enough incitement,
Enough threats that worse is yet to come,
Enough guns, tanks, bombs, warplanes, blood, pain, tears, and death.
We are appalled that adults think they can actually stop violence by hitting back even harder. There is no way that we can crush the Palestinians out of their demand for a state of their own. There is no way the Palestinians will force us to leave the region. ...

Faith-based violence and religious zealotry

Sharon locks up Arafat, but what is his endgame?
Peter Hirschberg, Ha'aretz, March 30, 2002

Two decades after overseeing the eviction of Yasser Arafat from Beirut, Ariel Sharon came within a step Friday of exiling him from the West Bank, as the prime minister sent IDF troops smashing into the Palestinian Authority Chairman's compound in Ramallah, seizing the building in which his office is located, and literally confining him to a single floor.

"If Arafat wants to go to the bathroom," said one Israeli commentator, only half-joking, "he now needs Israeli permission."

"This situation is different to Beirut," said another observer. "Arafat might have been under siege then, but now there is only a wall separating him and the Israeli soldiers."

With night enveloping Ramallah, Sharon, who labelled Arafat an "enemy" Friday morning and said he would be "isolated," took further practical steps to illustrate what he had in mind. The PA leader's three-storey office building, located in the compound shelled and then seized by IDF troops, was plunged into darkness when troops cut off electricity. The Associated Press reported that phone lines were also severed, leaving Arafat with only a cellphone with which to communicate with the outside world.

The invasion of Arafat's compound and the seizing of Ramallah, is certainly only the first phase in a military operation that is expected to fan out through the towns and villages of the West Bank. The mobilization of reserves which began Friday - Sharon said 20,000 would be called up - is testimony to the scale of the operation the prime minister has planned, and which has been triggered by a series of terror attacks which have claimed 30 Israeli lives in the last three days.

With a submachine gun theatrically placed on his desk, Arafat feverishly called leaders around the world, pleading with them to intercede and stall the IDF operation. In interviews to Arab TV stations, the PA leader sounded fatalistic, some might say melodramatic: "May God give me the honor of becoming a martyr in this holy land," he told Abu Dhabi television. "Despite all that we're facing now, we will not surrender."

Defense Minister Benjamin Ben-Eliezer made it clear, however, that while Arafat was now literally imprisoned in his office, he would not be personally harmed. U.S. Secretary of State, Colin Powell, told reporters at a press briefing he had received a similar commitment from Sharon: "He advised me it would not include bringing any harm to Chairman Arafat, or killing him," Powell said of his conversation with Sharon.

Despite the pledge, no one was ruling out the possibility Friday that the legendary Sharon-Arafat standoff might ultimately end with the Palestinian leader being ignominiously evicted from the Palestinian- controlled areas.

In fact, there were many more questions than answers Friday, as the 18-month-old conflicted lurched toward yet a new level of escalation. What is Sharon's endgame? Does he have a plan that goes beyond his declared intention of smashing the Palestinian terror infrastructure? Is he ultimately hoping to precipitate Arafat's departure, believing a new, more moderate Palestinian leadership will replace him? It was that type of penchant for political engineering displayed by Sharon when he was defense minister during the Lebanon War, which had such tragic consequences.

How long can Israel afford to keep 20,000 of its citizens mobilized? And can Sharon, who said Friday that the military operation would last at least several weeks, maintain public support for an extended military campaign?

The Labor Party does not appear on the verge of bolting the government, and this is likely to help solidify public consensus for the military action. Sharon's determination to keep the national unity government intact, is the result of a lesson he does appear to have learned from Lebanon - that it is impossible to wage war effectively when the public is divided.

But if troop casualties begin to mount, the operation continues for weeks, maybe months, and the suicide bombers continue to strike, Sharon might find the strong public support that exists at present for a harsh military campaign against the Palestinians, beginning to erode.

International backing for any wide-ranging Israeli military action, will evaporate much quicker, especially with the pictures of Israeli troops and tanks invading the West Bank, replacing those of Israelis being killed in suicide bombings, on television networks around the world. Acutely aware that there will be mounting international pressure on Israel to end its military operation, Sharon called on all Israelis to unite behind the government.

With the prime minister enjoying tacit support from the Americans for a harsh military response to the latest wave of attacks - Powell said Friday that Israel had the right to "self-defense" - he does have some diplomatic leeway in which to maneuver. For now, at least. But the Americans, who still harbor plans for a possible strike against Iraq, will not allow him to proceed completely unfettered.

"So far the Bush Administration has saddled Sharon with three restrictions: 'no' to expelling Arafat, 'no' to bringing down the PA, and 'no' to reconquering the territories," writes Ha'aretz diplomatic correspondent Aluf Benn. "Will the US stick to this, or will it cut Sharon some additional slack? How will the US limit Israel's scope of action, and how vigorous will it be in enforcing these limits?"

Europe insists on Arafat's status as a legitimate authority

200 Palestinians surrender in Ramallah; Arafat refuses Sharon's offer of exile

Kentucky:

Kentucky won't set nursing ratios - at least for now
Legislators let two bills die for this session  
<http://www.courier-journal.com/business/news2002/03/29/bu032902s177679.htm>
Patrick Howington, phowington@courier-journal.com, The Courier-Journal, March 29, 2002

FRANKFORT -- How many hours can a hospital nurse work and still treat patients safely? And how many patients can one nurse safely care for? Those have traditionally been matters for hospital officials to determine. But that is changing, as state governments become more concerned about patients tended by tired or overworked nurses. This year, California became the first state to set minimum nurse-to-patient ratios for hospitals; other state legislatures are considering similar measures. In the past two weeks, Minnesota and Washington became the fourth and fifth states to enact laws limiting the amount of overtime nurses can be required to work, and protecting them if they refuse. Kentucky won't join those states, however -- at least not this year. Legislators turned aside two nurse-staffing bills during this session of the General Assembly, which ends soon. ...

Another US healthcare tragedy (see article above):

Those legislators in Kentucky know the same thing the legislators in all states know. If they or their family end up in the hospital, they will, most likely, be given VIP status. Is there a nurse alive who has not seen VIP treatment given to "pillars" of society in the local hospital? I suspect in any major city, certainly here in Boston, Ma$$., nurses have seen famous celebrities and politicians come in to the hospital with advanced notice given to the staff. I sure have. At one world renowned hospital here in Boston, when a physician is admitted, his addressograph is printed with MD on it. In Boston, several hospitals have special wards for the wealthy and famous and well insured. That should be the next movement in nursing ... equal treatment and nursing care for all! If we are going to advocate for the public, we should advocate for the public. If nursing unions announced there would be no more special consideration (ie, refuse to work in the penthouse) given to celebrities, the wealthy, politicians and otherwise advantaged folk in this society and their families, you can bet staffing legislation would be passed in a New York second.

No wonder why the public and policy makers are confused?

"A nurse is truly a nurse only if she has patients."

Manitoba:

Winnipeg likely to have surplus of nurses by 2005: study
<http://www.canada.com/search/site/story.asp?id=F35D5042-0649-4744-8861-DE341D74BB2F>
Canadian Press, March 22, 2002

WINNIPEG -- A new study forecasts that Winnipeg will probably have a surplus of hundreds of nurses by 2005. The study's findings contradict the conclusions of other profiles of the country's nurses. Other studies predict shortages will get worse, not better, as Canada's population ages. The Manitoba study is attracting notice for more than just its findings. The timing of its release at the 11th hour before a nursing strike is being criticized as insensitive. The study was conducted by the Manitoba Nursing Research Institute for the Winnipeg Regional Health Authority and first released in October 2001. It made a second launch as the feature article of the latest Nurscene, the official publication of the College of Registered Nurses of Manitoba. College registrar Sue Neilson says she is shocked the timing of the study's publication in the magazine could be interpreted as deliberately political.

Nurses plan job action despite planned negotiations

Massachusetts:

MNA Launches Mobilization Effort for Statewide Safe Staffing Petition Drive
Here's How You Can Help!
<http://www.massnurses.org/News/002004/launches.htm>
Massachusetts Nurses Association, April, 2002

Organized under the theme "Registered Nurses: The Key to Quality Care," from May 1 - 7 the MNA will be conducting a statewide petition drive for Safe Staffing Legislation to highlight ³Nurses Week. We are now beginning the countdown to the petition drive. Beginning the week of April 1, nurses in MNA bargaining units across the state will be leafleting at their facilities to inform other nurses of the need to get active in the campaign for safe staffing and to start planning to be out in their communities and neighborhoods between May 1 and 7th collecting signatures.

Below is information that has been mailed to team leaders in all the bargaining units. This includes a memo introducing the campaign, a time line for the campaign, the first of four flyers to be developed and distributed in the nurse education effort, the petition itself and a flyer designed to be handed out to the general public as you ask for their signatures.

These materials can be adapted by any other nurse, nursing school faculty member, or individual who wants to use these tools to educate and motivate other nurses to get involved in this historic effort. If you are a member of an MNA bargaining unit, make sure your unit is participating, if you don't belong to an MNA facility, you can still participate by organizing groups of nurses where you work to participate. If every nurse got just one petition filled out, we would have thousands of signatures.

Other highlights of this campaign: we will be running radio advertisements (statewide) before and during the petition drive to raise public awareness of the issue and the drive. On May 9, we are planning a Caravan for Safe Care, where a special media event will be planned, with buses from the Pittsfield, the North Shore and Cape Cod will traverse the state collecting the petitions and delivering them to the State House. Stay tuned for further details.

Special Dates to Remember:

Situation critical

Hospitals grapple with an increasing shortage of registered nurses

Not even the lure of a $10,000 signing bonus could entice Liz Joubert back into nursing. Joubert, a former registered nurse, left the profession in January 2001 after 37 years to take a job as safety officer at Siena Construction in Cambridge. Just a few months into her new job, another area hospital called with the promise of a signing bonus if she would come back. "Money has nothing to do with it," said Joubert, who was making in the high 60s when she left nursing. "(The hospital) couldn't guarantee staffing ratios, and that's the reason I left nursing," she said. "I had too many patients to care for. I felt I was putting them at risk. I brought it time and again to the administration, and they just said, `Do the best you can.' " Doing the best they can is no longer good enough for RNs who are leaving the nursing profession in droves, causing a nationwide shortage of nurses. ...

Hospitals to resume liver transplants: In turnaround plan, Beth Israel Deaconess recruits 6 surgeons

Assabet course helps aids get LPN skills

Kevin Burchill has come under fire for what some see as an abrasive management style.

Patients Treated for Heart Attacks Have Lower Mortality Rate at RN-Unionized Hospitals

Direct contracting may come to state

Patent documents raise questions in dispute on endoscope infection risk

Consultant's report expected by mid-May

Legislators seek Medicaid funds

Bell tolls for dead

About 50 Cape residents join other Bay Staters to lobby lawmakers for full Medicaid funding.

Access to gold-plated health care
Jeannie Chaisson, RN, Auburndale, Boston Globe, March 31, 2002

I appreciated Claire McCabe¹s description of home-care nursing and its benefits to patients (³Gold-plated medicine,² letter, March 24). However, I feel that she has missed the point of the services that Drs. Steven Flier and Jordan Busch plan to offer, which is more time and attention from one¹s primary-care provider. Access is the commodity being purchased.

Perhaps more than any other health care professionals, home care nurses should know that for most chronically ill patients it takes money to purchase access to care. McCabe can coordinate and provide care for her patients only while they meet Medicare¹s narrowly constrained definitions for a reimbursable episode of care.

After that point, the home care nurse, the physical therapist, the dietician, and the social worker all go away. The patient and family are left either to pay for nursing care privately or forgo it.

Over the past decade all parts of our health care system have steadily reduced access to the care of nurses. At the same time, access to the care of physicians has rapidly eroded, with shortened visit times and an alarming trend of doctors refusing to accept new Medicare clients because of low reimbursement rates.

Rather than bashing colleagues who are looking for ways to improve patients¹ access to high-quality care, we need to join together with those who realize that the American health care system provides far too little for the chronically ill. Perhaps then gold-plated care can become the standard for patients regardless of their disposable income.

Minnesota:

Governor Ventura Signs Ban on Mandatory Overtime Bill

Minnesota Nurses Applaud Tri-Partisan Effort

ST. PAUL -- Governor Jesse Ventura signed into law today landmark legislation to limit the use of mandatory overtime when a Registered Nurse considers herself/himself too tired to perform safe patient care. The Mandatory Overtime Prevention Act (SF 2463/HF 2993) makes it illegal for health care employers in acute care settings to take action against a nurse for refusing to work overtime. The bill makes it clear that the nurse exercises her/his own judgment as to whether she/he can safely provide care to patients. "This bill places authority to make judgments about our own professional practice in the rightful hands of nurses," said MNA Board Member Patty Koenig, RN. "As nurses we are bound by our licensure standards and our ethical code to always act in the best interest of our patients. Our patients need to be able to depend on our best judgment. Yet many nurses throughout Minnesota find themselves working when they know they are not safe. They know in their hearts that they should not be handling syringes, giving medications or providing medical treatment." ...

Governor Ventura signed the following bill into law yesterday (March 25, 2002) on No Mandatory Overtime in hospitals in MN. The MN Nurses took the lead on this along with the USWA (as a part of a hospital and clinic coalition that we formed with MNA) to get this bill passed. This law is effective for RNs and LPNs in hospitals starting on January 1, 2003.

11 Sec. 3. [181.275] [REGULATING NURSES' OVERTIME.] 7.12
Subdivision 1. [DEFINITIONS.] For purposes of this section, the following terms have the meanings given them: (1) "emergency" means a period when replacement staff are not able to report for duty for the next shift or increased patient need, because of unusual, unpredictable, or unforeseen circumstances such as, but not limited to, an act of terrorism, a disease outbreak, adverse weather conditions, or natural disasters which impact continuity of patient care; (2) "normal work period" means 12 or fewer consecutive hours consistent with a predetermined work shift; (3) "nurse" has the meaning given in section 148.171,subdivision 9; and(4) "taking action against" means discharging; disciplining; threatening; reporting to the board of nursing; discriminating against; or penalizing regarding compensation, terms, conditions, location, or privileges of employment.
Subd. 2. [PROHIBITED ACTIONS.] Except as provided in subdivision 3, a hospital or other entity licensed undersections 144.50 to 144.58, and its agent, or other health carefacility licensed by the commissioner of health, and the facility's agent, is prohibited from taking action against a nurse solely on the grounds that the nurse fails to accept an assignment of additional consecutive hours at the facility in excess of a normal work period, if the nurse declines to work additional hours because doing so may, in the nurse's judgment, jeopardize patient safety. This subdivision does not apply to a nursing facility, an intermediate care facility for persons with mental retardation, a licensed boarding care facility, or a housing with services establishment.
Subd. 3. [EMERGENCY.] Notwithstanding subdivision 2, a nurse may be scheduled for duty or required to continue on duty for more than one normal work period in an emergency.
Subd. 4. [EXCEPTION.] Section 645.241 does not apply to violations of this section. Sec. 4. [EFFECTIVE DATE.] Sections 1 and 2 are effective January 1, 2003.

Jon Youngdahl, Coordinator
USWA Health Care Workers Council, c/o USWA District #11
2829 University Ave. SE, Suite 100, Minneapolis, MN 55414
(612) 623-8003 (Phone),(612) 623-8840 (Fax), jyoungdahl@uswa.org (E-mail)

Newfoundland:

Nfld. nurses postpone strike vote
<http://www.canada.com/search/site/story.asp?id=0016869E-B109-4CCD-AAEC-3500302888B6>
Canadian Press, March 27, 2002

ST. JOHN'S, Nfld. -- The Newfoundland nurses union has postponed a strike vote and decided to return to the bargaining table. Last week, the province gave the nurses a proposal calling for concessions. The union said in a news release that the proposal was unacceptable. But Debbie Forward, the union president, said the executive and branch presidents have discussed the situation and decided to try negotiating again. She said if they go through the process and government "insults" the nurses by offering something that isn't acceptable, then an immediate strike vote will be held. Nurses are looking for a 20 per cent salary increase over two years. The union also wants action on pay equity. No date has been set for the next round of talks.

New York:

Mount Sinai Nurses Protest Unsafe Staffing
<http://www.nysna.org/NEWS/press/pr2002/pr031502.htm>
New York State Nurses Association, March 15, 2002

NEW YORK, March 14, 2002 - Proposed layoffs at The Mount Sinai Hospital will further threaten patient care, according to the facility¹s registered nurses. Insufficient staffing has already been cited by the State Health Department as a factor in the death of a patient at the facility in January, and additional layoffs will only make matters worse, the nurses say. As a result, the nurses expressed their frustration over this situation with an informational picket from 11:00 AM to 2:00 PM Thursday, March 21, in front of the hospital on Fifth Avenue between 98th and 101st streets. The nurses, represented by the New York State Nurses Association (NYSNA), are trying through their current contract negotiations to develop solutions to the hospital¹s staffing problems. But management refuses to even acknowledge that there is a problem, and is continuing with its plan to cut an estimated 450 positions. So far, 15 registered nurse positions have been eliminated and NYSNA anticipates there will be more. An entire unit has already been shut down, a move that NYSNA believes is the result of irresponsible cost cutting that has no regard for the needs of patients. ...

Death sparks debate over minimum hospital staffing
Claire Hughes, Albany Times Union, March 19, 2002

ALBANY, NY -- The death of a healthy transplant donor at one of the nation's premier hospitals drew sharp criticism from the New York state Health Department, which faulted Mount Sinai for leaving an inexperienced surgical resident to care for 34 patients. Just as troubling, according to some experts, is that the state has no minimum staffing requirements at hospitals. The lack of oversight comes as administrators struggle to find enough nurses, while balancing their budgets amid growing cost pressures. New Yorkers have no way of knowing whether there will be enough staff on duty to care for them when they check in. ³Horrible glitches like (what) occurred at Mount Sinai will happen from time to time, unfortunately,² said Dr. John Balint, director of the Center for Medical Ethics at Albany Medical College and a member of the ethics committee of the American Association of the Study of Liver Disease. ³We are asking the health care system to perform at a level that it is being strained by the demand that is being put on it,² he said. ³We are getting somewhere near the limit on what we can do.² The New York State Nurses Association, a union, has warned for years that inadequate staffing can lead to medical complications and deaths. ³It can happen anywhere,² spokeswoman Nancy Webber said. Yet legislation that would establish minimum staffing levels in New York hospitals has gained little support among most lawmakers. The state Health Department only investigates staffing levels if a problem arises, spokesman John Signor said. Usually, he said, officials look at the results of care and leave it up to hospital managers to decide how to achieve quality. But there is little consensus on what's appropriate. Health Commissioner Antonia Novello said last week that investigators found about one nurse for every seven patients on Mount Sinai's transplant unit, where Mike Hurewitz, a Times Union reporter, died three days after donating part of his liver to his ailing brother. Other transplant centers in New York staff on a one-to-one ratio or have one nurse for every four or five patients, she said. At Albany Medical Center's kidney and pancreas transplant unit, the patient-to-nurse ratio is always 1 to 4 or 1 to 5, Dr. David Conti said. Staffing is higher for those who have heart transplants at Albany Med, with two or three nurses for every five patients -- a ratio of about 1 to 2. The nurses association argues that minimum staffing levels would improve conditions for both patients and nurses, making the profession more attractive in the midst of an unprecedented shortage. Statewide, about 10 percent of nurses' positions in hospitals are unfilled, according to a survey conducted last year by the Healthcare Association of New York State, a hospital trade group. About 30,000 registered nurses are working in non-nursing jobs, the survey found. The Democrat-led Assembly supports the nursing union's position and has previously passed a bill to mandate minimum staffing levels. ³Nursing staffing is key to quality care,² said Richard Gottfried, chairman of the Assembly's health committee. ³Unless the state sets standards, we will never see adequate funding for adequate staffing.²

'Inadequate' Care: State cites hospital's treatment of liver donor who died

B¹klyn protests continue, joined by labor unions

RNs say agreement fails to protect patient care

New Zealand:

Regional Mental Health Crisis Continues
<http://www.scoop.co.nz/mason/stories/PO0203/S00166.htm>
Public Service Association, March 31, 2002

At today¹s meeting of Auckland Mental Health stakeholders, PSA delegates spoke of the urgent need to find both long and short term solutions to the crisis facing the Auckland mental health service. ³It was good to hear that everyone from the Ministry of Health to the DHB¹s, acknowledge and share the PSA¹s view that a very serious problem exists for Auckland mental health services. But while everyone agreed urgent solutions are required, nothing has yet been agreed to² said National PSA secretary Richard Wagstaff. ³The PSA called for immediate relief on crisis and acute services in the form of creating an interim facility to take the heat out of the system. A facility for the Auckland region is needed ASAP while we work on longer term plans to bridge the gap between acute and community services² said Richard Wagstaff. ...

Nova Scotia:

South Shore Health Authority to cut nurses
<http://www.canada.com/search/site/story.asp?id=182661BA-DE18-438D-91EC-A7CEB8AB5BD0>
The Canadian Press, March 22, 2002

BRIDGEWATER, NS - Up to a dozen nurses will be losing their jobs because of cuts at the South Shore District Health Authority. Jim Merkley, CEO of the authority, said Thursday that the Health Department in Nova Scotia has approved most of the authority's draft budget, including the proposed elimination of 25 nursing positions. Some of the positions are currently vacant and won't be replaced, but Merkley said that as many as 12 nurses will have to be let go. Three hospitals could be affected by the job cuts. ...

Norway:

University graduates unprepared

Minister of Labor and Government Administration, Prof. Dr. Victor D. Norman, says Norwegian universities and colleges largely produce bureaucrats unsuited for life in the business world.

"The emphasis in the university and college sector is actually, in extreme terms, educating civil servants and nurses - that is, aimed at meeting the needs of the public sector," Norman told state broadcasters NRK. Norman, former chancellor of the Norwegian School of Economics and Business Administration in Bergen, believes the bias towards the public sector weakens the ability of Norwegian businesses to compete abroad. ...

Ottawa:

Nursing shortage kills patients

First-of-a-kind study reveals people dying unnecessarily; Not enough registered nurses on the job

A shortage of experienced registered nurses in Ontario is costing lives, a study funded by the Ontario government says. The study, the first of its kind in Canada, offers definitive proof that the survival rate of seriously ill hospital patients depends in part on the training and experience of the nurses who treat them. The research used information from about 47,000 patients discharged from 75 Ontario hospitals between April 1998 and April 1999. The study, published this week in the Canadian Journal of Nursing Research, found that if a hospital increased the proportion of registered nurses by 10 per cent, five fewer patients in every 1,000 would die within 30 days of leaving hospital. ...

Registered practical nurses can be used better

Pennsylvania:

Pennsylvania Registered Nurses Speak Out
<http://www.pennanurses.org/Newsletters/reportlo.pdf>
Pennsylvania Association of Staff Nurses & Allied Professionals

There is perhaps no greater dilemma confronting our country¹s health care system than an acute, nationwide shortage of Registered Nurses. As the first Baby Boomers grow older and their health care needs increase, hospitals, clinics and long-term care facilities are finding themselves chronically understaffed and unable to attract and retain enough RNs. Younger Americans, especially women, no longer view nursing as a highly desirable and richly rewarding profession. And despite efforts to import nursing personnel from other countries such as Ireland and the Philippines, the crisis is projected to get even worse: US nursing school applications and admissions are at record low levels and tens of thousands of veteran RNs are leaving the profession long before their retirement years. ...

Issue One letters: Medicare cutbacks - A health-care crisis

Québec:

Expand the role of nurses, order says

Call for Québec to table a bill that would finally recognize new health-care responsibilities

Nurses called on the government yesterday to expedite a bill enabling them to perform certain medical procedures that are officially off limits for them. Gyslaine Desrosiers, president of the Ordre des Infirmières et Infirmiers du Québec, said the health-care system has changed radically since the introduction 30 years ago of regulations governing professional orders. "In the years that followed," Desrosiers said, "the nurses had to take on more responsibilities. As a result, now they perform certain medical procedures they are not supposed to under the law. That's how obsolete this law has become." ...

Romanow offers sneak peak at one health remedy inspired by Québec

Rhode Island:

Legislator owes health-care workers apology
<http://www.projo.com/report/html/opinion/07262481.htm>
A.H. Liddle, Warwick, Providence Journal, March 22, 2002

Are the doctors and nurses at Rhode Island hospitals a bunch of incompetent stumblebums who cavalierly harm their patients and then duplicitously cover up their mistakes in collusion with a corrupt Department of Health? That's basically the charge leveled by Rep. Norman Knickle in his Jan. 2 op-ed piece ("RI DOH in bed with hospital lobby"). ...

Racial insensitivity at Salve Regina

Saskatchewan:

Sask. nurses need raise or they'll leave, says union representative
<http://www.canada.com/search/site/story.asp?id=115280AE-775C-4FCD-920F-EF762E9AFA31>
Regina Leader-Post, March 22, 2002

REGINA (CP) - Wages for Saskatchewan nurses will need to be more competitive if hospitals hope to stop nursing staff from moving to nearby provinces, the president of the Canadian Federation of Nurses Unions said Thursday. Kathleen Connors said four provinces, including Alberta and British Columbia, offer higher wages than Saskatchewan. Ontario, the top-paying province when it comes to nurse's wages, pays a maximum of $31.45 per hour, followed by $30.11 per hour for Alberta nurses, $29.75 for BC nurses and $25.49 for Québec nurses. Saskatchewan nurses fall in the middle of the national pay scale, making a maximum of $24.92 per hour. "What the comparisons do is show Saskatchewan nurses don't have far to go if they so choose," said Connors. "It's tempting for nurses to make that move. Being in the middle of the pack in a cross-country comparison doesn't cut it when you're close to BC and Alberta." ...

Essential services legislation requested

Scotland:

Free and easy for the Scots

North of the border is about to see a revolution in care funding.
But, it's a very different story in England and Wales

The treatment of elderly people in England and Wales lives in the shadow of the Scottish parliament. The Scots have voted in favour of a system of free care for elderly people, whether they are in a residential home, their own home or a hospital. On July 1, first minister Jack McConnell will usher in the new regime that will cost an estimated £100m a year extra on the current health and social services budget. There is likely to be a cheer from Labour MSPs given that free long term care for the elderly topped the poll in a recent BBC survey designed to find out the public's five priorities for improving the NHS. ...

South Africa:

Save the babies now, Cosatu tells government
<http://www.iol.co.za/index.php?click_id=125&art_id=qw1017378721582B223&set_id=1>
Sapa, March 29, 2002

The Congress of South African Trade Unions (Cosatu) on Thursday called for the government to supply the anti-retroviral Nevirapine in state hospitals immediately, saying it had been tested sufficiently and endorsed by several reputable sources. "Cosatu is convinced that Nevirapine has been tested sufficiently for it to be rolled out throughout the country. Cosatu's argument about the safety and efficacy of Nevirapine for the prevention of mother-to-child transmission of HIV is endorsed in five international medical reports," the statement said. The union federation also urged the government to cut costs by licensing the production of generic versions of anti-retrovirals. ...

NUM vows to strike on medical aid

Victoria:

Not So Happy Campers
<http://workers.labor.net.au/129/editorial_editorial.html>
Peter Lewis, Editor, Workers Online, March 22, 2002

It's a crude political truism: it's better to be inside the tent pissing out than outside the tent pissing in. At least for those on the inside. Victorian unionist Dean Mighell decided to get some fresh air this week in the most public way and the spray he's delivered the Party is causing waves. Mighell announced he was quitting the ALP and joining the Greens and threatened to take his union with him. His reasons are hardly revelations for Workers Online readers: the party has lost touch with its roots, it treats the union movement with contempt and has become the sort of relation that it is embarrassing to be seen around. ...

Washington:

Nurses Win Right to Refuse Mandatory Overtime

Landmark Legislation Passed Washington State Legislature March 8, 2002

"This is a huge victory for quality patient care. Forcing nurses to work overtime above their regularly scheduled shift is not safe for patient," said Louise Kaplan, PhD, ARNP, WSNA President. Health care experts tell us that long hours take a toll on mental alertness and requiring nurses to work overtime when they are already exhausted can result in serious medical mistakes, medication errors, transcription errors and errors in judgement. Studies have linked infection outbreaks at hospitals to excessive overtime work. In addition to the health risks, mandatory overtime also takes its toll on the working family. Many nurses are left to make last minute arrangements for childcare or other preplanned activities such as classes. The use of mandatory overtime also drives nurses away from the profession, thus exacerbating an emerging nursing shortage that is expected to worsen dramatically over the next 10 years. Judy Huntington, MN, RN, WSNA Executive Director, emphasizes that "recruitment alone will not solve the nursing shortage. This bill is a giant step toward improving the workplace in order to recruit more people into the profession and retain experienced nurses." ...

³Every man should periodically be compelled to listen to opinions which are infuriating to him. To hear nothing but what is pleasing is to make a pillow of the mind." -- St. John Ervine - sent in by a Michigan RN

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