(Editor’s Note: In accordance with the wishes of the vast majority of
dues-paying members, the united leadership of the Massachusetts Nurses
Association continues to pursue a progressive agenda to take on the health
care industry, a key component of which is winning independence from the
reactionary American Nurses Association. Continued attachment to ANA is
costly, embarrassing and dangerous. Desperate to maintain its cash flow and
stifle the example the nurses of Massachusetts are giving in bucking market
medicine, ANA has unleashed a campaign of lies and personal attacks unseen in
the United States in decades. The current issue of The American Nurse reveals
the further devolution of ANA along the lines of a corporate model, with
Linda Stierle now listed on the masthead as chief executive officer instead
of executive director and with the announcement that ANA will be highlighted
by the Fox News Network as a ‘Champion of Industry’ on March 8th (which many
of us have realized for quite a while now). To get the straight facts on
MNA’s developing campaign to break out of its abusive relationship with ANA,
go to Sandy’s Links <http://users.rcn.com/wbumpus/sandy>; and for ongoing
coverage of MNA’s work on behalf of nurses, nursing and patient care, go to
the MNA web site <http://www.massnurses.org>. If you’d like to sound off, go
to the Nurses.com discussion page on this issue
<http://www.nurses.com/discussionforums/user/non-frames/list.asp?forumid=588>.

Or send me your observations and insights, for future editions of Seachange
Bulletin. - Sandy Eaton, RN, Quincy, Massachusetts)

------------------------------------------

FOR IMMEDIATE RELEASE
February 6, 2001
Contact: David Schildmeier 781-249-0430 or 781-830-5717


National Survey Underscores Growing Crisis in Nurse Staffing/Patient Safety
MNA Points to Results in Pushing Safe Staffing Bill on Beacon Hill

MNA Takes Issue with ANA's Response to the Staffing Crisis
Opposes ANA's Industry-Friendly Model Staffing Legislation

CANTON, Mass. -- A national survey of registered nurses released today has
revealed a growing crisis and continued deterioration of the quality of
patient care in our health care system, driven by deplorable working
conditions and unsafe staffing levels for nurses.

According to the survey of more than 7,000 nurses conducted by the American
Nurses Association over the internet, 75 percent of nurses surveyed feel the
quality of nursing care at the facility in which they work has declined over
the past two years, while an alarming 40 percent said they would not feel
comfortable having a family member cared for in the facility where they
worked. Nearly 70 percent identified inadequate staffing as the cause of the
declining care at their facility. Even more discouraging in light of the
growing nursing shortage is the finding that over 54 percent of nurse
respondents would not recommend their profession to their children or their
friends.

"This information is nothing new to the nurses of Massachusetts, who have
been reporting similar data and advocating for legislative reforms to improve
these conditions since 1995," said Denise Garlick, RN, President of the
Massachusetts Nurses Association. "It is not uncommon for medical/surgical
nurses at a Massachusetts hospital to be assigned between 9 - 12 patients on
a shift, or nurses working in long term care to be assigned 30 - 40 patients.
Home care nurses, who a few years ago were seeing 5-6 patients in a day, are
now being asked to see between 7 - 9 patients. In all of these settings,
patients are more acutely ill and in need of more nursing care."

Garlick and the MNA point to such data as evidence for the need for immediate
and comprehensive staffing legislation; specifically, the need for passage of
legislation to mandate safe nurse-to-patient ratios in all health care
settings, similar to landmark legislation passed in California in 1999.


In December, the MNA filed an impressive package of bills to provide
unprecedented protection for nurses and patients in Massachusetts. The
centerpiece of that package is "An Act Relative to Sufficient Nurse Staffing
to Ensure Safe Care," which is a safe staffing bill sponsored by State
Representative Christine Canavan, RN (D-Brockton) and State Senator Robert
Creedon (D-Brockton) who both served as co-chairs of the Nursing Commission,
a legislative committee that spent the last year investigating the current
nursing crisis.

Since filing the bill, MNA has won widespread attention from both state and
local industry watchers and policymakers, including the state's Governor. At
the last meeting of the Governor's Task Force on Health Care Reform, MNA
Executive Director Julie Pinkham raised the issue of the current nursing
shortage, and the need for passage of safe staffing legislation as a means of
creating working conditions that will allow for the recruitment and retention
of nurses. Governor Paul Cellucci agreed with Pinkham, citing the nursing
shortage as equal to, if not surpassing the shortage of teachers in
Massachusetts. He further expressed his desire to work with the MNA on
solutions.

In addition to its staffing bill, the MNA has also teamed up with the
California Nurses Association to draft and file federal legislation to ban
mandatory overtime, a practice being utilized by health care managers to
compensate for a lack of adequate staffing. The bill, which was filed last
fall by U.S. Congressmen James McGovern (D-Mass.) and Tom Lantos (D-Calif.),
has already garnered broad support in Congress.

The Lantos-McGovern bill, entitled the "RN and Patient Protection Act,"
amends the Fair Labor Standards Act to bar mandatory overtime beyond 8 hours
in a work day or 80 hours in any 14 day work period, except in the case of a
natural disaster or in the event of a declaration of emergency by federal,
state or local government officials. Voluntary overtime is permitted under
the legislation.

MNA Takes Issue With ANA's Response to Crisis
Opposes ANA's Industry-Friendly Staffing Legislation

The MNA is concerned about model legislation that was unveiled by the
American Nurses Association in conjunction with the release of its survey
data. Specifically, the MNA is concerned that the ANA has not joined them in
calling for legislation mandating safe staffing levels and nurse-to-patient
ratios, similar to what has been proposed on the state level in Massachusetts
and passed in California. Instead, the ANA is proposing that its member
states file a staffing bill that not only is very weak, but that also
contains a provision that could accelerate the current staffing crisis.

First, the ANA-proposed staffing bill merely calls for health care facilities
to establish their own patient classification systems, with no mandate to
adhere to the standards they create. The bill appears to codify into law
requirements similar to those already made of hospitals by the Joint
Commission on the Accreditation of Health Care Organizations (JCAHO).

"This is a weak and totally ineffective approach to the problem their own
survey so poignantly demonstrated," said Garlick. "Their suggested staffing
legislation only calls upon the industry to develop their own standards for
measuring staffing. This approach amounts to putting the fox in charge of the
hen house. If we could trust the industry to staff safely and appropriately,
we wouldn't be in the crisis we are in. Hospital staffing must be regulated."

The MNA is joined in their position by Dr. Lucien Leape, the nation's leading
authority on preventable medication errors, and one of the authors of the
Institute of Medicine's groundbreaking report on medication errors. Leape has
stated his support for regulation of staffing ratios to prevent medical
errors, and has called for a legal ban on mandatory overtime.

Even more concerning to the MNA is the inclusion of a clause in the proposed
ANA staffing bill that would allow hospitals to experiment with "alternative
methods of assuring adequate staffing." The MNA is appalled that such
language has been included as it is specifically designed to allow hospitals
to reintroduce workplace redesign "schemes" that result in the replacement of
licensed nurses with lesser qualified unlicensed aides and technicians.

It was the introduction of these types of "alternative methods" of staffing
that caused the deskilling (replacing licensed nurses with unlicensed
personnel) and the subsequent speed up of the RN workforce, which has created
this unprecedented shortage of nurses throughout the U.S. The MNA has spent
more than a decade successfully fighting against these plans, which have been
proven to have disastrous results for nurses and, more importantly, for
patients.

"If passed into law, this could be the most dangerous piece of nursing
legislation in the history of our profession," said Julie Pinkham, RN, MNA
Executive Director who is a nationally recognized expert and speaker on the
dangers of so called "alternative models of care. "We are talking about
sanctioning by law the health care industry's right to experiment with
patient care models that do away with nurses. This legislation is so
objectionable and anti-nurse, one would have thought it was written by the
American Hospital Association, not the American Nurses Association.

The nurses of Massachusetts, like the nurses in California, who have led the
nation in combating these dangerous trends, believe the only real solution to
this problem is the development and enforcement of strict nurse to patient
ratios that are based on the standards of nursing practice and the acuity
level of the patient.

It is precisely because of these differences in philosophy and the ANA's
moderate approaches to the problems of nurses that the MNA is now seeking to
disaffiliate from the American Nurses Association and pursue affiliations
with more like-minded, progressive nursing organizations whose actions match
their rhetoric when it comes to defending nurses and their patients.

# # #


David Schildmeier
Director of Public Communications
Massachusetts Nurses Association
800-882-2056 x717 (Within Mass. only)
781-830-5717
781-821-4445
781-249-0430 (cell phone)
508-426-1655 (pager)

---------------------------------------

Special Meeting to Vote on Disaffiliation from ANA

DATE: Saturday, March 24, 2001
TIME: 1:00pm
PLACE: Mechanics Hall, Worcester, MA

If you have questions or would like more information about this important
issue, please contact Eileen Norton at 800-882-2056 x 777 or email her at
enorton@mnarn.org

----------------------------------------

Why Disaffiliate from the ANA

This is to inform you that the MNA Board of Directors has scheduled a Special
Business Meeting for the membership to vote on a bylaw proposal to
disaffiliate from the American Nurses Association. The meeting has been
scheduled for Saturday, March 24, 2001, at Mechanics Hall in Worcester.
Disaffiliation is the only issue to be discussed at the March meeting. The
doors for seating will open at 12pm and the meeting will begin promptly at
1pm.

On November 9, 2000, the membership voted on this issue at the Annual MNA
Business Meeting, the most well attended business meeting in MNA history.
While an overwhelming majority of members (62 percent) voted in favor of
disaffiliation, supporters failed by just 4 percentage points (just 49 votes)
to reach the two-thirds super majority necessary to authorize the split with
the ANA. Following the vote, the Board and Cabinet received petitions from
our membership in a number of bargaining units, as well as a number of phone
calls requesting that the MNA once again address this issue as soon as
possible.

The MNA Board of Directors Supports Disaffiliation

The Board wants all members to know that at our meeting in January, we voted
unanimously to support disaffiliation from the ANA. We have been joined by
many of the leadership groups within the organization, including the Cabinet
for Labor Relations, the Executive Board of Unit 7, the Congress on Health &
Safety, the Boards of Districts 2 and 3, and the leadership of nearly every
MNA bargaining unit.

Why We Need to Disaffiliate Now

* We believe the organization needs to marshal its resources to address a
growing budget deficit and to clear the way for a concentrated effort to pass
landmark staffing legislation. More importantly, ANA is proposing a number of
changes in June that could place our Association and our members in jeopardy.

* The ANA wants to make it mandatory that the MNA become part of the ANA’s
national union, the United American Nurses. Our attorney, Alan McDonald, has
advised us that belonging to this union, because of the way it is structured,
places every union contract in jeopardy, would prevent us from organizing new
nurses, and would, at minimum, open the MNA to costly legal challenges.

* The ANA is proposing a dues increase of more than $35 for all of our
members, along with additional assessments related to a proposed AFL-CIO
affiliation. As the current MNA leadership is opposed to increases in dues,
and as we are struggling with our own deficit budget, we believe the best
course is to decide this issue as quickly as possible.

* Adding to our concern is ANA’s proposal to add a new bylaw to allow them
to discipline state nurses associations that disagree with their policies,
which would include sanctioning the MNA for not wanting to participate in
their national union. Once the bylaw is in effect, it is unlikely we will
ever be able to leave ANA.

Do Not Believe the ANA Smear Campaign

In recent weeks, you may have may have been bothered at home by pre-recorded
telephone messages concerning the upcoming vote on disaffiliation. You need
to know that these calls do not originate from the MNA, but are part of a
malicious smear campaign from the American Nurses Association, implemented in
concert with a disgruntled minority of members among the leadership in
District 5. Instead of arguing the merits of continued affiliation, they have
engaged in a concerted effort to telephone members, file frivolous lawsuits,
use direct mail and other means to slander the Association and the hard
working volunteers and staff who represent you. There is not a shred of truth
to any of their allegations and we deplore this behavior.

We view this as an unfortunate and unseemly attack on all members of the MNA,
and a disservice to our profession. We are appalled that ANA is going to such
great lengths to attack this organization, solely to hold onto your dues
money. We urge you to contact the MNA directly if you have any questions or
concerns related to this campaign and to carefully consider the real
intention behind any information you receive from the ANA in this campaign.

Those who support disaffiliation do so because it is in the best interests of
this organization and its members. We encourage you to consider the facts and
our reasons based on those facts for disaffiliating from ANA. Most important
of all, we urge you to come to the meeting on March 24, 2001 and cast your
informed vote for an independent MNA. This is a struggle for the future of
your Association, the MNA, and for our ability to continue to protect and
defend our profession.

Registration Procedures

All MNA members in good standing are eligible to attend and vote at the
business meeting and there is no cost to attend. Because the MNA office is
not open on Saturday, there will be no new membership recruitment on the day
of the vote — non-members cannot join onsite for the purpose of voting.

To avoid long waiting lines getting into the meeting, which occurred at the
last meeting, pre-registration for the meeting is strongly encouraged. While
onsite registration is allowed, for those who pre-registered seating at the
front of the meeting hall will be set aside.

To pre-register for the meeting you only need to do one of the
following: call, write, fax or email Robin LeCain at MNA, providing your name
and telephone number no later than March 19, 2001. She can be reached