Massachusetts Nurses’ Legislative Campaign
Below is another very timely story that appeared in the the MetroWest
concerning issues of mandatory overtime and poor staffing at Leonard Morse
Hospital in Natick. Sadly, this story could be written about almost every
hospital in Massachusetts. It comes on the heels of a Boston Globe front-page
story on the same problem. The media is doing a great job covering this
issue, now it's time to work on a solution. That's why nurses, and health
care advocates need to join the hundreds of other nurses and activists who
have already registered to be at the State House on March 8th from 9 a.m. to
Noon for "Nurse Lobby Day." This is our first major step this year in
educating our legislators about the need to pass our safe staffing bill - the
only true solution to the nursing shortage, unsafe patient care, mandatory
overtime and even ER diversions. To register for Lobby Day, call Martha
Campbell at 781-830-5725.
It all comes down to staffing. Be there on Thursday, and if you can't make
it, visit the MNA web site, www.massnurses.org, to learn about our safe
staffing bill and what you can do to see that it is passed. MNA is also
hosting a "Nursing Summit on Staffing Legislation," an intensive three day
summit for nurses and nursing activists who want to work on making this
legislation a reality. The Summit is being held April 5 - 7, 2001 at the
Seacrest Resort & Conference Center in Falmouth. For more information, or to
register, Call Sue Clish at 781-830-5723.
<http://www.townonline.com/metrowest/06581736.htm>
Nurses: Overtime forced by hospital
By Michelle Hillman, MetroWest News
March 2, 2001
NATICK - Nurses at Leonard Morse Hospital say they are forced to work
overtime and have filed reports with their union, the Massachusetts Nurses
Association, detailing unsafe staffing levels.
"It’s just a nightmare up there lately," said union representative Carolyn
Anderson.
The chief executive officer of MetroWest Medical Center, which Leonard Morse
is part of, said under no circumstance does the hospital force people to work.
"We don’t force anybody to do anything," CEO Mark Clement said. "It’s not
about coercion or force."
Clement said sometimes a busy day at the hospital will require the staff to
work extra hours.
"Our patient census is not as predictable as we’d like it to be," he said.
On Wednesday, lack of staff in the hospital’s medical/surgical unit resulted
in the transfer of four emergency department patients to Framingham Union
Hospital, which is also part of MetroWest Medical Center.
Supervisors also wound up working as staff on the medical/surgical floor at
Leonard Morse Wednesday.
A Wednesday meeting that nurses had scheduled with Anderson to talk about
being coerced into working mandatory overtime had to be canceled because they
were too busy.
That same day, a medical/surgical nurse filed an unsafe staffing report with
the union, because there were four registered nurses caring for 31 patients.
The nurses association considers more than six patients per nurse to be
unsafe.
In a separate incident, Anderson was made aware of a situation where a nurse
was being threatened that she would be abandoning patients if she didn’t stay
extra hours after her shift.
"Management will often threaten nurses’ licenses," she said. "It’s scary.
This is your livelihood."
Susan Burns-Tisdale, chief nursing officer at Leonard Morse, said that a
supervisor told three nurses that a shift requiring overtime had to be
covered and "somebody needs to stay."
Anderson said the nurses’ contract says they must work mandatory overtime
only if someone calls in sick.
Burns-Tisdale said she spoke to the nurse who worked that shift and is
speaking to the supervisor to determine exactly what happened.
Burns-Tisdale said the nurse had just worked an 8-hour shift and was tired
but "believed she needed to stay." Burns-Tisdale agreed the supervisor
approached three nurses after someone called in sick and told them one of
them "needed to stay."
Hospital officials said they are doing everything they can to fix the
staffing shortage. The Medical Center recently hired a nurse recruiter and so
far, 48 nurses have been hired.
"We recognize there’s an issue in terms of staffing," Clement said. He said
eight nurses were recently hired specifically for the medical/surgical floor.
Clement said the hospital can’t always predict patient volume. He said
administrators base staffing levels on other hospitals of equal size around
the country.
Burns-Tisdale admitted there are times that mandatory overtime can be
imposed. But from November to the present, she said, the hospital has used
mandatory overtime less than 1 percent of the time.
"Mandatory overtime is not something we want to use," Burns-Tisdale said.
"It’s something we use in an emergency."
Burns-Tisdale also said that before this week, she had not received
complaints from nurses about mandatory overtime.
Anderson said since she became the union representative for Leonard Morse
nurses 2 1/2 years ago, mandatory overtime and staffing have been recurring
problems.
"This mandatory overtime is a huge problem," she said. "It’s growing."
She said the problems intensified when five nurses left the medical/surgical
unit several months ago.
In the incident where four nurses were caring for 31 patients, there were
three patient-care associates or unlicensed helpers on the floor.
"We don’t consider this safe," Anderson said.
Burns-Tisdale said that of 31 patients, nine were discharges that didn’t
require a high level of care.
"It was a busy day," Burns-Tisdale said. "We were overwhelmed with
admissions."
Clement said the hospital works hard not to turn patients away and calls in
extra staff when possible. That includes asking staff to work overtime,
recruiting nurse managers to work on floors and calling in per diem staff.
Regarding the five nurses who left the medical/surgical unit, Clement said
Leonard Morse still has a lower nurse turnover rate than other hospitals of
similar size in the Tenet system. Dallas-based Tenet Healthsystem Inc. is a
nationwide hospital chain which owns MetroWest Medical Center.
Burns-Tisdale said that she and two other managers went up to the
medical/surgical floor to help out on Wednesday. Two supervisors were called
in as well as another nurse.
Burns-Tisdale said she spoke to the nurses who worked on the floor Wednesday
and said they have "anxiety" about the hospital's ability to provide enough
staff in the future.
She said Leonard Morse nurses can be responsible for as many as seven or
eight patients, but that depends on how ill they are.
"We really strive to make sure nurses feel comfortable," Burns-Tisdale said.
Anderson said late last year, she received 12 or 13 unsafe staffing reports
over the course of three or four months, but this year, she has only received
a couple.
The last time Anderson said she met with hospital officials about staffing
was about six months ago.
"We know that there are issues and there have been issues," she said.
----------------------------
The Institute of Medicine (IOM) has released its long-awaited report on the
American Health Care system, which states the U.S. Health Care System is
broken and unworkable. (See Globe Story Below) It clearly states that the
solutions do not lie in making doctors and nurses work harder or smarter. A
complete overhaul is needed. The nurses of Massachusetts agree, and that is
why the Massachusetts Nurses Association is a member of MASSCARE, a coalition
of more than 70 health care, labor and citizen advocacy organizations pushing
for passage of the Massachusetts Health Care Trust Bill, legislation that
would create a single-payer health care system in Massachusetts that would
guarantee access to quality care for all citizens, which is based on the
needs of our citizens, not on the balance sheets of insurance companies.
Nurses believe incremental approaches to addressing the health care crisis
are doomed to fail. Fundamental reform is needed, accompanied by immediate
action to improve the quality of care patients receive by passing safe
staffing legislation. These two measures - fundamental reform of the health
care system, and safe staffing legislation - will be the focus of the MNA as
it pursues a progressive agenda for reform in the coming legislative session.
To learn more about these initiatives, visit the MNA web site at
<http://www.massnurses.org>, and come to Nurse Lobby Day on March 8th at the
State House from 9 - Noon.
<http://www.boston.com/dailyglobe2/061/nation/US_health_system_seen_ailing+.sh
tml>
US health system seen ailing
By Maggie Fox, Reuters
March 2, 2001
WASHINGTON - The entire US health system is creaky and unworkable and has to
be completely overhauled to make it safe and efficient, a team of government
advisers said yesterday.
Patients need to take on more of a role in their own care, and computers and
the Internet need to be drawn in to make sure essential health information
gets used, the specialists, appointed by the Institute of Medicine, said.
And Congress needs to create a $1 billion fund to make sure that medical
research gets translated into practice in hospitals, clinics and doctors'
offices as soon as possible.
The committee, which issued a report in 1999 that found more people die from
medical mistakes each year than from highway accidents, breast cancer, or
AIDS, said that early finding was only the ''tip of the iceberg.''
''It's not a gap in care. It's a chasm,'' committee member Dr. Donald
Berwick, president and chief executive officer of the Institute for
Healthcare Improvement and a pediatrics professor at Harvard Medical School,
said in an interview.
''The current system cannot do the job. There is no way the current health
care system can close those gaps. It is not about doctors and nurses trying
harder. They are trying as hard as they can.''
What needs changing, the report says, is the entire way in which US health
care is organized and delivered. This means hospitals, insurance companies,
health maintenance organizations, clinics and the individual doctor's office.
''The system is failing because it is poorly designed,'' William Richardson,
chairman of the committee and president of the W.K. Kellogg Foundation in
Battle Creek, Mich., said in a statement.
''For even the most common conditions, such as breast cancer and diabetes,
there are very few programs that use multidisciplinary teams to provide
comprehensive services to patients.''
The panel said in its 1999 report that 98,000 people die in the United States
every year because of medical mistakes such as getting the wrong medication.
''We are still killing people,'' Berwick said. ''There is a lot of effective
care that patients don't get. Diabetics fail to get regular treatments that
allow their blood sugar to be controlled and they lose their eyes and so on.
Children with ear infections get unnecessary antibiotics. We are saying we
have got to stop that.''
Care needs to be based on the needs of the patient, the report recommends.
''Patients today don't feel in control. They get confused. They are often
forgotten.'' The panel said patients should have access to their medical
records and input into their care. They should be able to use e-mail to ask
simple questions of doctors and health insurance should pay for that time.
''Everyone waits in this system,'' Berwick added. ''Doctors wait, nurses
wait, the patients wait.'' A more efficient system would do away with such a
waste of time.
Medical decisions should be based on the latest scientific research, the
committee added. Numerous reports show that despite clear evidence that
certain drugs help heart attack victims, for instance, huge numbers do not
get such drugs.
This story ran on page 3 of the Boston Globe on 3/2/2001.
© Copyright 2001 Globe Newspaper Company.
David Schildmeier
Director of Public Communications
Massachusetts Nurses Association
800-882-2056 x717 (Within Mass. only)
781-830-5717
781-821-4445 (fax)
781-249-0430 (cell phone)
508-426-1655 (pager)
-------------------
Save the Date for Nurse Lobby Day 2001
March 8, 2001 – 9 am to Noon
This Year’s Theme, "Safe Staffing = Quality Patient Care"
This is to remind all nurses, and supporters of nurses, to mark your
calendars and make your plans to attend the MNA’s annual "Nurses Lobby Day"
at the Massachusetts State House. Lobby Day 2001 will be held on Thursday,
March 8, 2001 from 9 am to 12 noon, with registration beginning at 8:30 am.
If you are nurse, you need to be at this event to demonstrate to the
legislature why nursing is important and what they can do to support nurses
in delivering the care patients deserve.
This year is especially important given that the MNA is hoping to pass
landmark legislation to guarantee safe staffing levels in all health care
settings, a measure that would protect and improve nursing practice, protect
patients and prevent medication errors, and provide the best long-term
solution to the nursing shortage.
The agenda for this year’s event includes:
Safe Staffing = Quality Patient Care, a presentation on the crisis in health
care safety caused by chronic understaffing, as well as a review of our safe
staffing bill, An Act Relative to Sufficient Nurse Staffing to Ensure Safe
Care.
Addressing the Nursing Shortage, a review of innovative legislation to
address the shortage, which has been drafted and supported by Senator Richard
Moore.
Violence in Today’s Health Care Workplace, a review of new legislation
proposed by the MNA to prevent violence against health care workers.
Single Payer Health Care, a review of the Massachusetts Health Care Trust
Bill, which would provide a single payer health care system in the
Commonwealth.
This will be followed by education on how a bill becomes law, tools for
effective grassroots lobbying, and an opportunity to meet with legislators
and policymakers.
This event, which draws hundreds of nurses and nursing students from
throughout the Commonwealth, is designed to educate nurses about the
legislative process, allow legislators an opportunity to speak to our
members, and most important of all, provides an opportunity for nurses to
visit their own legislators to promote important nursing legislation.
This is every nurses opportunity to speak directly to those who have the
power to address the problems nurses face every day in their practice. You
need to be there. For more information, call the MNA department of
legislation and government affairs at 800-882-2056, x 725 or email
mcampbell@mnarn.org
------------------------
Short Web Directory:
Sandy's Links <http://users.rcn.com/wbumpus/sandy>
Massachusetts Nurses Association <http://www.massnurses.org>
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