Editor’s Note: Today, April 6th, two conferences on the crisis in nurse
staffing took place in Massachusetts. The Massachusetts Nurses Association
convened a nursing summit on the nurse shortage, with keynote presentations
by Jill Furillo, RN, Director of Legislation for the California Nurses
Association, detailing the struggle for enactment and impact of California’s
new mandated nurse-patient ratio law and Representative Christine Canavan,
RN, lead sponsor of MNA’s Nurse Sufficiency bill, laying out the specifics of
parallel legislation in Massachusetts. Coincidentally, at the very same time,
the Massachusetts Organization of Nurse Executives, comprising many of those
who presided over the dismantling of support systems for bedside nurses,
together with deskilling and downsizing, had the audacity to assemble to
strategize on ways to defeat mandated staffing levels, joining the national
campaign of other industry front groups such as the Joint Commission on the
Accreditation of Health Care Organizations and the American Nurses
Association. On March 17, 2000, the members of the MNA Board of Directors
expressed the expectation that an ANA affiliate would be set up in
Massachusetts upon the disaffiliation of MNA from the ANA federation. For
California this happened on October 1, 1995, as soon as the CNA House of
Delegates cast its 92% disaffiliation vote. Below you will find the formal
announcement of the formation of that Massachusetts ANA affiliate. We
recognize this as the acknowledgment that the vast majority of organized
nurses in Massachusetts want nothing to do with ANA, that the debate is over
and it’s time to move on. Nevertheless, additional law suits have been filed
in federal court against MNA, to invalidate the 1925-413 vote of March 24th
and even to invalidate the court-ordered special mail ballot for those who
were unable to travel to the special business meeting to vote either because
of religious obligation or because it was their weekend to work and were
unable to secure coverage. As hundreds, perhaps thousands, of direct
care-givers are voting on ANA by mail, ANA realizes how truly embarrassing
this tally will be. Please note that the new ANA affiliate was incorporated
on March 23rd, even before the overwhelming vote of March 24th. We wish our
colleagues in MARN well, realizing that the changes in health care have led
us down divergent paths. After emotions have had time to cool, there will be
issues and initiatives we may choose to support together. As for ANA, we say,
just go away. And to St. Francis Hospital VP and ANA president Mary Foley,
get lost! -- Sandy Eaton, RN, Quincy, Massachusetts

To our CMA friends and supporters:

Last evening, the inaugural meeting of the Board of Directors of the
Massachusetts Association of Registered Nurses was held. In spite of an
extremely unfortunate and disappointing meeting outcome on March 24th, many
nursing leaders in Massachusetts remain energized and committed to continued
affiliation with ANA. As Barbara Blakeney so aptly put it: "We are
disappointed, but not demoralized." Most importantly, we look forward to
working together to create a future that will move nursing forward united in
strength, resolve and purpose.

It is our unwavering commitment to our patients that will always unite us in
purpose. And it will be our one strong voice - a global union of all nurses,
not only staff nurses or those fortunate enough to be represented by
collective bargaining, that will propel our profession successfully forward
into the future. We are grateful for your support throughout these difficult
months and look forward to joining you once again in the very near future.

Massachusetts Association of Registered Nurses (MARN) Board of Directors:

Karen A. Daley - President
Barbara A. Blakeney - Vice President
Margaret T. Barry - Treasurer
Cynthia A. LaSala - Secretary
Peggie Griffin-Bretz - Director
Maura K. Fitzgerald - Director
Jackie Hayes - Director
David M. Keepnews - Director
Mary J. McKenzie - Director
Eleanor V. Venetzian - Director

Date of Incorporation: March 23, 2001

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Local nurses rally for more staff

by Gail McCarthy, Gloucester Daily Times

March 31, 2001

Local nurses joined thousands of other nurses across the state in an historic
vote last Saturday that will allow them to push harder for safe staffing
levels in hospitals and other health care facilities.

The watershed vote took place in Worcester when more than 2,300 nurses of the
Massachusetts Nurses Association (MNA) voted to break away from their parent
group, the American Nurses Association (ANA).

The state nurses believe the national organization has ignored the issue of
safe staffing and they will now pursue laws on the state level that will
ensure lower patient-nurse ratios.

Among those nurses were about a dozen who work at Addison Gilbert Hospital,
and more than 60 from Northeast Health Systems, the parent corporation. Some
went by bus, others by car.

"It's so exciting," said Gloucester's Peggy O'Malley, vice president of the
state nurses association. "We never had this number of nurses turn out at any
statewide meeting ever. It shows what a critical issue this is for nurses and
how strongly they feel and how willing they are to get personally involved."

"You really see that strength lies in numbers," said Judi Gross, an Addison
Gilbert nurse. "This really demonstrates that when people actively work
together, then you become a force to be reckoned with and you can have a say
in things."

Nurses of Northeast Health Systems are new to union business, having
negotiated their first contract in May of 2000 after two years of work.

But their joining the union, in part, was precipitated by the same pressures
felt by nurses across the state, which led them to the Saturday special
business meeting. They are concerned about what they call the "corporate
invasion" of health care.

"Our biggest reason for organizing was unsafe staffing," said Joanne Laschi,
an Essex resident and chairperson of the Northeast Hospitals nurses union.
"The ANA is part of this problem because they allowed this stuff to happen.
The ANA was not out there saying you can't replace registered nurses with
unlicensed people and create a model that left too many patients than nurses
can care for."

Janice Bishop, vice president of patient services at Northeast, stressed that
the hospital intends to work with the union on staffing.

"Our goal is to work collaboratively with them to achieve what's best for
patients," said Bishop.

A committee was formed last summer to deal with just that issue, she added.

Laschi said Saturday's meeting was inspiring because it represented direct
caregivers trying to reclaim their profession for the benefit of both nurse
and patient.

Nurses at Addison Gilbert Hospital are increasingly concerned about staffing
issues, said Laschi. "They have a decent standard of care there now, but
nurses are concerned because of hospital claims of rising costs that could
impact staffing ratios."

Laschi said nurses believe that a safe ratio for a hospital floor nurse is
between four to six patients. But it is not uncommon to have six to 10, she
said.

The 20,000-member Massachusetts Nurses Association is pushing for legislation
-- Bill 1186 now before state lawmakers -- to regulate nurse-to-patient
ratios, a bill opposed by hospital industry.

Although hospital officials may say there are not enough nurses to meet
increased staff ratios, O'Malley replied that nurses will return to active
practice if they know they can provide quality care. Many left the profession
because of the poor working conditions.

Jeanine Burns, an Addison Gilbert nurse, said Bill 1186 is of paramount
importance to the future of the nursing profession, both in terms of
protecting patients and in protecting the integrity of the nursing practice.

Burns said current regulations of the Department of Public Health only
require hospitals to provide sufficient nursing care without defining what is
sufficient.

Local nurses urge citizens to express their support of such a bill to their
state representative or senator.

The Massachusetts Nurses Association is not the first to disaffiliate from
the national group. California broke away five years ago. Maine is taking a
similar vote on April 28.

Gross noted that once the California nurses broke off with the American
Nurses Association, they lobbied and succeeded in enacting legislation.

"I wish people knew that it's really good to get involved, even though it's
time-consuming," she said.

Saturday's vote means the state nurses' group can reallocate its money that
once went to the national association and use it to push an aggressive agenda.

"That means $1.2 million that we can immediately put toward these efforts,"
said O'Malley. "First we had to free ourselves of an all-too conservative
(national association), which leaves us with more resources to pursue our
political agenda."

O'Malley said the next stop is the Statehouse for the Massachusetts Nurses
Association.

Public education

Laschi said nurses here, like those across the state, are trying to educate
the public. They believe citizens need to work with nurses and lawmakers to
move legislation forward.

"In our state the conditions in Massachusetts hospitals are worse than they
are in other states due to the high penetration of managed care," said
O'Malley. "We need to take on the whole political system that underlies the
health care system. It is not just in crisis. It is disintegrating around us.
Nurses are ready to lobby, educate and take action."

She likened nurses to news correspondents on the front line.

"They're saying people are dying from things they should not die from because
they aren't able to get into the hospital or we have too many patients to
care for and don't see something terrible is about to happen before it's too
late," said O'Malley.

Laschi noted that changes in reimbursements to hospitals for care provided
has affected nurses. Not only are nurses caring for more patients, many of
them are sicker than in the past.

Now that California and Massachusetts, two of the largest and most powerful
state nurses associations, are out of the American Nurses Association, others
may take similar moves. A new national organization may begin to take shape.

"We are ready and willing to join forces with other states who are committed
to fighting for the front line caregivers and for taking a strong stand on
patient care issues and the protection of our profession," said Denise
Garlick, the Massachusetts Nurses Association president in a release. "This
is the beginning of a bright and powerful future for nurses, not only here,
but anywhere there are nurses who want to be part of a movement for real
reform and dramatic change."

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

Bay State nurses vote to break from national association
Rancorous split already in court

by Anne Barnard, Boston Globe

April 5, 2001

In a sign of growing upheaval in health care, Massachusetts nurses have
apparently voted to secede from their national parent organization to pursue
a more aggressively pro-union agenda.

The divorce may not be final, but, in practice, the Massachusetts Nurses
Association and the American Nurses Association act as if they've already
split.

They back competing bills in Congress, wrestle in court, and call each other
liars and spies. And the Massachusetts group, the state's largest nurses'
organization, is trying to cast itself as a national leader, saying the
Washington, D.C.-based group failed nurses and patients by being too moderate
at a time of crisis.

''Our leaders have betrayed us,'' said Julie Pinkham, a nurse and labor
organizer who was named executive director of the Mass. Nurses Association
after a boardroom uprising in December.

Such rhetoric infuriates the leaders of the American Nurses Association, who
believe the state group is jumping the gun. They went to court to contest
last month's vote in Worcester, whose final results may prove to be as late
and litigious as Florida's presidential ballot.

''While they're being led by a very small and vocal group, Massachusetts
nurses are not interested in this disaffiliation,'' said Mary Foley, the
national president.

In the Worcester vote, 1,925 nurses voted for the split, 413 voted against.
That reversed the results of a Nov. 9 vote in which a majority supported the
split, but fell short of the two-thirds margin needed to change the bylaws.

Pro-split leaders had argued that the earlier vote, held on a Wednesday,
failed to reflect the will of staff nurses who could not get out of work. In
turn, the national group argued that the second vote, held on a Saturday,
prevented Orthodox Jews and people who worked weekends from voting.

Orthodox Jews and people who sign affidavits saying they missed the vote
because of work will get a chance to vote in an absentee ballot, but
Massachusetts leaders ''would be extremely surprised'' if that reversed their
position, said spokesman David Schildmeier. ''We're confident that our
direction is the will of the membership.''

Results are not expected until April 30, and even then will likely be
problematic. The absentee ballots will be tallied by the American Arbitration
Association, but the national group is arguing that the MNA should have
obtained approval from the judge before sending out the ballots.

Even before the vote, leaders of the Massachusetts group replaced the
pictures of past presidents in their white nurses' caps with picketers from
the St. Vincent's Hospital strike in Worcester and a banner reading
''Revolution.''

That angered some MNA leaders, including former president Karen Daley, who
had argued that infighting would keep nurses from working together
effectively on issues that are high on the national agenda, such as staffing
shortages and forced overtime.

Bills to address the problems are being introduced in Congress and in the
state Legislature, often with the two groups advocating different versions.

The MNA backed a bill introduced last month by Representatives Tom Lantos,
Democrat of California, and Jim McGovern, Democrat of Worcester, the city
where the MNA led the strike that forced St. Vincent's Hospital to ban
mandatory overtime.

The ANA is not officially opposing that bill but is not supporting it either,
Foley said. Its approach, based on the Fair Labor Standards Act, is too
narrowly focused on hourly workers and doesn't deal with work-time issues
involving salaried nurses, Foley said.

Things have gotten personal between Foley and some of the MNA leaders. ''It's
like the hospital industry has a spy, and it's the president of the American
Nurses Association!'' said Pinkham, Massachusetts executive director.

The ideological split has its roots in the goal of each organization to
represent both unionized nurses and nurse managers and educators. The
national group in particular must strive to balance the interests of state
affiliates which oppose union organizing, and those that, like the 20,000
-member MNA, function largely as powerful labor unions.

The next question is whether other heavily labor state groups will follow
Massachusetts' lead and break away. The MNA is exploring an alliance with the
California Nurses Association, the only other state to secede.

© Copyright 2001 Globe Newspaper Company.

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How the MNA defines "staff nurse"
(from The Massachusetts Nurse, March 2001)

In talking about the new vision and direction for the MNA, confusion has
arisen as to what is meant by the term "staff nurse" in MNA literature. Some
have misinterpreted the term to limit it to include only unionized hospital
nurses. This is not at all what we mean by the term staff nurse. When we
refer to staff nurses, we are talking about any nurse who spends the majority
of his or her time providing hands-on care. Of course this includes acute
care nurses, but it also includes home care and long term care nurses, school
nurses, nurse practitioners, nurse midwives, psychiatric clinical nurse
specialists, occupational health