Bills call for minimum nurse staffing
<http://www.telegram.com/news/city/nurses.html>
by Richard Nangle, Telegram & Gazette
May 15, 2001
SPRINGFIELD-- Mounting concern over a nationwide nursing shortage led to some testy exchanges yesterday during a legislative hearing on several bills that address staffing issues in hospitals and nursing homes.
Several nurses urged the Legislature's Joint Committee on Health Care to adopt House 1186, a bill that would mandate nurse-to-patient ratios in hospitals. The bill, similar to a law enacted in California in 1999, was filed by Sen. Robert S. Creedon Jr. and Rep. Christine E. Canavan, both Brockton Democrats and co-chairmen of a special legislative nursing committee. The bill provides for fines of up to $25,000 to institutions that violate staffing regulations, which the state Department of Public Health would be required to adopt. During the hearing at Western New England College, state Sen. Richard T. Moore, D-Uxbridge, said he could not support the bill without a provision capping overtime. Sen. Harriette L. Chandler, D-Worcester, voiced a similar concern. But Denise Garlick, president of the Massachusetts Nurses Association, insisted that proper staffing levels should come first. Mr. Moore countered that he would be concerned about admitting himself into a hospital that relied on overtime to comply with staffing requirements.
Mandatory overtime was the catalyst for a nurses strike last year at St. Vincent Hospital at the Worcester Medical Center. But legislators noted yesterday that they are wary of doing anything to exacerbate the nursing shortage.
The Federation of Nurses and Health Professionals last month released a national survey, which concluded that unsatisfactory working conditions may prompt one in five nurses to leave the profession in the next five years.
Of those nurses, 75 percent said increased staffing, more flexible schedules and higher salaries could change their minds. More than 900 current and former nurses participated in the study.
Yesterday, some nurses said they often leave work knowing they have not provided adequate one-to-one care for many of their patients, while at the same time knowing they had done the best they could under the circumstances. They accused hospital management of paying lip service to the problem.
Health care officials said mandatory staffing legislation ignores the individuality of different institutions and patient-care situations. They said management and nursing teams ought to have the power to set their own staffing levels.
³Staffing should be established by need and not by a fixed number,² said Mary Rose Coughlin, director of nursing at the Hampden County Correctional Center.
And Maureen Sroczynski, former president of the Massachusetts Organization of Nurse Executives, said hospitals in difficult financial situations would be unable to handle the cost of staffing requirements.
Kim O'Connor, a 23-year nursing veteran who works in Northampton, countered by saying she and her colleagues are tired of hearing management tell them to work smarter, do more with less and be thankful they have a job at a time when nurses no longer can spend time at a patient's bedside or give a back rub. Many of the 150 people at the hearing applauded her speech.
The Massachusetts Nurses Association supports requiring one nurse for every four or five patients. The association said that there are now staffing ratios of anywhere from 1-to-6 to 1-to-10 at hospitals throughout the state.
A U.S. Department of Health and Human Services report issued last month found a strong correlation between nurse staffing and incidence of patient urinary tract infection, pneumonia, shock and upper gastrointestinal bleeding, as well as hospital length-of-stay. More staffing was linked to a 3 percent to 12 percent drop in the adverse patient outcomes.
The study was based on 1997 data from more than 5 million patient discharges from 799 hospitals in 11 states, including Massachusetts.
The Massachusetts Nurses Association contends that staff reductions have worsened working conditions and the nursing shortage itself. The association says many Massachusetts nurses have turned away from the profession believing they cannot provide high quality care in the state.
Medical and surgical nurses in Massachusetts are assigned nine to 12 patients on a shift while long-term care nurses are assigned 30 to 40 patients, according to the association. Home care nurses are seeing seven to nine patients a day, compared to five to six just a few years ago. The Health and Human Services study was a result of a 1993 congressional hearing that focused attention on the delivery of nursing care in hospitals and its effect on patient care.
A 1999 Harvard study found that 18 percent of consumers rated their last hospital stay fair or poor.
Last month, U.S. Rep. James P. McGovern, D-Worcester, co-sponsored legislation that would ban mandatory overtime for nurses. At nearly the same time, President Bush proposed a 60 percent cut in federal funding for medical education, down to $140 million.
One the bills up for debate yesterday, the Clara Barton Act, proposed by Mr. Moore, would provide $25,000 starting bonuses over several years to new nurses in the top 15 percent of their classes.
And Mr. Moore said the passage of the income tax-cutting Question 4 last fall will make it all the harder for the state to budget enough money to allow hospitals and nursing homes to raise nurses' pay and reduce staffing ratios.
³People don't seem to pay much attention until either they or a family member goes into a nursing home,² he said.
³Our society doesn't see this until there is a crisis,² Ms. Chandler said.
©2001 Worcester Telegram & Gazette Corp.
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FOR IMMEDIATE RELEASE
May 18, 2001
Contact: David Schildmeier (781) 249-0430 or (508) 426-1655 (Pager)
RNs at the Memorial Hospital, Hahnemann and Home Health & Hospice Campuses of U. Mass/Memorial File for Election Today With NLRB
WORCESTER, Mass. - The registered nurses of U. Mass./Memorial Health Care who work at Memorial Hospital Campus Hahnemann Campus, the Home Health and Hospice Campus as well as in the doctor's office connected with Memorial Hospital in Worcester today filed a petition with the National Labor Relations Board (NLRB) seeking an election for union representation by the Massachusetts Nurses Association (MNA).
On May 16, local political, labor and community leaders joined nurses from the Massachusetts Nurses Association and the nurses at the Memorial/Hahnemann Campus of U. Mass/Memorial Health Care for a rally to support the Memorial/Hanhemann nurses' call for voluntary recognition of MNA as their union. Immediately following the rally, a delegation of the Memorial/Hahnemann organizing committee visited the office of Dr. Russo to hand-deliver a written request for a fair and legal process of voluntary recognition of a union for the registered nurses.
More than 70 % of the 800 registered nurses estimated to work at these facilities have signed union authorization cards seeking union representation by the Massachusetts Nurses Association. With 50 percent plus one vote, employees can win voluntary recognition of their bargaining unit from management.
In addition to filing for an election, the MNA has made an additional overture to the labor officials of UMMHC to seek a meeting as soon as possible to discuss the potential for a process for voluntary recognition, and barring that, a process for an expedited election, that would prevent a costly and anti-union campaign. In a telephone conversation today, UMMHC, while not agreeing to voluntary recognition, did set a meeting for next Thursday, May 24, 2001 to discuss the process for an expedited election.
"While we still believe the easiest and best solution is a card check election, similar to what was granted other unions at the facility, we are pleased that the corporation is interested in exploring an alternative to a lengthy election process," said Eileen Norton, representative from the MNA working with the organizing committee for the nurses.
By seeking voluntary recognition, the nurses would avoid the unnecessary expense and conflict that can result from a contentious union election campaign and an anti-union campaign, leaving more money available to be spent on patient care. An expedited process for an election might include an agreement to forego costly and lengthy hearings before the NLRB to determine who is eligible for representation. Both sides could meet and come to an agreement on their own as to who is eligible to vote, and could agree to an election date within a few weeks. The MNA would also seek a neutrality agreement that bars the use of anti-union consultants, who are firms that specialize in efforts to stop employees from unionizing.
A desire to have a legal right in decision-making that would improve patient care and working conditions at the facility are a key motivation for the nurses' organizing campaign at Memorial.
"We are seeking a union to have a voice in the decisions that impact our ability to practice safely and competently," said Jacqueline Brosnihan, an operating room nurse and a member of the union Organizing committee. "We want a union to give us the power to address our concerns about issues such as understaffing and mandatory overtime. Nurses also want and deserve parity in salary, benefits and working conditions with our colleagues in the Worcester area, including our colleagues on the U. Mass Medical Center Campus."
The MNA represents more than 700 nurses working at U. Mass Medical Center. In fact, last March, the MNA nurses ratified a two-year contract that included salary increases of between 12 - 25% depending on experience, as well as language that grants the nurses the right to refuse mandatory overtime, similar to the language negotiated last year by the nurses at St. Vincent Hospital/Worcester Medical Center following a historic 49-day strike over the issue. The nurses at St. Vincent Hospital are also represented by the Massachusetts Nurses Association.
"Seeing what unionized nurses are able to achieve with the MNA through collective bargaining was major motivation for our drive to organize our own bargaining unit with the MNA," Brosnihan said.
With more than 20,000 members, the Massachusetts Nurses Association is a professional association and the largest union of registered nurses in the Commonwealth. The MNA union represents more than 18,000 nurses in 85 different health care facilities. In 1998, more than 540 nurses at St. Vincent Hospital won a NLRB election for representation by the MNA. Also in 1998, the Worcester Public Health Nurses selected the MNA as their collective bargaining representative.
"Worcester has become a hotbed of union activity and concerted nurse activism," said Karen Higgins, RN, and Chair of the MNA's state union. "Our union members in Worcester are setting the standards for what empowered nurses can achieve through collective bargaining to protect their patients and to defend the practice of nurses. They are looked upon as leaders, not only in Massachusetts, but also throughout the nation. We would be proud to add the Memorial nurses and hope we can move quickly towards that end through voluntary recognition of their union."
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Understaffing of nurses
<http://www.boston.com/dailyglobe2/138/editorials/Understaffing_of_nurses+.shtml>
RECENT STUDY showing that understaffing of nurses on hospital wards is bad for patients' health is a no-brainer. Patients on understaffed wards are more likely to suffer from pneumonia, urinary tract infections, gastrointestinal bleeding, and shock. Their hospital stays are longer, and the researchers said short staffing could be a factor in thousands of deaths annually. At Brockton Hospital, nurses are threatening to strike over what they see as that hospital's refusal to staff adequately and avoid mandatory overtime for nurses.
The Massachusetts Nurses Association says one solution to understaffing is a bill before the Legislature that would set mandatory staffing standards. The nurses see the new study, done for the federal Health Resources and Services Administration, as justification for the bill, though the study's two principal authors - Peter Buerhaus of Vanderbilt University School of Nursing and Jack Needleman of the Harvard School of Public Health - both oppose state mandates.
Needleman doubts that state mandates could be fine-tuned enough to account for differences in the severity of patients' illnesses, the physical layout of a ward, and the experience of individual nurses. He also worries that hospitals unable to meet standards would simply shut down the wards, forcing emergency rooms to keep patients longer and causing even more diversions to other hospitals.
Massachusetts hospitals also oppose state mandates. They attribute the staffing problem to the increasing shortage nationwide of nurses and to the extreme financial pressure created by inadequate Medicaid and Medicare reimbursements and by cost-cutting managed-care organizations. In this state, two-thirds of all hospitals say their operating budgets are running in the red.
To bring more young people into nursing, the hospitals favor a state bill backed by Senator Richard Moore that would grant $25,000 starting bonuses to top-ranking student nurses. They also back a federal bill sponsored by Senator John Kerry that calls for a Nursing Service Corps that would provide scholarships to students who agree to work as nurses for several years.
Starting bonuses and scholarships are worthy approaches, but they will not cure today's shortages. Nurses suffer along with patients. Nursing groups say the shortages are a reason that many nurses leave the profession long before retirement age. In a recent survey by the American Nurses Association in which 75 percent of nurses responding said care at their institution had declined in the past two years, 68 percent listed inadequate staffing as a major factor.
If hospitals cannot quickly solve this problem using voluntary staffing standards, they will invite state action.
This story ran on page 22 of the Boston Globe on 5/18/2001.
© Copyright 2001 Globe Newspaper Company.
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Unions unite; Teamsters talks set for Monday
<http://usnewspapers.about.com/newsissues/usnewspapers/gi/dynamic/offsite.htm?site=http://www.tribune%2Dchronicle.com/>
by David Kerester & Bob Bromley, Warren Tribune Chronicle
May 19, 2001
YOUNGSTOWN - Striking union workers from Forum Health and Humility of Mary Health Partners held a joint rally Friday, as labor disputes involving the two health care systems continued with no end in sight.
Striking members of Teamsters Local 377, the union representing St. Elizabeth Health Center's non-professional workers, arrived at the Forum Health Northside Medical Center around 4 p.m. Friday to show their solidarity with that hospital's striking nurses. The rally was scheduled for 4 to 8 p.m.
"We're impressed by the gesture and appreciate their support," said Linda Warino, past president of the Youngstown General Duty Nurses Association and a member of the union's negotiating team.
The approximately 870 service, clerical and maintenance workers from St. Elizabeth and some of its sister satellite facilities have been off the job since May 12. Main issues in the work stoppage are wages and benefits.
Negotiations in the St. Elizabeth strike have been scheduled for 3:30 p.m. Monday at the Holiday Inn in Boardman.
Meanwhile, no new negotiations are scheduled for the Forum dispute, which has seen more than 700 nurses off the job since May 1. In addition to Northside, that strike affects Tod Children's Hospital, Beeghly Surgical Center and Beeghly Emergency Room.
Talks between the nurses and the hospital system broke off Thursday with no progress made, while a spokeswoman for Forum took issue Friday with how the role of hospital officials in the negotiations were portrayed by the union.
Forum Health officials did not show for the negotiating session, instead faxing a proposal to the meeting site.
"It was made to sound like we just didn't show up, but that wasn't the case," said Evonne M. Woloshyn, senior vice president of marketing and community relations for Forum Health.
Woloshyn said that after developing their proposal and speaking to the federal mediator, it was suggested by the mediator that hospital officials not attend initially, instead letting the mediator take the proposal to the table.
The plan called for hospital negotiators to be on-call, and to come to the meeting after the union had looked at the offer and made a counter proposal, Woloshyn said.
"But the nurses flatly refused ... and did not make a counter proposal. We were told they had not changed their mind on anything," she said.
In a prepared statement, the hospital system said, "Forum Health is extremely disappointed that our nurses continue to focus on debating the issues in the community, instead of discussing them at the bargaining table. Resolution of this work stoppage will only come at the bargaining table."
But Bonnie Lambert, YGDNA president, said Thursday night the proposal contained few differences from where talks had been previously.
Speaking at Friday's rally, Lambert said, "It did not address staffing, it did not address mandatory overtime or health insurance for retired nurses." She also said that the proposal was presented to them as "a package deal, all or nothing."
"We are real unhappy that we got a faxed proposal instead of an opportunity to negotiate face to face. You can't talk to a fax machine," Lambert said.
Those at Friday's rally, like Dr. Richard Marina, a gastroenterologist at Forum, expressed a wish that the sides get together soon and start talking.
"I'm out here because I've seen no movement in two weeks. The nurses seem willing to sit down and discuss things, but I've not seen that on the other side. I don't think the nurses are 100 percent right, I don't think the company is 100 percent right. I think it may be somewhere in between. I just want this situation to end," Marina said.
www.tribune-chronicle.com
Copyright © 2001 Tribune Chronicle
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Nurses decide on powerful new strategy for the future
<http://www.ireland.com/newspaper/ireland/2001/0514/hom9.htm>
© 2001 ireland.com
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Cuts would put patient safety at risk - nurses
<http://www.stuff.co.nz/inl/index/0,1008,795414a1931,FF.html>
The Nelson Mail
17 May 2001
Patient safety in Nelson's hospitals will be compromised if there are any further cuts to funding, nurses union representative Jackie McGrath says.
Reacting to claims by Nelson MP Nick Smith on Tuesday that Nelson and Marlborough's public health service is facing an $8 million deficit in the next financial year, Ms McGrath said there could be dire consequences if there were further funding cuts.
"Nursing safety and patient safety will be compromised. I don't believe there is any fat in the system at the moment.
"If there are any further cuts to staffing ratios, it will put extra pressure on nurses, and I don't think there are any further cuts to be made."
Ms McGrath said Nelson's nurses were at the bottom end of the national pay scale, and were expecting a "significant" wage increase this year.
"If nurses don't get a significant pay increase, (the health board) will have a great deal of difficulty in recruiting and retaining them."
Health bosses have conceded that they are looking at a deficit, but say it is nowhere near what Dr Smith is claiming.
The Nelson Marlborough District Health Board is finalising its budget, but has said it will not know exactly how much money it will receive until the Government releases its budget on March 24.
The Government has said that the figures quoted by Dr Smith are out of date, and that health funding will be increased in the budget.
The chairman of senior medical officers at Nelson Hospital, Stephen Low, said he was also concerned but that Dr Smith's claims had yet to be substantiated.
Even so, a deficit could affect the hospital's redevelopment, which was already at the limit of what doctors thought was feasible, he said.
It could also threaten the introduction of a new digital radiology service .
Dr Low said management was unable to find any money for something as basic as a new physiotherapy pool, and the hospital still did not have an adequate meeting room for clinical staff and visiting doctors.
© Independent Newspapers Limited 2001.
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UTH's Junior Nurses Strike
<http://allafrica.com/stories/200105150242.html>
The Post (Lusaka)
May 15, 2001
Lusaka -- Junior nurses at Lusaka's University Teaching Hospital (UTH) yesterday withdrew their services in protest against delayed payment of their April salaries.
Confirming the nurses' go-slow yesterday, UTH acting public relations manager Priscilla Kamuti assured them that they would be paid today.
Copyright © 2001 The Post. Distributed by AllAfrica Global Media (allAfrica.com).
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