Minnesota:


Update: 4:00 pm 5/26/01

Talks End. Stage Set for Nation's Largest Nursing Strike.


Negotiations between nurses and hospitals concluded Friday evening when Federal Mediators advised both negotiating teams that a settlement was unlikely to be achieved. The two sides are still far apart on issues of staffing, scheduling and economics.

Hospitals presented an offer that upped the wage proposal a meager 1.1% and inadequately addressed insurance caps and continued to ignore longevity bonuses that would reward loyal, long-term employees.

In addition, they proposed the introduction of a "blue ribbon panel" to study the nursing shortage. It is difficult enough to understand why a concept of this nature was brought to negotiations regarding workplace issues, but it is even more perplexing in light of the abundance of existing research already available about the issue.

The finest minds in the country have published extensive research findings and recommendations, including The Institute of Medicine, The Joint Commission on Accreditation for Healthcare Organizations, the American Hospital Association's own sub-group, the American Organization of Nursing Executives, and the American Nurses Association. MNA itself has helped Senators Wellstone and Dayton conduct hearings across the state on the nursing crisis.

Nurses are demanding action, not more research. And viable actions are already at hand, with successful examples of the American Nurses Association Magnet Hospital program that directly correlates nurse-sensitive indicators, such as staffing levels and input into workload, with positive patient outcomes.

The result is, as of June 1, 7,800 nurses will withhold their services in a work stoppage starting at 5:30 am.

Nurses are emphatically unified in their determination to stand up and speak out for safe patient care. Nurses have demanded bold changes in their contracts, and proposals advanced by the hospitals remain far from adequate.

Meanwhile, community support continues to pour in to the MNA offices from individuals and organizations in the form of memos, voices mails and pledges of donations.

If you would like to contribute to a strike fund to help nurses who may be walking the picket lines, please plan to do so after the May 31st deadline. Make your check payable to MNA Strike Fund and send Attn: John Lose, 1625 Energy Park Drive, St. Paul, MN 55108.

If you want to email words of support to us, here's your chance:
jrabbers@mnnurses.org

Rally for Nurses, Rally for Patients

Thursday, May 31
6:30 pm to 7:30 pm
Aldrich Arena, White Bear Avenue
Maplewood, MN

*    Come and support each other
*    Experience the support of your community

Minnesota Nurses are taking a stand for the future of nursing and the safety of patients.

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Patient-staff ratios at heart of nurse dispute
<http://www.startribune.com/viewers/qview/cgi/qview.cgi?story=84248841&template=metro_a>


by Glenn Howatt & Josephine Marcotty, Star Tribune


May 27, 2001


The fundamental conflict driving metro-area registered nurses to the brink of a strike is what to do about hospitals that have too many patients and not enough workers.

That imbalance has produced a contentious set of issues that the Minnesota Nurses Association has slapped onto the bargaining table: how to manage staffing and who has the power to close the doors to patients and say "no" to doctors.

Money also is an issue -- the 7,700 nurses in talks with 12 metro-area hospitals rejected an 18 percent pay increase over three years. But workload was a big factor in the nurses' vote to authorize a strike. Contract talks broke off Friday night with little hope of resuming before next Friday's strike deadline. Hospital officials said they offered a 19.1 percent wage increase before talks ended.

There's no question that hospitals and nurses sometimes are overwhelmed with patients, partly because of an older population.

Shirleen Gandhi-Kozel, spokeswoman for the Minnesota Hospital and Healthcare Partnership, which represents 12 hospitals, said that finding a balance between nurse staffing levels and patient demands will require discussions not only with nurses and hospitals, but with doctors and the community.

But nurses say tight hospital budgets underestimate the number of nurses who will be needed on shifts, and hospitals are often reluctant to send customers to competitors.

Some hospitals have found solutions. The Mayo Clinic in Rochester, whose nurses are not union members, has a program that administrators and nurses say manages the workload well. But it relies on the goodwill of managers, doctors and nurses -- and above-average staffing levels.

Balancing acts


Many hospitals, including United in St. Paul and Abbott Northwestern in Minneapolis, try to balance workloads using measurements of how sick patients are, something known as acuity. Such measures recognize that the sickest patients may need a nurse almost full time.

United nurses said that in reality, such balancing efforts don't work. The hospital determines an average number of nurses needed for each unit, and then sets budgets accordingly. Then comes a day, or several days, with too many patients or too few nurses and suddenly the staff is overwhelmed, nurses said.

"Management feels the need to stick to budget, and they control staffing," said Linda Slattengren, an orthopedic registered nurse at United and a member of the union bargaining committee for RNs at United and Mercy hospitals.

Nurses at Abbott Northwestern won the right in contract negotiations three years ago to "jointly determine" nurse scheduling through a cooperative effort with hospital management. And though a committee of managers and RNs developed an acuity-based system, the nurses now say the hospital didn't adopt its staffing recommendations.

"There is a sense of betrayal among the nurses," said Therese Copeland, an RN who is a 12-year veteran of the hospital and one of the union negotiators. "The staff increases we got were minuscule."

Gandhi-Kozel said many cooperative efforts between hospitals and nurses to limit staffing have not succeeded because they failed to include doctors. She said including physicians on committees may solve the problem.

"This is a bigger issue than can be bilaterally decided at the bargaining table," she said.

Business decisions also can affect the staff. Copeland points to the recent decision by Abbott Northwestern to become the maternity provider for all of HealthPartners clinic members in the west metro area -- which will add 1,100 babies each year to the hospital's maternity wards, a 25 percent increase.

Some obstetricians are concerned about having enough nurses.

"We cannot handle this volume of patients with the circumstances at Abbott that we have now," said Dr. Lea Fairbanks, a perinatologist and employee of Allina Health System, the hospital's parent organization. Even patients waiting for inductions and C-sections can face delays, she said.

An Abbott Northwestern spokeswoman said that hospital officials are working on solutions to absorb the new business.

A few improvements


Some nurses say that hospitals have made some improvements.

Bernadine Engeldorf, a United RN who works in behavioral health, said the hospital assures that psychiatric units are well staffed in case patients become physically or emotionally distraught.

The hospital, in collaboration with registered nurses, has also recently created a number of new positions called care coordinators. They are registered nurses who are asked to handle discharges, and, most important, deal with the most complicated cases.

The negotiators bargaining on behalf of United and Mercy nurses want nurses who are in charge of hospital units to have more power -- a radical change.

"Allow the charge nurse to cap admissions without going through a manager," said Nikol Rogers, an RN who works in United's birth center. She also is on the negotiating committee.

But capping admissions means closing the doors to physicians and patients, which sometimes happens now.

"I call up admitting and they say 'yea' or 'nay,'" said Dr. Timothy Komoto, a family physician at the Bloomington Lake Clinic in Minneapolis. And if admitting says no, "then we have to make other arrangements," he said.

Nurses argue that hospitals should do that sooner and more often, but Komoto said it's the patient who pays.

"You can delay hip surgery for a long time," he said. "But if you have pain every waking moment of the day, would you rather have the procedure done in 10 days or 10 months?"

Some hospitals have won awards for their ability to do high-quality patient care and keep nurses satisfied with their jobs. The credentialing arm of the American Nurses Association, the parent body of state nurses unions, has awarded what is known as the magnet hospital designation to 34 health-care organizations, including the Mayo Clinic.

Mayo has adopted a nurse staffing system that is determined strictly by patient volume, said Doreen Frusti, chairwoman of the Mayo's Department of Nursing. Nurses on the floor who manage the system and the hospital follow the nurse-to-patient formula religiously, Frusti said.

"Then you don't need to get into tit-for-tat or who has the power," she said. "The power is the patient need -- it's the great equalizer."

However, the hospital must have a large enough staff to deal with above-average patient levels -- close to 100 percent of capacity.

In the long run, she said, this style of management saves the clinic millions of dollars because of reduced staff turnover. Each RN who quits costs about 150 percent of his or her salary in training, education, and the cost of temporarily replacing the nurse, Frusti said.

Glenn Howatt is at howatt@startribune.com
Josephine Marcotty is at marcotty@startribune.com

© Copyright 2001 Star Tribune. All rights reserved.


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For a series of articles on nursing in the Twin Cities:


<
http://www.startribune.com/viewers/qview/cgi/qfolder.cgi?template=nurse_f&folder=1516>

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Ohio:


Nurses strike pickets head downtown
<http://usnewspapers.about.com/newsissues/usnewspapers/gi/dynamic/offsite.htm?site=http://www.tribune%2Dchronicle.com>


by Christopher Bobby, Warren Tribune Chronicle


May 27, 2001


YOUNGSTOWN -- With no new talks scheduled in the strike between nurses and Forum Health facilities, pickets took to Federal Plaza Saturday to sound off on their positions.

The rally featured as many as 200 nurses -- many of them in uniforms -- and other supporting union members.

Nurses with Forum in Alliance held up signs, as did supporting union members from the Ohio Education Association, United Steelworkers of America, and Teamsters Local 377, which recently reached agreement with St. Elizabeth Health Center, ending another strike.

Several nurses carried signs reading: "Safe Hours -- Safe Staffing -- Quality Care." They say the hospital's refusal to hire more nurses to fill holes on the daily schedule often leaves them working double shifts.

"Criminals run the hospitals. And they don't seem to understand that slavery is not legal in the United States," said Chris Colello, president of Teamsters Local 377, who spoke to the group.

Jim Graham, president of United Auto Workers Local 1112 at General Motors Corp. assembly plant in Lordstown, called for a "peaceful, but smart" demonstration.

"We need to stick together. You are at war. Expect to get your hands dirty," Graham told the nurses, who walked off the job on May 1.

The strike by 771 nurses of the Youngstown General Duty Nurses Association affects Northside Medical Center, Tod Children's Hospital, Beeghly Emergency Room and Beeghly Surgical Center.

Bonnie Lambert, president of YGDNA, said mandatory overtime remains the big issue in the bargaining talks. It also serves as the major issue with nurses around the country.

"We've given them (Forum Health management) several options like a Mommy shift that allows nurses to send kids off to school and still pick them up. We've suggested calling in agency nurses to fill the holes and even a two-tiered, per diem arrangement where only some are on call. We're ready to negotiate any time," said Lambert, who served as a master of ceremonies for the rally.

"Do you have the courage to carry this through? We've had nursing shortages before. We can handle this, but not with mandatory overtime," said Mary Ellen Patton, executive director of District 3 of YGDNA.

Patton also referred to a 1966 strike at Northside and Southside hospitals in Youngstown when for the first time in history, nurses resigned en masse. She said the move fostered the formation of more nursing unions and strengthened the unions in existence at the time.

Linda Warino, a member of the nurses' negotiating team, told the crowd that Ohio House Bill 78, which outlaws mandatory overtime among nurses, would help the matter. "We're an aging community here. Whose going to care for us when we need it?" she asked.

The issue appears to be affecting nurses other than those at Forum Health. California and Massachusetts already have laws in place that limit a nurses' shift to no more than 12 hours, and one speaker said thousands of nurses in Minneapolis are set to strike June 1 over the same issue.

Still other nurses showed their anger with the hospital's use of replacement workers who were flown in as the strike began.

Bill Padisak, president of Service Employees International Local 627, which represents Licensed Practical Nurses, nurses aides and medical technicians at the same hospitals, said that when it was learned that many of the "scabs" were staying at the Metroplex, labor leaders canceled an upcoming union banquet at the Liberty motel and banquet center.

Copyright © 2001 Tribune Chronicle


Donations to the strike fund may be made out to the ŒYoungstown General Duty Nurses Association¹ or, simply, ŒYGDNA,¹ and mailed to strike headquarters. Messages of support would also be warmly welcomed.


Strike Headquarters
Medical Care Employee Federal Credit Union
630 Gypsy Lane, Suite 1
Youngstown, Ohio 44505
Next door to Northside Hospital
Phone: 330-746-6344 or 330-716-2196
Fax: 330-746-6351
Office open 5:00 a.m. to 11:00 p.m., 7 days a week

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

Massachusetts:


What the Community Can Do To Support the Brockton Hospital Nurses


The Brockton Hospital nurses are very grateful for all the tremendous support and encouragement we have received from the community, not only in Brockton, but from the general public throughout the Commonwealth and from throughout the nation. It is clear that the public understands that the issues we are fighting for - safe patient care and safe working conditions - are their issues as well. The nurses are seeking a commitment by this hospital to hire and retain the staff needed to take care of patients safely, without forcing nurses to work overtime when they are too fatigued or ill to provide safe nursing care.

Many have asked what they can do to support the nurses. Here are some suggestions:

*    Call, fax or email Brockton Hospital CEO Norman Goodman. Tell him you support the nurses and its stand in these contract negotiations. Tell him to get back to the table and settle this contract NOW. Phone # 508-941-7002; Fax # 508-941-6100; Email <
mailto:info@brocktonhospital.com> info@brocktonhospital.com.

*    Call, fax Brockton Hospital Board of Trustees Chairman Fred C. Petti. He has refused to meet with the nurses to discuss their concerns. Tell him you support the nurses and its stand in these negotiations and urge him to allow a settlement of this contract. Phone # 508-565-1040; Fax # 508-565-1500; Email <
mailto:fcp@stonehill.edu> fcp@stonehill.edu.

*    Join the nurses on the picket line. Call the Brockton Nurses'strike office at 508-427-5833 to find out where and when you are mostneeded. If possible, organize groups of friends and colleagues to picket inlarge numbers.

*    Donate (and make checks payable) to the Brockton Hospital Nurses Strike Fund; mail them to Brockton Hospital Nurses' Strike Office, 707a Centre St., Brockton, MA 02302.

*    Tie a green ribbon around the old oak tree. People are wearing green ribbons (the color of Brockton Hospital) and/or tying green ribbons around car antennas, trees and poles outside their homes and businesses in support of the Brockton Hospital Nurses.  

*    Organize an event or activity to draw attention to the nurses' plight. Groups are encouraged to organize events, demonstrations and other activities to support the nurses. However, call the strike office to find out what else is being planned to ensure your event does not conflict with other activities.  

*    Bring food and beverages to the nurses on the strike line.

For information, updates on activities, information on the strike, or directions to the strike headquarters and picket locations, visit the MNA Web site at  <
http://www.massnurses.org> www.massnurses.org.

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

Vermont:


Support Nursing Home Workers
<http://www.corpwatch.org/action/2001/014.html>


Source: United Electrical, Radio & Machine Workers of America (UE)
Posted: May 23, 2001

The 120 women and men at Berlin Health and Rehabilitation in Barre, Vermont voted to join UE last summer. In so doing, they became the first private nursing home in Vermont to organize. Berlin workers organized in response to declining resident care, chronic short staffing, poverty wages, and a lack of respect.

Short Staffing: Short staffing means that on night shift there is often only 1 nurses aide to care for 52 residents. Short staffing means residents sometimes goes weeks without receiving a tub bath; it means bed sores occur because there is enough staff to reposition residents; it means there is little time to comfort a dying resident or to serve meals while they are still warm. Short staffing increases the nursing home's profits but it hurts residents and results in increased on the job injuries for workers.

Poverty Wages: One 15 year employee, a woman from Barre, Vermont, does not yet make $7 an hour. Over 10% of Berlin's workers earn minimum wage, 25% do not make $7 an hour and well over 80% earn less than what the Vermont State Legislature has determined is a Livable Wage. This means that many of Berlin's employees rely on state and federal programs for help with medical bills, heat, food and other assistance.

This for-profit nursing home receives the majority of its funding from public sources (Social Security, Medicare & Medicaid). In turn the company pays wages so low that its workers are forced to receive public assistance. In other words, the public pays twice to subsidize this for profit entity.

Berlin Health & Rehab is owned by CPL REIT, a multinational corporation that is the largest private owner/operate of nursing homes in Canada and the owner of 20 nursing homes in the U.S. Ninety-five percent of CPL's Canadian facilities are unionized, and Berlin is the first of its U.S. holding to organize.

Since last summer, the workers at Berlin at have been fighting for a first contract. The company is insisting on an open shop, a loss in benefits and no improvements in staffing. Since the organizing campaign began (and continuing to date) the company has used the notorious anti-worker law firm Jackson Lewis to represent the nursing home. These $400 an hour lawyers have orchestrated an all war in Berlin workers.

The company has engaged in a non-stop campaign of intimidation, harassment, discriminatory treatment and other unfair labor practices. To date, the UE has accused the company of 27 separate violations of U.S. law, and the National Labor Relations Board is investigating the charges.

A negotiation session has been scheduled for May 31st.

The workers of Berlin Health & Rehab need your help. Please take the time to contact the company at one of the addresses below and insist that CPL do right by its U.S. employees.

How You Can Help


Please contact management at Berlin Health & Rehabilitation and CPL REIT and tell them to respect our rights and finish bargaining a fair contract now.

Call, email or write
Barry Reichmann
CEO of CPL REIT
175 Bloor St. East
South Tower Suite 601
Toronto Ontario
M4W3R8 Canada
TEL: 416-961-6378
FAX: 416-929-5450
EMAIL:
mylsaght@cplodges.com
Please send "CC" to
ueuvm@together.net

For more information, contact:
Robin Alexander, UE Director of International Labor Affairs
One Gateway Center, Suite 1400
420 Fort Duquesne Blvd.
PGH., PA. 15222-1416
Tel: 412-471-8919
Fax: 412-471-8999

CorpWatch
PO Box 29344
San Francisco, CA 94129 USA
Tel: 415-561-6568 Fax: 415-561-6493
URL:
http://www.corpwatch.org
Email:
corpwatch@corpwatch.org

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

New Hampshire:


Nursing shortage grows toward unhealthy level
<http://www.boston.com/dailyglobe2/147/newhampshire/Nursing_shortage_grows_toward_unhealthy_level+.shtml>


by Ralph Jimenez, Boston Globe


May 27, 2001


MANCHESTER - New Hampshire's nursing shortage, already nearly critical, is worsening. The number of vacant positions has tripled in the last four years, according to the N.H. Hospital Association.

With few young people entering the profession, the average age of the state's nurses, now 46, is expected to hit 50 within a few years. Meanwhile, the state's population is aging. New Hampshire has fewer elderly residents than the national average but a disproportionately high percentage of middle-aged people destined to need nursing care.

''We have absolutely seen units shut here in New Hampshire hospitals due to a lack of staff. We have seen elective surgeries canceled. ... The shortage also drives up the wait for elective procedures,'' said Lisa McGunnigle, a registered nurse and the association's vice president for health law and policy.

At least one-third of the state's hospitals are operating in the red. Many nursing homes are struggling as well. Poor financial health has kept them from raising salaries to attract and keep nurses.

''Stress on the job is also definitely a problem due to cutbacks by public and private payers,'' McGunnigle said.

The vacancy rate for registered nurses, licensed practical nurses, and certified nurse assistants working in the state's hospitals now averages 9.43 percent. For nursing assistants it hit 13.56 percent. Each nurse is caring for more patients and those patients, thanks to frugal managed-care rules, are sicker than ever.

''That vacancy rate is already based on a bare minimum of jobs because they have already pared so low,'' McGunnigle said of the state's hospitals. ''Nine out of those 26 hospitals are working with negative operating margins and the rest aren't doing too well either, so changes in the payment structure have really forced them to cut back on staff,'' she said.

That means nurses work longer hours. It also makes for more complaints from dissatisfied patients and their loved ones, complaints that add to the job stress.

''I handle the complaints that come here. I've only been doing it for a year but one of my most frequent complaints is that `I didn't see my nurse all night,''' McGunnigle said.

Hospitals, nursing homes, and the state have been trying to make it easier to enter the nursing profession. Earlier this month, the Southern New Hampshire Regional Medical Center in Nashua launched a cooperative program with New Hampshire Community College to offer a two-year associate nursing degree. A new $200,000 education wing on the hospital campus will allow an initial class of 16 students to work while going to school. Tuition will be under $5,000 and schedules will be flexible to accommodate family and jobs.

''New Hampshire, and the nation, is facing a serious shortage of nurses, which, if not reversed, could lead to a crisis in our health care system,'' Governor Jeanne Shaheen said at a ceremony marking the opening of the new school.

Like many employers, the medical center is willing to subsidize continuing education for nurses - moving from an LPN to an RN, for example, in exchange for a commitment to continue working for the hospital. But despite such efforts and the offer of signing bonuses by some institutions, the shortage continues.

''There are just so many more options available to women today and the percentage of men who go into nursing remains small,'' said JoAnn Allison, assistant director of nursing education for the state Board of Nursing.

Those who do become nurses quickly learn that they don't have to practice in a hospital, Allison said.

''The most dramatic image people have of nurses is what they see on television shows like `ER','' Allison said. ''But you can work in a community clinic, a day surgery center, do parish, school, or camp nursing, or you could become a nurse educator or like I am, a nurse regulator,'' she said.

Some nurses leave direct care to enter the marketing and sales end of health care; others work for insurance companies.

''The younger generation graduating from school today is able to demand a lot more flexibility from their jobs, and hospitals have to operate 24 hours a day, seven days a week. It's not the kind of place where you can work when you feel like, or work from home,'' McGunnigle said. Nurses who work making health care decisions for HMOs work 9-to-5 and generally have weekends and holidays off, she said.

During the last nursing shortage, in the 1980s, the state began recognizing the licenses of Canadian nurses. They have helped fill the gap in some parts of the state, Allison said.

Also, she said, ''There is a significant component of foreign nurses, particularly from the Philippines, and you will see a lot of them in nursing homes.''

Nursing educators are hoping for a turnaround but have yet to see any signs that the situation is improving. ''It is a very `me-oriented' generation coming out of college and somehow, if we were to shift the culture to one that again values care-giving we would see it turn around. I don't offer an explanation of how to do this,'' McGunnigle said. ''But we have to return to valuing the giving of care, whether it's to our children, our elders, or our sick.''

This story ran on page 1 of the Boston Globe's New Hampshire Weekly on 5/27/2001.
© Copyright 2001 Globe Newspaper Company.


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

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