Lead Stories: Nurses strike ends on day 104, Hospitals closing at Œepidemicı rate, Health care union loses its bid to represent four groups at St. Anthony's Medical Center, Hundreds of Nurses and Seniors Converged on State House Today to Call for Legislation to ensure Safe Nurse-to-Patient Ratios to Improve Patient Care and Address RN Shortage, Kentucky Nurses on the Move, INO two hour stoppage passes with all acute emergencies being responded to, City ranks among worst for nursing home care, Single Payer Universal Health Care Alert, Testimony of Leo Stolbach to LECG for the Commission on Universal Health Care, John Ashcroft's Palmer Raids, Ramallah hospital at eye of storm & links to 156 background articles and action calendar for Massachusetts.

³... the 1999 strike and its aftermath have wrought a seachange. The angels of mercy have turned themselves into a formidable fighting force.² - Irish press reporting on first convention of the Irish Nurses Organisation following the national nursesı strike of 1999.


Nurses strike ends on day 104
Anna Demian, The Times of Smithtown, Saint James & Nesconset, March 15, 2002


On March 8 and 9 registered nurses (RNs) on strike from St. Catherine of Siena Medical Center in Smithtown voted to accept a three-year contract proposal that would end the 104-day walkout. The 450 RNs, represented by the New York State Nurses Association (NYSNA), will begin to return to work on March 17. When nurses went on strike on November 26, 2001 they were calling for staffing guidelines to be included in their contract, for the elimination of mandatory overtime, for flex-time to continue to be a staffing option, and for retirement benefits. According to Barbara Crane, a St. Catherineıs RN and leader of the hospitalıs union chapter, the nurses got everything they went out on strike for. ³We are very happy with the contract,² said Crane, expressing relief that the strike was over. Crane said in many ways the strike was a positive experience. ³We have learned that we are absolutely valuable and that respect is our right.² ³We are looking forward to having our nurses return to work,² said James M. Wilson, president and CEO of St. Catherineıs. According to Wilson the starting salaries, per diem rates, tuition reimbursement and other incentives will help the hospital to recruit new nurses as well retain current ones. ³ Š The new contract upholds our system values of justice and respect for our staff. In line with these standards, our efforts will now shift to renewing our working relationship and rebuilding our team.² The task of reunifying hospital staff may be a difficult one according to nurses. ³I think we have a lot of work to do,² said Crane. ³Rebuilding the relationship with administration will take time [and] cooperation on both sides.² The vote was 302 to 31 in favor of the contract. NYSNA spokesperson Mark Genovese explained the ³no² votes saying, ³In a sense the nurses who voted no were sending a message to the hospital saying they didnıt like the way administration handled the strike and that they were still uncomfortable returning to work.² Hospital spokesman Andy Kraus would not comment on whether the hospital was detrimentally effected by the strike, either economically or in terms of staff relationships. Said Kraus, ³The hospital continued to operate smoothly during the work stoppage thanks to the efforts of physicians, employees and volunteers.² He added that hospital administration is pleased that the contract was supported overwhelmingly by the nurses and said the hospital was ready to work to rebuild relationships. Incorporated into the contract are unit-by-unit and shift-by-shift staffing guidelines regulating nurse to patient ratios. RNs will be able to file grievances against the hospital if they feel these guidelines are not being met. The contract prohibits the hospital from mandating overtime except in emergency situations. The nurses, who used to get time and a half for all over-time, will now get an additional $11 for each of the first four hours of mandatory overtime and an extra $16 for each of the second four hours. The money is viewed as both a disincentive to the hospital in assigning mandatory overtime and an incentive to nurses to volunteer for mandatory overtime. Nurses were guaranteed that flex-time ‹ the option of working three, 12-hour days per week rather than five, eight-hour days ‹ would not be eliminated as an option for the life of the contract. In lieu of retirement health benefits the hospital will pay nurses ages 60 to 65 who have worked for St. Catherineıs for 20 years $2,500 per to purchase health insurance. Salary increases were also included in the contract with 5 percent increases each year and other increases based on experience and night shift differentials. The base starting salary for a full-time RN will be increase from $50,000 to $55,000 over the life of the contract. Pay rates for per diem nurses will also increase. Nurses will receive retroactive pay increases dating back to May 15, 2001 when their last contract expired. Other items included in the contract are tuition reimbursement and compensation for volunteering to work night and weekend shifts. While nurses are set to return to work on March 17, it may take up to two weeks to phase them back in because they may need to finish work assignments they took during the strike.


Hospitals closing at Œepidemicı rate

More than 30 in Mass. have shut doors in recent years
Patriot Ledger staff and news services, March 14, 2002


Despite an international reputation for top-notch hospital care and cutting-edge medical research, Massachusetts is in the throes of a health care crisis. The state has lost more than 30 hospitals since 1980, fueling emergency room gridlock, a drop in psychiatric care and a loss of a third of its hospital beds. Health officials fear that what one legislator called an ³epidemic² of closings could worsen as facilities sruggle to gain control of teetering finances. While most of the former hospitals are still in the health care business - as outpatient facilities, nursing homes or rehab centers - the fact that so many acute-care hospitals have shut down has doctors, nurses, hospital officials and lawmakers concerned. ³The outlook remains bleak,² with the average hospital losing money every year, said Alan Knight, chief executive of Jordan Hospital in Plymouth. ³There are another dozen hospitals that are probably vulnerable enough to be candidates for closure in the next four or five years.² Unless hospitals get more money, patients will find more barriers to treatment, he said. ³We will see long waiting times and increased morbidity because of delays,² Knight said. Richard Brooks, executive vice-president of Milton Hospital, said community hospitals are especially pressed. Government programs and health maintenance organizations donıt pay hospitals enough to cover the cost of services, he said. When the state stopped regulating hospital rates in the early 1990s, HMOs could ³pick and choose who they wanted to pay,² Brooks said. ³In our case, they pay us less than they pay the neighboring hospitals,² he said. Larger, more powerful hospitals have recently forced HMOs to pay more, but many community hospitals lack that kind of leverage, Brooks said. The most recent hospital to face closure is Deaconess-Waltham Hospital. On Tuesday, its owner agreed to keep the facility open for two months while supporters come up with a business plan. It is the latest example of a fiscally strapped hospital on the brink, a scene played out in Malden, Quincy, Fitchburg and Everett in recent years. Quincy Hospital escaped shutdown three years ago when the city and state came up with $45.3 million in loans and appropriations. The former city hospital changed its name to Quincy Medical Center and became a private facility affiliated with Boston Medical Center. Last year, the hospital lost $5.8 million on operations, but chief executive Christine Schuster told Quincy city councilors thatıs an improvement over previous years. The hospital has not yet completed its audited financial report for the year. Jordan Hospital and South Shore Hospital in Weymouth both reported profits last year. Jordan earned $3.5 million on operations and South Shore earned $401,000. Results for Brockton Hospital, which went through a costly nursesı strike last year, were not available. Caritas Good Samaritan Medical Center, which received ³distressed hospital² funds last year, has not completed its audited report, state officials said. Milton Hospital lost $3.1 million on operations and ended the year with a net loss of $537,000 even after revenue from investments. Itıs the first time in 17 years the hospital has reported a net loss, Brooks said. In the past decade alone, the number of acute care hospitals in Massachusetts has dropped from 98 to 79. During the same time, the number of hospital beds has fallen 30 percent, from more than 23,000 to less than 16,000. Two-thirds of Massachusetts hospitals are losing money. Advocates say the steady rate of hospital closings has failed to galvanize the stateıs top political leaders. ³It becomes a news item for the local paper, but because theyıre not all happening at once, it doesnıt seem to be the epidemic that it is,² said state Sen. Richard Moore, D-Uxbridge, co-chair of the Health Care Committee. ³Itıs a regional issue and itıs getting worse.² Quincy Medical Center vice-president Mary Sweeney said, ³Youıve seen Quincy, then Hale (Hospital in Haverhill), now Deaconess-Waltham go through a crisis and each of them found a solution. ³But doing something piecemeal is perhaps not the best thing for hospitals,² she said. State officials ought to take ³a more global view² and examine the entire healthcare system, Sweeney said. The reasons for the hospital closings are complex. They include a shift in patients from community hospitals to larger teaching hospitals, cuts in Medicare reimbursement, sharp cost increases due to nursing shortages and the strong economy and the rise of HMOs and managed care plans, which pay hospitals lower rates than other private insurers. Richard Averbuch, spokesman for  the Massachusetts Hospital Association, said hospitals in the state have lost $1.1 billion in the past five years. ³Hospitals donıt reach the point of closure suddenly,² he said. ³It takes years to develop.²

Recovery effort

Faced with disappearing hospital beds, the Legislatureis looking at an ³early warning system² for faltering hospitals. Measures being considered include:
* Requiring the owners of troubled hospitals give a 180-day warning before closing any essential services. Currently, 90-day notice is required.
* Giving the attorney general the power to approve or block a hospitalıs sale or closure.
* Keeping a closer eye on the fiscal information hospitals already submit to the state.
* Strengthening the stateıs Distressed Hospital Fund to give failing hospitals a financial lifeline. Acting Gov. Jane Swift cut the fund from $15 million to $5 million this year.
* Placing ailing hospitals in state receivership.

Closures (The Associated Press)

More than 30 Massachusetts hospitals have closed during the past two decades. Many of the former acute care hospitals have been converted to other health care facilities, such as outpatient clinics or nursing homes:

* B.S. Cable Memorial Hospital, Ipswich (1980)
* Longwood Hospital, Boston (1981)
* Winchendon Hospital, Winchendon (1982)
* Doctorıs Hospital of Worcester, Worcester (1985)
* Harvard Community Health Plan Hospital, Boston (1986)
* Fairlawn Hospital, Worcester (1987)
* Mary A. Alley Hospital, Marblehead (1987)
* Brookline Hospital, Brookline (1988)
* Farren Memorial Hospital, Montague (1988)
* Parkwood Hospital, New Bedford (1988)
* Choate Memorial Hospital, Woburn (1989)
* Santa Maria Hospital, Cambridge (1989)
* Holden Hospital, Holden (1990)
* Massachusetts Osteopathic Hospital, Boston (1990)
* Hunt Hospital, Danvers (1990)
* St. Lukeıs Hospital, Middleboro (1990)
* Worcester City Hospital, Worcester (1991)
* J.B. Thomas Hospital, Peabody (1993)
* Hahnemann Hospital, Boston (1993)
* Amesbury Hospital, Amesbury (1993)
* St. Margaretıs Hospital, Brighton (1993)
* Heritage Hospital, Somerville (1994)
* Winthrop Hospital, Winthrop (1994)
* St. Josephıs Hospital, Lowell (1994)
* Ludlow Hospital, Ludlow (1994)
* Providence Hospital, Holyoke (1996)
* Goddard Hospital, Stoughton (1996)
* Lynn Hospital, Lynn (1996)
* Burbank Hospital, Fitchburg (1997)
* Boston Regional Medical Center, Stoneham (1999)
* Malden Hospital, Malden (1999)
* Symmes Hospital, Arlington (1999)

Source: Massachusetts Hospital Association; Massachusetts Division of Health Care Finance and Policy


Health care union loses its bid to represent four groups at St. Anthony's Medical Center
<http://home.post-dispatch.com/channel/pdweb.nsf/da37732b0078d6c285256ad500494df3/86256a0e0068fe5086256b7f0035c62a?OpenDocument&Highlight=0,nurses>
Mikal J. Harris & David Nicklaus, Saint Louis Post-Dispatch, March 17, 2002


The United Health Care Workers of Greater St. Louis on Saturday lost its latest bid to represent workers at St. Anthony's Medical Center, the area's third-largest hospital. The National Labor Relations Board supervised a three-day representation election at the hospital. Four groups of workers - registered nurses; skilled technicians, including licensed practical nurses; skilled maintenance workers; and service workers - voted against organizing and selecting United Health Care Workers. The union lost two elections at St. Anthony's in 2000.

Here's how the votes broke down:
* Skilled maintenance workers voted 23-9 against the union's representation.
* Service workers voted 845-350 against the union. Forty-three votes were challenged.
* Technicians voted 212-113 against the union. Ninety-four votes were challenged.
* Registered nurses voted 511-407 against representation. Fifty-nine votes were challenged.

"I believe that the employees have spoken," said Dave Seifert, president and chief executive officer of St. Anthony's Medical Center. "They've said that they don't want to be organized and that they support the program that we have in place." Jerry Tucker, an adviser to the union, praised the employees who campaigned for representation and said he didn't know what their next step would be. "Those who fought for the union fought a good fight, and they're very strong in terms of their beliefs," Tucker said. More than 3,000 workers were eligible to cast secret ballots in the election.

Reporter: Mikal J. Harris\E-mail: mikalharris@post-dispatch.com\ Phone: 636-946-3903, ext. 241


Copyright (C)2002, St. Louis Post-Dispatch



Hundreds of Nurses and Seniors Converged on State House Today to Call for Legislation to
ensure Safe Nurse-to-Patient Ratios to Improve Patient Care and Address RN Shortage
<http://www.massnurses.org/News/002003/lobbyday_pr.html>
Massachusetts Nurses Association, March 12, 2002
Contact: David Schildmeier 781-821-4625 x717 or 781-249-0430


BOSTON, Mass. - More than 350 nurses and senior citizens from all corners of the Commonwealth converged on the State House today for a "Nurse Lobby Day" event sponsored by the Massachusetts Nurses Association. The nurses of Massachusetts are mobilizing for passage of landmark "safe staffing" legislation to mandate safe nurse-to-patient ratios in hospitals and nursing homes. According to the MNA, inadequate nurse staffing levels, and unsafe nurse-to-patient ratios in all health care settings are the primary causes of the nursing shortage, the rise in ER Diversions, an increase in medical errors, mandatory overtime, decreased satisfaction of nurses with their practice, a dramatic rise in injuries among nurses, and a dramatic decline in the quality of care received by Massachusetts citizens. "Nurses are in this building to educate our legislators about the immediate need to improve nurse staffing levels in this Commonwealth.  We are here to say that nurse staffing in this state and in this country is nothing less than a public health care crisis," said Karen Higgins, President of the MNA and a critical care nurse at Boston Medical Center. "Legislators need to know that there will be no solution to the problems of medication errors, mandatory overtime, ER Diversions, or the nursing shortage itself, unless you fix the underlying cause of all these issues - it's all about staffing. Our message is without safe staffing, there can be no safe care." Isaac BenEzra, a member of the Mass. Senior Action Council, a senior activist organization that has endorsed the safe staffing bill, said, "Seniors are here to tell our legislators, safe staffing is not a luxury, it's a matter of life and death. It is time to insure that patients will not be at risk when they go to a hospital or nursing home. Safe staffing contributes to quality health care." The day's event was to draw attention to HB 1186, An Act Relative to Sufficient Nurse Staffing to Ensure Safe Care, which would mandate the creation, posting and monitoring of appropriate nurse staffing ratios that are sufficient to care for the planned and unplanned needs of patients. The bill was filed and 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 a year investigating the current nursing crisis. Similar legislation was passed in the state of California, and last month California became the first state in the nation to mandate nurse-to-patient ratios in hospitals. According to the MNA, nurse-staffing ratios in Massachusetts's hospitals are inadequate and oftentimes unsafe. While a nurse on a typical floor should be caring for no more than five patients, it is not uncommon for nurses in Massachusetts to be assigned eight to 10 patients. Michael D'Intinosanto, RN, chair of the MNA Congress on Health Policy and Legislation, the MNA organizational body that organized the event, pointed to a "series of research studies that prove the point we are here to make ... The research is clear, we have the research, poor staffing harms patients ... now we need action." For example, last Spring, the US Department of Health and Human Services released a study that showed a direct link between poor nurse staffing levels and a variety of patient complications, including thousands of deaths each year. Last summer, a special legislative commission issued its report on the state of nursing and nursing practice in the Commonwealth, in which they identified a nursing crisis in our health care system, primarily driven by issues of poor staffing and mandatory overtime in Massachusetts hospitals. The Chicago Tribune reported in a three-day series published in September 2000, that a majority of hospitals nationally have significantly reduced registered-nurse staffs. Since 1995, at least 1,720 patients have died and 9,584 others were injured in cases linked to overwhelmed nurses. A Washington Post story cited a report from US Pharmacopeia, which is maintaining a national database for hospital medication errors. The report found more than 6,000 errors in 56 facilities that were attributed to overworked nurses. The report did not blame the nurses but held the workplace environment responsible. "The primary contributing factors to medication errors were distractions and workload increases, many of which may be a result of today's environment of cost containment," concluded the report.

What the Bill Does

Current DPH regulations only require hospitals to provide "sufficient" nursing care, without defining what is sufficient. The legislation would solve the problem by mandating the creation, posting and monitoring of nurse staffing levels in all health care settings that are sufficient to care for the planned and unplanned needs of patients. The major provisions of the legislation include:

  *    The creation of a nurse staffing commission that must work collaboratively with the Department of Public Health (DPH) in relation to the development of a nurse staffing plan;
  *    The promulgation of staffing rules and regulations within one year of the passage of the act, which includes safe nurse-to-patient ratios, based on the needs of the patient;
  *    Each facility would be required to anticipate, design and adhere to a daily written staffing plan specific to each unit or specialty area of practice as required by patients or residents to maintain safety and to support nursing staff compliance with applicable professionally recognized standards of nursing practice;  
  *    That the regulations shall be enforced by DPH and that they be based upon accepted standards of nursing practice, patient or resident classification system(s), patients' or residents' acuity level and functional capacity for self-care;
  *    The creation of specialty registered nurse positions which increase the quality of patient care including: Nurse Executive, Occupational Health and Safety Nurse, and Quality Assurance Nurse;
  *    Clear language related to the role of the licensed nurse and the inability for institutions to delegate to unlicensed personnel duties which demand nursing expertise;  
  *    The utilization of research by the designated quality assurance registered nurse to evaluate nursing services and nurse staffing in relation to medical errors and patient outcomes;
  *    Strong consumer protections for "sufficient nurse staffing" including a prominent posting of the daily written nurse staffing plan on each unit to reflect the nurse-to-patient ratio per each shift as a means of consumer information and protection; and
  *    A requirement that the facility will provide each patient and/or family member with a toll free hotline number for the Division of Health Care Quality at DPH, which may be used to report inadequate staffing. Such complaint shall cause investigation by DPH to determine whether any violation of law or regulation by the facility has occurred and fines for such substantial violations.


Kentucky Nurses on the Move


Dear Colleagues and Friends,

Don't suffer in silence. Let's take a message to Frankfort! Patients and nurses need relief from forced overtime and understaffed units! We're going to Frankfort on:

Thursday, March 28, 8:00 AM
Frankfort, Room 149, Capitol Annex
Cars will be leaving from NPO at 6:00 AM. For a ride call 459-3393.
(NPO, Medical Arts Bldg., 1169 Eastern Parkway, #2200)

If it's impossible for you to go, send your message with us. Fill in your opinion on the letter below and return it to NPO before the hearing. It's time for representatives in Frankfort to hear the truth from patients and nurses. Come lift up your voice!

Send your old shoes. Nurses around the country have been lining up their worn out shoes as a demonstration of the wear and tear on nurses. The empty shoes also symbolize the nurses we have lost from the profession due to the working conditions. Drop off your old nursing shoes at NPO prior to the hearing. If no one is in, please leave them by the door.

You can read HB 91 on line at: <http://www.lrc.state.ky.us/record/02rs/HB91/bill.doc>

Representative Joni Jenkins' HB 91 will come before the House Health and Welfare Committee at 8:00 AM in Hearing Room 149 of the Capitol Annex. You are invited to speak to the committee on the need for safer staffing and an end to mandatory overtime. If you choose not to speak, we invite you to attend the hearing. Just let us know if you'd like a ride by calling 459-3393. If it's impossible for you to go, send your message with us. Fill in your opinion on the letter to the committee and get it back to NPO before the hearing. We'll make certain that the committee gets your message. It's time for representatives in Frankfort to hear the truth from patients and nurses. Come lift up your voice!

Sincerely,

Patty Clark, RN, President                       Susan Yost, RN, Executive Director

Letter to the Representatives on the House Health and Welfare Committee:

The patients and nurses in Kentucky's hospitals and nursing homes need the protection of HB 91.

It is urgent that you act to end forced overtime because:

_____________________________________________________________

_____________________________________________________________

_____________________________________________________________

Your vote for safer staffing is important because:

_____________________________________________________________

_____________________________________________________________

_____________________________________________________________

Please vote for HB 91, Rep. Joni Jenkins' Patients' Bill of Rights.

Signed:

Name____________________________________

Address__________________________________

City____________________Zip______________

Phone______________email_________________

Please return signed forms to NPO, 1169 Eastern Parkway, Suite 2200, Louisville, KY 40217 prior to March 21. Further info: NPO 459-3393.


INO two hour stoppage passes with all acute emergencies being responded to

Work to rule now underway - organisation will accept invitation to LRC talks
<http://www.ino.ie/news_detail.php3?nNewsId=2712&nCatId=170>
Irish Nurses Organisation, March 13, 2002


The two hour stoppage of INO members in the countryıs A&E Departments proceeded earlier today with, as promised, all acute emergencies being responded to without delay. In a number of locations around the country there was occasion for the emergency response nursing team to attend acutely ill people and this was done in all such cases. At 2.00 pm today the INO members in A&E Departments commenced a continuous work to rule which involved the nurses withdrawing from clerical, administrative, portering and extended role duties. Late this afternoon the Organisation was informed that the Minister intended to request the Labour Relations Commission to intervene in the current dispute, the INO will respond positively to any invitation received from the LRC in recognition of the statutory bodyıs position in resolving workplace disputes. Speaking this evening Liam Doran General Secretary said ³The INO membership showed total commitment to the campaign during todayıs two hour stoppage, and have now commenced a work to rule aimed at pressurising management while at the same time ensuring all patient nursing care needs are met fully. As we have said consistently this matter requires continuous engagement in order to resolve the outstanding issues and we would welcome the assistance of the LRC in this regard².


City ranks among worst for nursing home care
Lisa Eckelbecker, Worcester Telegram & Gazette, March 17, 2002


WORCESTER -- A Colorado company has ranked Worcester among the nation's worst cities for nursing home care, a move that has drawn protests from state health officials and local nursing home operators. Health Grades Inc. of Denver announced last month that 10 of Worcester's 22 nursing homes had been cited for violating four or more federal regulations involving harm to patients over four years. But state officials contend that Health Grades' method of rating nursing homes does not provide a balanced picture of facilities, and nursing home operators said the reports brand them for isolated incidents, paperwork problems or disagreements with overzealous inspectors. The spat reflects an ongoing controversy that has even involved Congress over how best to give consumers information on quality of nursing home care. ³Quality has got so many different dimensions to it and so many things that people care about,² said Dana B. Mukamel, associate professor of health policy at the University of Rochester Medical Center in Rochester, NY. ³We need to find things that people care about and find ways to include them in the measurement process.² Health care report cards have emerged in recent years as businesses have sought tools to help them and their employees decide which doctors, hospitals, nursing homes and health plans are providing the best services. Several states and the federal government have created nursing home report cards that are free online. Businesses such as Health Grades and SeniorCare Resources Inc. of Delaware charge fees for their report cards. Although different report cards emphasize different factors, all rely on the same basic set of information: data collected by state inspectors, known as ³surveyors,² who visit nursing homes every 9 to 15 months or after complaints to determine whether facilities are complying with federal Medicare and Medicaid regulations. Surveyors examine records, talk to residents and observe conditions. They assess everything from food preparation to treatment of pressure sores. In Massachusetts, the state Department of Public Health uses certain information from regular and complaint surveys to create report cards. The federal government uses only regular surveys. Health Grades focuses on any violation reflecting harm to a patient. All of which has led to criticism. The US House Committee on Government Reform recently blasted federal report cards prepared by the Centers for Medicare & Medicaid Services because they ignore complaint surveys, which sometimes turn up serious violations. Massachusetts officials question Health Grades' decision to single out nursing homes with four or more actual-harm violations over a four-year period and argue that the state's method of focusing on certain measurements related to quality of care over three years is superior. Health Grades responds that it is pointing out nursing homes that have, on average, one serious violation per year and that consumers like Health Grades' additional practice of rating nursing homes with up to five stars. ³Consumers can simply see at a glance where a facility stands in our area,² said Janet D. Burkhard, director of content for the company. Report cards such as those prepared by Massachusetts may be ³a little confusing to a layperson who's not familiar with what all that means.² The disagreements boil down to the methods used to rate something that is very difficult to quantify: good care. ³We're all in the business of trying to give information to people that will make their decisions easier,² said Paul I. Dreyer, director of the state's Division of Health Care Quality. ³None of these methods is perfect.² Concerns about quality at nursing homes have become more urgent in recent years as nursing home operators have struggled with financial and labor difficulties. Nursing homes blame Medicaid, the state-federal health program, for not fully covering the cost of caring for sick, frail people. They also complain that labor shortages have hampered hiring and forced them to rely on high-cost temporary nurses to fill out their staffs. A number of national nursing home chains have reorganized under bankruptcy protection. Whatever the cause, state officials say that violations at nursing homes are on the rise. Worcester landed on Health Grades' list of among the worst cities for nursing home care after the company calculated that nearly 46 percent of Worcester's facilities had four or more violations, formally known as ³deficiencies,² of actual harm during the four-year period ending in late 2001. Deficiencies frequently relate to pressure sores, falls and ensuring that patients eat enough food and drink enough fluids. Sometimes, deficiency citations point out clashes between nursing homes and surveyors over the best way to help patients. At Knollwood Nursing Home last year, workers began feeding a woman to ensure her nutrition, according to one survey. The surveyor cited the nursing home for not seeking a way to help the woman eat on her own. Other times, deficiencies pile up because of care given to a few people. At University Commons Nursing Care Center, a 164-bed nursing home that is part of the UMass Memorial Health Care system, a surveyor last year cited the case of a woman with multiple medical ailments who could walk with a walker when she was admitted in January. But by July, the surveyor saw her being wheeled about in a wheelchair, and the woman reported she could no longer walk on her own. Workers, the surveyor wrote, said they were unaware that the woman used a walker. Nursing home officials are generally sensitive about survey results, and some declined to speak with the Telegram & Gazette about how their facilities performed on surveys and report cards. Others said they were frustrated that report cards do not reflect corrective actions taken after inspections or the special circumstances that can lead to deficiencies. Mark Shelton, a spokesman for UMass Memorial, said University Commons officials felt they were unfairly cited because surveyors judged events in a subacute care unit, a unit for people coming out of hospitals, according to the standards of a regular nursing home. In addition, Mr. Shelton said, surveyors found no deficiencies when they revisited University Commons in October. ³The University Commons takes a lot of patients that other facilities won't take,² he said. ³If there weren't subacute facilities like that available, the alternative is those residents would be in the hospital.² Report cards also fail to convey what patients and relatives have to say, said Christopher T. Lane, administrator of the 124-bed St. Mary Health Care Center. St. Mary was cited for a number of deficiencies in 2000, but none in 2001. ³Some of our best ideas come from the families,² he said. ³They (report card companies) are publishing something for the entire country. They ought to take the time to talk to families.² Some administrators acknowledged they had been cited for deficiencies, but described the problems as record-keeping failures, not lapses in patient care. ³In long-term care, the paperwork has increased tremendously over the past 10 years,² said Janet M. Davis, director of nursing at Christopher House of Worcester, a 156-bed nursing home with a waiting list. ³My nursing staff wants to take care of patients, and sometimes I think the paperwork is the last thing that gets done.² In general, the Worcester nursing homes cited by Health Grades for the most deficiencies also scored below average on the state's report cards. Those noted by Health Grades for zero or few deficiencies generally scored high on the state's report cards. But one nursing home that has a perfect score on the state report cards, Greenery Extended Care Center, was among those cited by Health Grades for six deficiencies involving harm to patients. The rating included the results of two 1999 surveys conducted after complaints. An administrator at Greenery declined to comment last week. Mr. Dreyer of the DPH said the case pointed out the problems with the Health Grades method. Deficiencies from isolated events involving two Greenery patients end up tarnishing a nursing home that went through two annual inspections without any deficiencies, he said. ³We don't think it's a fair way to characterize this,² he said. Report cards do need to become more sophisticated, and some moves are under way to develop new report cards, according to Ms. Mukamel of the University of Rochester. The federal government is studying ³risk-adjusted² measurements, which would take into account risk factors such as diabetes when measuring how patients are faring and the quality of care they received. Worcester nursing home administrators said they also want people to put the report cards aside. ³We encourage folks to come into the building and to tour, and because we're so local and most of the folks are local, folks will come in at all hours,² said Barbara E. Garbarczyk, the new administrator at Clark Manor Nursing Home. What it gives people, she said, is ³assurance that their care is being taken care of.²


İ2002 Worcester Telegram & Gazette Corp.



Single Payer Universal Health Care Alert
<http://www.mainenurse.org>

"as Maine goes, so goes the nation"


Maine will lead the nation with single payer universal health care if ...
* The feasibility study gets funded. (Maine recently passed a law that directs a Security Board to implement a single payer universal health care system for the State of Maine.)
* The report is published ASAP. (The State of Maine has appropriated $10,000 for the Security Board and it will cost $40,000 plus to fund the feasibility study and produce the report. Help make universal health care history! Send your check to:


MSNA, PO Box 2240, Augusta, ME 04338. Make checks payable to Treasurer, State of Maine



Testimony of Leo Stolbach, MD, to LECG for the Commission on Universal Health Care
Ad Hoc Committee to Defend Health Care, February 27, 2002


My name is Leo Stolbach. I am a Medical Oncologist, who has been practicing in Massachusetts since 1964, except for 3 years when I was Chief of Medical Oncology at the Ottawa Civic Hospital and Ottawa Cancer Clinic in Canada and had a chance to practice in a Single Payer System that worked well. I am testifying as a member of the Board of Directors of the Ad Hoc Committee to Defend Health Care, which represents health care providers committed to improving the quality and accessibility of health care in Massachusetts. We believe that market driven medicine, meaning any health care system that is founded on traditional market systems theories, is fundamentally flawed. Traditional free-market theories simply do not apply to health care consumers due to the fact that most consumers do not enjoy the free choice to consume, or the ability to seek competitive vendors to obtain medical care. A heart attack victim, cancer patient, or a person being treated for high cholesterol cannot seek out multiple vendors or alternative products in search of competitive prices. In emergencies, they must receive the care given to them. In non-emergencies they are pigeon holed into accepting the care offered to them, ie, the one drug that works for them, or the one treatment that their doctor prescribes. There are no alternatives for many patients. With a product that, by nature, strips the consumer of the ability to purchase alternative products from competing vendors, free-market theories fly out the window. Add to that the fact that people are forced to consume health care services in order to remain healthy or simply stay alive, the concept of profit making becomes perverse. Frankly stated, there is no room for profit taking in health care delivery. We come before you with the premise that health care is not a privilege but a right, as is the case in most industrialized nations. We believe that health care should be provided to everyone. The majority of uninsured persons in Massachusetts are working poor who cannot afford insurance premiums and are not offered any benefits from their employers. They are not the indigent, who cannot contribute anything towards the cost of their care. And they are not the elderly, who generally have complicated health concerns, and therefore, high cost care. Ironically, they are a relatively easy, and inexpensive, population to insure. When we talk about universal health care we always come back to the same question: who is going to pay for it? Iım sure that you are familiar with Sager and Socolarıs work regarding a single payer system, which projects that there is enough fat in bloated administrative budgets to cover the uninsured in Massachusetts if the system is streamlined. However, they arenıt the only ones who claim that there is enough money out there.  John McDonough recently stated at a Mass. Medical Society (MMS) State of the Stateıs Health Care meeting that the money lost from the tax rollback could completely fund a universal health care system in Massachusetts. MMS commissioned reports by Sagerıs group and another by the Lewin Group, which demonstrated that single payer would cost either slightly less or slightly more than what we are now paying for health care. Money spent on large administrative budgets and redundant paperwork is wasted dollars, and there is no justifiable reason that we should be spending health care funds on either advertising or lobbying. Our need for funding health care in Massachusetts is too great for HMOs to waste patient premiums on desperate attempts to gain market share. In the year 2000, HMOs in Massachusetts spent 5 million health care dollars to defeat Ballot Question 5, which called for universal health care. Proponents were outspent 50 to 1, but despite this campaign funding discrepancy supporters of Q5 obtained 48% of the total votes, demonstrating an incredibly strong support for universal health care. There are presently two schools of thought. One that says: Let’s wait and see what happens, do more studies, and put off making the decision to implement universal health care even though we know it’s the right thing to do. Then there is the school of thought that I subscribe to: LETıS JUST DO IT - NOW! If we implement a system of universal health care we will, as suggested by the Sager and Lewin Group studies, be able to pay for it. Iım sure the debate over the best way to structure the system will never end. We can talk about it forever - letıs just do it. In addition to universal health care, we believe in ensuring quality care for everyone. Hospital policies, including inadequate staffing and mandatory overtime, not only wear thin on nerves and force health care providers to work past the point of exhaustion, sometimes 16-24 hours at a stretch, these policies kill patients. Describing nurses as ³victims of hospital mismanagement,² the Chicago Tribune last year linked more than 1,700 deaths to staffing shortages and money-saving policies. We need to protect the quality of health care by ensuring that there is enough hospital staff to perform the duties required of them and we need to protect our non-profit hospitals which have a proven track record of providing better quality care than for-profit institutions. We believe that affordable prescription drugs should be available to all. The drug industry is the most profitable industry in America. Again, billions of dollars each year are wasted on advertising and lobbying, and hundreds of millions of dollars owed to taxpayers in royalties are not paid to the publicly funded institutions such as NIH that conduct the initial-stage research vital to developing drug products. And finally, we need to save our hospitals. Waltham-Deaconess is a perfect example of the system gone awry. A community hospital that provides essential services is about to go out of business and our hands are tied to save it. People in this room, the MNA, Mass Senior Action, SEIU and many others are working diligently to save the hospital but the State is not making it easy. The funds are there, but the possibility of privatization still exists with its many pitfalls. In conclusion, we believe that in the Commonwealth of Massachusetts, which on a per capita basis spends more than twice as much on health care as any country in the world, access to excellent health care should be available to all our residents. The resources are out there to achieve universal health care; now we need the will to accomplish it. In addition, I would like to suggest that the issue of universal health care has a civil rights component. In Massachusetts, only 1 out of every 10 whites is uninsured whereas 1 in 7 blacks and 1 in 4 Hispanics lack health insurance. Uninsured people live sicker lives and die younger. The struggle for universal health care is the unfinished piece of the civil rights movement.


John Ashcroft's Palmer Raids
Clancy Sigal, The New York Times, March 13, 2002


LOS ANGELES ‹ The federal government is still holding hundreds of Middle Eastern and Asian men rounded up after the terrorist attacks on Sept. 11. Most are jailed on minor immigration violations, but they are being held indefinitely, presumably as the government looks for some connection to terrorists. Americans who object to this tactic of indiscriminate roundups, Attorney General John Ashcroft told a Senate committee in December, "only aid terrorists." No one wants terrorists to operate in our country, but the consequences of this kind of government action can be long-lasting. On this, I have family history to look to. In the summer of 1919 a series of dynamite bombings, carried out by anarchists, swept over several American cities. A suicide bomber blew himself up outside the Washington home of Attorney General A. Mitchell Palmer. Then, on Sept. 16, 1920, the House of Morgan in lower Manhattan was blown up, killing 33 people and injuring 400. The anarchist threat was terrifying, just as the terrorist threat is now. Most Americans supported Attorney General Palmer's campaign against the "Reds" ‹ an ill-defined menace that went far beyond the small group of actual anarchists and was blamed for pretty much anything that smacked of social conflict ‹ including, at various times, the woman's suffrage movement, a Chicago race riot and a wave of paralyzing industrial strikes. My Russian-immigrant parents fit the profile. They were foreign-born, Jewish, radical labor organizers who had actively participated in several turbulent strikes. They had no fixed address and were living in sin. They were arrested, jailed and almost deported during the infamous Palmer raids of 1920 and 1921. Attorney General Palmer was an angry man on a mission of vengeance. Using existing sedition laws, he and his chief investigating officer, a ravenously ambitious 24-year-old named J. Edgar Hoover, ordered 500 agents of the newly created Federal Bureau of Investigation to go after Communists, socialists, union activists, and pacifists and arrest them without warrants or judicial hearings. Homes were ransacked, political literature burned. Estimates vary, but between 4,000 and l0,000 people were secretly, efficiently rounded up. Like today's detainees, they were often held without bail, habeas corpus rights or access to lawyers. When I was growing up my father kept silent about the raids, but my mother told me federal agents had beaten him on the way to jail. Both of my parents were released to go back to their lives ‹ my mother after a few days and my father after a few weeks. They had feared being deported, as some of their friends were. The raids were a living presence in our house. At a later time, when J. Edgar Hoover's FBI came around to question me during the cold war, my mother politely met them at the door, invited them in for coffee and charmed them out of their intended purpose. But she was pale and terrified when I got home. In an understandable slip of the tongue she said: "The Palmers have been here. What have you done?" I wonder how many immigrant homes were like ours. The Palmer raids, though long ago, cut deep and left scars on individuals caught up in them and on America's views of how government could be permitted to deal with anyone dissident and different. What scars is our government inflicting today?

Clancy Sigal is a screenwriter and novelist.


Copyright 2002 The New York Times Company

 

Ramallah hospital at eye of storm

Small staff does best to cope with influx of wounded
Paul Adams, Toronto Globe & Mail, March 14, 2002


Three small puddles of bright red blood stained the pavement outside the only Ramallah hospital in Palestinian hands yesterday. People at the scene said it belonged to a 25-year-old Palestinian soldier shot by an Israeli sniper as he stood beside the ambulance ramp. The Israelis say they take care not to shoot near hospitals, but that was a difficult policy to follow yesterday as the enclave controlled by Palestinian gunmen in the West Bank's largest city shrank ever smaller. "Now, more than 95 per cent of the Ramallah area is under occupation," said Colonel Sabri Tumaizi, head of preventive security for Ramallah, who was trying to manage the steady flow of ambulances carrying injured Palestinian civilians and militiamen to the 36-bed Arabcare hospital. The Israelis rolled into Ramallah and nearby refugee camps late Monday with 150 tanks and armoured personnel carriers, aiming to root out terrorists and their hideouts. The Palestinian Authority urged resistance, but the ragtag mixture of uniformed and irregular fighters were at a massive disadvantage, armed mainly with rifles and a few rocket-propelled grenade launchers. The Israelis describe Ramallah, a city of about 200,000 and the West Bank's commercial and political hub, as an "axis of terrorism," from where a long list of attacks have been launched against Jerusalem, including one that killed 11 Israelis at a café last week. By yesterday afternoon, Israeli forces were in complete control of Ramallah, except a small area around the city's main square, where the hospital is located. The Israelis said they had rounded up dozens of terrorists and destroyed several bomb-making factories. The Arabcare hospital wore the scars of the frenzied 48 hours, with blood spattered in stairwells and on the uniforms of medical staff. The seven doctors and seven nurses, about a third the normal complement, who had worked without relief, said they had treated 45 people for serious injuries and that two men had died in their hands. Yesterday, a 42-year-old Italian journalist, Rafael Ciriello, died at the hospital, where he was taken after having been raked with machine-gun fire from an Israeli tank. Mr. Ciriello, a veteran freelance photographer who had worked in many war zones, was on assignment for the Italian daily Courier della Sera. The Israeli army expressed regret at the killing, but said it was not yet clear whether Israelis or Palestinians had shot him. In Rome, the Foreign Ministry summoned the Israeli ambassador and asked for a full explanation. Another journalist, Amide Rococo, who was with Mr. Ciriello when he was shot, said they were following some Palestinian gunmen through Ramallah when an Israeli tank appeared about 150 metres away and started firing. Dr. Mohammed Mubaied, who operated on Mr. Ciriello, said the photographer was hit by six soft-nosed, high-velocity bullets, sometimes called dum-dum bullets, that are designed to cause massive injuries. He said that Mr. Ciriello had bled to death, and that Israeli soldiers had delayed the ambulance from getting to the hospital. Mr. Ciriello was the first foreign journalist killed in the past 18 months of violence. Several other foreign journalists have been wounded during the Israeli incursion into Ramallah. Most of those treated at the Arabcare hospital were young men, almost the only demographic group that has dared to venture onto the streets of Ramallah since the start of the Israeli military sweep into the West Bank and Gaza Strip, which involves as many as 20,000 troops.


İ 2002 Bell Globemedia Interactive Inc. All Rights Reserved.

  

Strikes & Strife:

Nursing strike halted
<http://www.aftenposten.no/english/local/article.jhtml?articleID=288456>
Espen Brynsrud & Jonathan Tisdall, Aftenposten, March 8, 2002
OHSU hit with $310,000 strike penalty
<http://www.portlandtribune.com/archview.cgi?id=10236>
Mary Bellotti, The Portland Tribune, March 8, 2002
Doctors, nurses walk out from Gizo Hospital
<http://pidp.eastwestcenter.org/pireport/2002/March/03-11-15.htm>
Pacific Islands Report, March 8, 2002
Long Island nurses strike is over!
Saint Catherineıs RNs approve contract that limits overtime and ensures safe staffing
<http://www.nysna.org/NEWS/press/pr2002/pr030902.htm>
New York State Nurses Association, March 9, 2002
State nurses will go to arbitration in contract dispute
<http://www.startribune.com/stories/535/1921306.html>
Tony Kennedy, Minneapolis Star Tribune,  March 10, 2002
Nurses return to work in Smithtown
<http://www.news12.com/CDA/Articles/View/0,2049,5-5-35579-20,00.html>
News 12, March 11, 2002
St. Catherine Strike Ends: Nurses approve 3-year contract
<http://www.newsday.com/news/local/longisland/ny-linurs112619701mar11.story?coll=ny%2Dlinews%2Dheadlines>
Barbara J. Durkin, Newsday, March 11, 2002
In E-Mail, Striking Nurses Cast A Wide Web
<http://www.newsday.com/news/printedition/longisland/ny-limail122621379mar12.story>
Barbara J. Durkin, Newsday, March 12, 2002
Québec nurses reject contract extension, pay raise by 60-40 margin says union
<http://www.canada.com/search/site/story.asp?id=C3E69E1B-90A1-48B7-93A1-BB6EC4D4EDD9>
Canadian Press, March 14, 2002
Nurses march to demonstrate solidarity
<http://www.sanluisobispo.com/mld/sanluisobispotribune/2857962.htm>
Samantha Gonzaga, San Luis Obispo Tribune, March 14, 2002
Saint Catherineıs RNs to Return to Work
<http://www.nysna.org/NEWS/press/pr2002/pr031502_b.htm>
New York State Nurses Association, March 15, 2002
Sweets Ease Way as Nurses Return
<http://www.newsday.com/news/printedition/longisland/ny-linurs182628973mar18.story?coll=ny%2Dlinews%2Dprint>
Erik Holm, Newsday, March 18, 2002
Manitoba nurses vote on strike action; seek parity with Alberta
<http://www.canada.com/search/site/story.asp?id=6E7A8ED4-68D6-4C4A-89ED-CA9B77642175>
Scott Edmonds, Canadian Press, March 18, 2002
Premier promises gov't will do its best to prevent nurses strike
<http://www.canada.com/search/site/story.asp?id=AFB1FA70-1E20-41C5-BABD-5555AB2F26EA>
Canadian Press, March 18, 2002
Manitoba hospitals prepare for possible nurses' strike as talks continue
<http://www.canada.com/search/site/story.asp?id=84939586-639B-4417-A355-9FA5F1ACD4B1>
Scott Edmonds, Canadian Press, March 19, 2002
Nurses vote in favour of strike
<http://www.canada.com/search/site/story.asp?id=DA6EA6B3-AE7C-4045-A9B1-212B608A3DFB>
Canadian Press, March 19, 2002
"Insulting" wage offer to nurses
<http://sask.cbc.ca/template/servlet/View?filename=nurses020320>
Kathy Fitzpatrick, CBC Radio, March 21, 2002

Saving Hospitals:

Hospital could avert closing
<http://boston.bizjournals.com/boston/stories/2002/03/11/weekinbiz.html>
Boston Business Journal, March 8, 2002
Massachusetts experiencing ''epidemic'' of hospital closings
<http://www.boston.com/dailynews/068/region/Massachusetts_experiencing_epi:.shtml>
Steve Leblanc, Associated Press, March 9, 2002
State beset by hospital closings
<http://www.dailynewstribune.com/news/local_regional/ap_hospitals03102002.htm>
Steve LeBlanc, Associated Press, March 10, 2002
A hospital closing plan - just in case: CareGroup files proposal to meet a state deadline
<http://www.boston.com/dailyglobe2/069/west/A_hospital_closing_plan_just_in_case+.shtml>
Emily Sweeney, Boston Globe, March 10, 2002
Developer driven to revive hospital
<http://www.boston.com/dailyglobe2/069/west/Developer_driven_to_revive_hospital+.shtml>
Emily Sweeney, Boston Globe, March 10, 2002
MetroWest hospital in the black: Small measures lead to profit
<http://www.boston.com/dailyglobe2/069/west/MetroWest_hospital_in_the_black+.shtml>
Eun Lee Koh, Boston Globe, March 10, 2002
Hopes to save hospital still alive: Weekend negotiations held between CareGroup, developer and coalition
<http://www.dailynewstribune.com/news/local_regional/walt_hospital03112002.htm>
Patrick Golden, Daily News Tribune, March 11, 2002
Putting City Hospitals on Firmer Footing
<http://www.nytimes.com/2002/03/11/nyregion/11HHC.html?ex=1016880393&ei=1&en=0540b26ab6988e29>
Jennifer Steinhauer, New York Times, March 11, 2002
Editorial: Do the deal
<http://www.dailynewstribune.com/news/opinion/edithospital03112002.htm>
Daily News Tribune, March 11, 2002
CareGroup announces deal to save Waltham hospital
<http://www.boston.com/dailynews/071/region/CareGroup_announces_deal_to_sa:.shtml>
Associated Press, March 12, 2002
CareGroup announces deal to save Waltham hospital
<http://www.boston.com/dailynews/071/economy/CareGroup_announces_deal_to_sa:.shtml>
Steve Leblanc, Associated Press, March 12, 2002
Bay State hospitals busier, but still losing money
<http://www.boston.com/dailynews/071/economy/Bay_State_hospitals_busier_but:.shtml>
Associated Press, March 12, 2002
Lean hospitals see green: Operating losses still dog industry
<http://www.businesstoday.com/business/business/hosp03122002.htm>
Jennifer Heldt Powell, Boston Herald, March 12, 2002
Blue Cross, Tufts to investigate hospital
<http://ledger.southofboston.com/archives>
Sue Reinert, The Patriot Ledger, March 12, 2002
CareGroup, hospital call for agreement
<http://www.dailynewstribune.com/news/local_regional/walt_hospital03122002.htm>
Patrick Golden, Daily News Tribune, March 12, 2002
Property deal may save Deaconess-Waltham Hospital
<http://www.boston.com/dailyglobe2/072/business/Property_deal_may_save_Deaconess_Waltham_Hospital+.shtml>
Emily Sweeney, Boston Globe, March 13, 2002
Caritas Norwood stays afloat
<http://www.neponsetvalleydailynews.com/news/local_regional/norw_hosp03132002.htm>
Brian Falla, Neponset Valley Daily News, March 13, 2002
Off the critical list: Celebrations after handshake deal to prevent hospital closing
<http://www.dailynewstribune.com/news/local_regional/walt_hosp03132002.htm>
Patrick Golden, Daily News Tribune, March 13, 2002
Celebrations at hospital, hard work ahead
<http://www.dailynewstribune.com/news/local_regional/walt_hospside03132002.htm>
Brad Spiegel, Daily News Tribune, March 13, 2002
Editorial: On Hope Avenue
<http://www.dailynewstribune.com/news/opinion/edit03132002.htm>
Daily News Tribune, March 13, 2002
Waltham hospital saved: Coalition will assume control
<http://www.businesstoday.com/business/business/hosp03132002.htm>
Jennifer Heldt Powell, Boston Herald, March 13, 2002
Hospital rescue needs approval of state, owners: Some in city say they're skeptical
<http://www.boston.com/dailyglobe2/073/west/Hospital_rescue_needs_approval_of_state_owners+.shtml>
Emily Sweeney, Boston Globe, March 14, 2002
Health Commissioner to visit hospital: Deal signing delayed by scheduling glitches
<http://www.dailynewstribune.com/news/local_regional/walt_hospital03152002.htm>
Patrick Golden, Daily News Tribune, March 15, 2002
Health Commissioner to visit hospital: Deal signing delayed by scheduling glitches
<http://www.dailynewstribune.com/news/local_regional/walt_hospital03152002.htm>
Patrick Golden, Daily Tribune, March 15, 2002
Deaconess-Waltham survives
<http://www.dailynewstribune.com/news/local_regional/walt_hospital03162002.htm>
DeAnna Putnam, Daily Tribune, March 16, 2002
Editorial: Hospital rescue
<http://www.dailynewstribune.com/news/opinion/edit_hospital03182002.htm>
Daily News Tribune, March 18, 2002
Health chief applauds rescue deal
<http://www.dailynewstribune.com/news/local_regional/walt_hospital03182002.htm>
DeAnna Putnam, Daily Tribune, March 18, 2002
Hospital owner wasn't swayed by high bid
<http://www.businesstoday.com/business/business/hosp03182002.htm>
Jennifer Heldt Powell, Boston Herald, March 18, 2002
BI-Deaconess says 2 programs finding `alternative' homes
<http://www2.bostonherald.com/news/local_regional/bi03192002.htm>
Michael Lasalandra, Boston Herald, March 19, 2002
Good Samaritan Medical Center prepares for $20M hospital expansion
<http://enterprise.southofboston.com/archives>
Sean Flynn, Brockton Enterprise, March 21, 2002
Recovery company to start work: Cambio Health Solutions to begin hospital business plan
<http://www.dailynewstribune.com/news/local_regional/walt_hospital03212002.htm>
Patrick Golden, Daily Tribune, March 21, 2002
Hospital is hemorrhaging vital staff: Deal on horizon but some cannot wait
<http://www.dailynewstribune.com/news/local_regional/walt_hospital03222002.htm>
Patrick Golden, Daily Tribune, March 22, 2002

Organizing the Unorganized:

NLRB Rules Tenet Illegally Discharged Melanie Mobley
UHCW Wins Reinstatement & Full Back Pay For Poplar Bluff Hospital Nurse
<http://www.uhcw.org/Poplar%20nursre%20reinstated.htm>
United Health Care Workers of Greater Saint Louis
Nurses might face firing for unpaid dues
<http://home.post-dispatch.com/channel/pdweb.nsf/da37732b0078d6c285256ad500494df3/86256a0e0068fe5086256b7a0036821c?OpenDocument&Highlight=0,nurses>
Judith VandeWater, The Post-Dispatch, March 12, 2002
(Editorıs Note: the above article was published just a few days before the vote on union recognition at Saint Anthonyıs Hospital in Saint Louis - SE)
Retreat workers OK union
<http://search.newschoice.com/ArchiveDisplay.asp?story=d:\index\newsarchives\ne\neref\loc\20020316\1412526_3x16unionwinsretreatelectio.txt&source=www%2Ereformer%2Ecom&puid=&paper=Brattleboro+Reformer>
Tom Marshall, Brattleboro Reformer, March 16, 2002
Nurses seeking recognition of union plan rally
<http://www.signonsandiego.com/news/northcounty/20020316-9999_1mi16nurses.html>
John Berhman, Union-Tribune, March 16, 2002
Eureka! Landslide for North Coast Nurses, St. Joseph RNs Vote by 86% for CNA
Hospital Spent at least $31,000 per 'no' vote, CNA Estimates
<http://www.calnurse.org/cna/press/31602.html>
California Nurses Association, March 16, 2002
The nurses have spoken: 'Union Yes'
<http://www.times-standard.com/Stories/0,1002,2896%257E469255,00.html>
Jennifer Morey, The Times-Standard, March 17, 2002
St. Mary nurses may unionize
<http://www.vvdailypress.com/cgi-bin/newspro/viewnews.cgi?newsid1016642801,33373,>
Teri Figueroa, Victorville Daily Press, March 20, 2002
Nurses protest outside Palomar Medical Center
<http://www.nctimes.net/news/2002/20020322/54433.html>
Marty Graham, North County Times, March 22, 2002
Flex staffing keeps economy nimble: ŒJust in timeı labor force helping to spur quick rebound
<http://www.msnbc.com/news/727925.asp?0dm=C268B&cp1=1>
Clare Ansberry, The Wall Street Journal, March 22, 2002

Nursing Crisis & Attempts to Fix It:

Letters in Response to Articles on Nursing Crisis
<http://www.healthaffairs.org/freecontent/s39.htm>
Health Affairs, March, 2002
Healthcare approaching capacity Œcrisisı: survey
<http://www.modernhealthcare.com/news_briefs.php3?action=view&id=2793>
Modern Healthcare, March 8, 2002
International Recruiting Network: Addressing the nursing shortage
<http://portland.bizjournals.com/portland/stories/2002/03/11/focus7.html>
Heidi J. Stout, Portland Business Journal, March 8, 2002
Wanted: Qualified health workers
<http://philadelphia.bizjournals.com/philadelphia/stories/2002/03/11/story5.html>
John George, Philadelphia Business Journal, March 8, 2002
Health care board considers job cuts, bed closures
<http://www.canada.com/search/site/story.asp?id=E2E817C6-E0A9-4378-BF14-9A0B4F46C403>
Canadian Press & BN, March 8, 2002
Province could lose nurses over contract squabbles: Students at symposium say Manitoba not attractive
<http://www.canada.com/search/site/story.asp?id=2B2C070B-DE55-496F-94F6-60C0B9BF9779>
Canadian Press, March 10, 2002
Nursing trouble
<http://www.canada.com/search/site/story.asp?id=E5877975-E1DD-47D9-8282-D901222679B6>
Jim Day, Charlottetown Guardian, March 11, 2002
Patient safety group organizes
<http://austin.bizjournals.com/austin/stories/2002/03/11/daily1.html>
Austin Business Journal, March 11, 2002
UAB Hospital earns national nurses' award
<http://birmingham.bizjournals.com/birmingham/stories/2002/03/11/daily8.html>
Birmingham Business Journal, March 11, 2002
Nurse shortage hurts UCLA Medical Center
<http://www.dailybruin.ucla.edu/db/articles.asp?ID=18869>
Sabrina Singhapattanapong, Daily Bruin, March 11, 2002
Hospitals can cope: Thwaites
<http://www.theage.com.au/articles/2002/03/12/1015881948540.html>
AAP, March 12 2002
Health the big struggle
<http://www.theage.com.au/articles/2002/03/11/1015365767836.html>
Ewin Hannan, The Age, March 12 2002
Health Care Whistleblower Bill OKd: New protection for nurses, workers
<http://www.newsday.com/news/local/state/ny-stwhis122621373mar12.story>
Stephanie McCrummen, Newsday, March 12, 2002
Nurses to lobby at State House: Legislation aimed at bringing workers back to the profession
<http://www.metrowestdailynews.com/news/local_regional/nurses03122002.htm>
Michelle Hillman, MetroWest Daily News, March 12, 2002
Nurses to lobby at State House: Legislation aimed at bringing workers back to the profession
<http://www.metrowestdailynews.com/news/local_regional/nurses03122002.htm>
Michelle Hillman, MetroWest Daily News, March 12, 2002
Health aid fears aired in Boston
<http://www.masslive.com/news/unionnews/index.ssf?/news/pstories/ae313sta.html>
John F. Lauerman, Springfield Union-News, March 13, 2002
Nurses take center stage in clamor for state funds
<http://www.massnurses.org/News/002003/news_statefunds.html>
Shaun Sutner, Worcester Telegram & Gazette, March 13, 2002
A day in the life of a school nurse
<http://www.post-gazette.com/neigh_south/20020313snurse0313p3.asp>
Mary Niederberger, Pittsburgh Post-Gazette, March 13, 2002
Wanted: School nurses
<http://www.post-gazette.com/neigh_south/20020313smedicate0313p2.asp>
Mary Niederberger, Pittsburgh Post-Gazette, March 13, 2002
Nurses, Teachers On The Money
<http://workers.labor.net.au/128/news7_nurses.html>
Workers Online, Editorial, March 15, 2002
Healthy workforce a common-sense matter
<http://www.canada.com/search/site/story.asp?id=D298A30F-DDE1-4249-83EB-159958E08F22>
Editorial, Summerside Journal-Pioneer, March 15, 2002
Helpwanted: City hospital hiring 36 nurses to ease float pool shortage
<http://www.canada.com/search/site/story.asp?id=B4E24901-372D-4559-8230-076CCF75CB23>
Melanie Callahan, The Western Star, March 15, 2002
Healthy start to campaign to lure back nurses
<http://www.theage.com.au/articles/2002/03/15/1015909903562.html>
Tom Noble, The Age, March 16 2002
Nurses lobby for minimum staffing levels: New bill would put ceiling on staff-to-patient ratios
<http://www.boston.com/dailyglobe2/076/north/Nurses_lobby_for_minimum_staffing_levels+.shtml>
Kathy McCabe, Boston Globe, March 17, 2002
State nurses fear shortage will grow
<http://www.sacbee.com/content/politics/story/1875126p-1975041c.html>
Ed Fletcher, Sacramento Bee, March 17, 2002
Johnson & Johnson nursing campaign seeks to attract men
<http://www.newsday.com/news/local/wire/ny-bc-nj--malenurses0317mar17.story>
Newsday, March 17, 2002
Hospitals study treatments for an epidemic of error
<http://home.post-dispatch.com/channel/pdweb.nsf/da37732b0078d6c285256ad500494df3/86256a0e0068fe5086256b7f0023cef6?OpenDocument&Highlight=0,nurses>
Judith VandeWater, Saint Louis Post-Dispatch, March 17, 2002
Spending cuts send nurses south
<http://www.canada.com/search/site/story.asp?id=DEA5F844-DC4E-4447-869F-1AFFB69C12C1>
Kathy Tait, The Province, March 17, 2002
Vegas-area hospitals struggle with emergency room overcrowding
<http://www.sfgate.com/cgi-bin/article.cgi?file=/news/archive/2002/03/19/state0936EST0036.DTL>
Associated Press, March 19, 2002  
Nurses' experience, training affects patient mortality rates, study finds
<http://www.canada.com/search/site/story.asp?id=815C0E30-D50C-47D1-B69C-DE0E20F163C0>
Anne-Marie Tobin, Canadian Press, March 19, 2002
Nurses launching ads to help tell their story
<http://www.canada.com/search/site/story.asp?id=CBF05861-B89A-4A5D-9E41-B56BFF37BDA3>
Andy Walker, Summerside Journal-Pioneer, March 19, 2002
Nurses launch ad campaign with contract talks nearing
<http://www.canada.com/search/site/story.asp?id=6B48D050-78C8-4A8E-9675-5F057ACF38C4>
Dave Stewart, Charlottetown Guardian, March 19, 2002
Ads don't show reality of nursing life
<http://www.canada.com/search/site/story.asp?id=B0B1048E-25D5-49D1-B90E-F49E98333270>
Linda M. Socha, RN, Saskatoon, Saskatoon StarPhoenix, March 19, 2002
Chronic ER crowds convince Lahey Clinic to add beds
<http://www.businesstoday.com/business/business/hosp03202002.htm>
Jennifer Heldt Powell, Boston Herald, March 20, 2002

Irish Nurse Strike:

Nurses in Ireland Hold Brief Strike
<http://story.news.yahoo.com/news?tmpl=story&cid=&u=/ap/20020313/ap_on_re_eu/ireland_nurses_strike_3>
Associated Press, March 13, 2002
Talks so far fail to resolve nurses' dispute
<http://www.rte.ie/news/2002/0315/nurses.html>
RTé, March 15, 2002
Crunch talks aim to end nurses' dispute
<http://www.unison.ie/irish_independent/stories.php3?ca=9&si=713600&issue_id=7066>
Eilish O'Regan Health Correspondent, Irish Independent, March 15, 2002
Talks on nurses' dispute to start today
<http://www.ireland.com/newspaper/ireland/2002/0315/1247331182HM6NURSES.html>
Eithne Donnellan, The Irish Times, March 15, 2002
Nurses' action to continue over weekend
<http://www.ireland.com/newspaper/ireland/2002/0316/1222036939HM5NURSE.html>
Padraig O'Morain, The Irish Times, March 16, 2002
Nurses' work-to-rule talks at crucial stage
<http://www.rte.ie/news/2002/0319/nurses.html>
RTé, March 19 2002

Chronic Care, Chronic Crisis:

Report: Sex abuse rises in nursing homes
<http://www.boston.com/dailynews/067/region/Report_Sex_abuse_rises_in_nurs:.shtml>
Associated Press, March 8, 2002
Nursing home chain to pay $750G in patient's death
<http://www2.bostonherald.com/news/local_regional/nurs03142002.htm>
Michael Lasalandra, Boston Herald, March 14, 2002
Nursing-home assaults skyrocket in Mass.
<http://www2.bostonherald.com/news/local_regional/nurs03172002.htm>
Kay Lazar, Boston Herald, March 17, 2002

Structure of Health Care:

Executive bonuses: Health care takes care of its own
<http://www.managedcaremag.com/archives/0202/0202.compmon.html>
Managed Care, February 2002
Health Care for All: A conservative case
<http://www.commonwealmagazine.org/12002/february 22, 2002/22202ar.htm>
Donald W. Light, Commonweal, February 22, 2002
Health care debate: Canadians know medicare is something special
<http://www.canada.com/search/site/story.asp?id=F2E768FD-5FFA-429F-A628-F1EC21F5049B>
Dr. Arnold S. Relman, Edmonton Journal, March 08, 2002
Mental health parity fails: Assembly kills insurance plan
<http://www.captimes.com/news/local/21777.php>
Anita Weier, Madison Capital Times, March 8, 2002
Health services budget discussed
<http://www.masslive.com/springfield/unionnews/index.ssf?/news/pstories/ho38mean.html>
Natalia E. Arbulú, Springfield Uniion-News, March 8, 2002
A healthy plan for Massachusetts
<http://www.boston.com/dailyglobe2/068/oped/A_healthy_plan_for_Massachusetts+.shtml>
Robert Restuccia & John E. McDonough, Boston Globe, March 9, 2002
Editorial: Cutting care/Reconsider mental health reductions
<http://www.startribune.com/stories/561/1918461.html>
Minneapolis Star Tribune, March 10, 2002
Prescription for savings: Private plans offer some interim benefits, but only universal drug coverage serves public health.
<http://www.capecodonline.com/cctimes/edits/ed10.htm>
Cape Cod Times, March 10, 2002
Bid to widen health coverage sparks debate
<http://www.portland.com/news/statehouse/020312insurance.shtml>
Grace Murphy, Portland Press Herald, March 12, 2002
UCSD to end home health care services; losses cited
<http://www.signonsandiego.com/news/education/20020312-9999_1m12ucsd.html>
Tony Fong, San Diego Uniion-Tribune, March 12, 2002
Mental health workers at end of tether
<http://www.scoop.co.nz/mason/stories/PO0203/S00070.htm>
Public Service Association, March 13, 2002
Nurses appalled at Campbell snub of Romanow
<http://www.bcnu.org/News_Releases/NR024_2002.htm>
British Columbia Nurses Union, March 14, 2002
Bills target drug price controls
<http://www.nashuatelegraph.com/Main.asp?SectionID=25&SubSectionID=378&ArticleID=52615>
Associated Press, March 16, 2002
Better health care standard
<http://www.bangornews.com/editorialnews/article.html?ID=52947&town=&byline=&cname=OpEd&section=&tt=5PM>
Zev J. Myerowitz, Holden, Bangor Daily News, March 18, 2002
VAıs Uneven Health
<http://www.bangornews.com/editorialnews/article.html?ID=53010&town=&byline=&cname=Editorials&section=&tt=5PM>
Bangor News, March 19, 2002
A Canadian first: major private role proposed in new Abbotsford hospital
<http://www.canada.com/vancouver/story.asp?id={1BEA7247-55D8-4E91-B8C4-91FFC9AB08B3}>
Jeremy Sandler, Vancouver Sun, March 19, 2002
Tiers of Health
<http://www.bangornews.com/editorialnews/article.html?ID=53258&town=&byline=&cname=Editorials&section=&tt=6PM>
Bangor Daily News, March 23, 2002

Politics, as Usual:

W.'s First Enron Connection: Update on the Bush-Enron Oil Deal
<http://www.TheNation.com/capitalgames/index.mhtml?bid=3&pid=21>
David Corn, The Nation, March 4, 2002
Report: Military Plans Nuke Hits on 7 Countries
<http://www.nydn.com/2002-03-09/News_and_Views/Beyond_the_City/a-143868.asp>
Leo Standora, New York Daily News, March 9, 2002
Mike's Book Tour Diary: Police Raid, Shut Down My Booksigning in San Diego
<http://www.michaelmoore.com/diaries/book_diary_2002_0311.html>
Michael Moore, March 11, 2002
Tighter borders remain open to emergency units
<http://www.bangornews.com/editorialnews/article.html?ID=52482&town=&byline=&cname=Statewide&section=&tt=10PM>
Wilson Ring, The Associated Press, March 11, 2002
The Myth of the Global Economy
<http://www.commondreams.org/views02/0312-07.htm>
Mark Weisbrot, Common Dreams, March 12, 2002
US May End Curbs On Aid to Colombia
<http://www.washingtonpost.com/wp-dyn/articles/A29575-2002Mar14.html>
Karen DeYoung, Washington Post, March 15, 2002
The Colombian Elections: Some old, some new, and some uncertainties
<http://www.zmag.org/sustainers/content/2002-03/16mondragon.cfm>
Hector Mondragon, Z Magazine, March 16, 2002
Report: Powerful labor union set to back Pataki
<http://www.newsday.com/news/local/wire/ny-bc-ny--governorsrace0317mar17.story>
Newsday, March 17, 2002
Robinson quits UN job
<http://news.bbc.co.uk/low/english/world/europe/newsid_1878000/1878864.stm>
BBC News Online, March 18, 2002
Rights chief at UN to resign: Mary Robinson irked US by frank criticism
<http://www.boston.com/dailyglobe2/078/nation/Rights_chief_at_UN_to_resign+.shtml>
Alexander G. Higgins, Associated Press, March 19, 2002
Peace activists report a surge of new support
<http://www.boston.com/dailyglobe2/078/metro/Peace_activists_report_a_surge_of_new_support+.shtml>
Michael Rosenwald, Globe Staff, March 19, 2002
GOP Gov. Pataki endorsed by health care workers' union that normally backs Democrats
<http://story.news.yahoo.com/news?tmpl=story&u=/ap/20020319/ap_to_po/new_york_governor_1>
Jim Fitzgerald, Associated Press, March 19, 2002
Union Crosses Party Lines for Pataki
<http://dailynews.yahoo.com/h/nyt/20020320/lo/union_crosses_party_lines_for_pataki_1.html>
Adam Nagourney,  The New York Times, March 20, 2002

³Cry ŒHavocı and let slip the dogs of war!²:

Palestinian Medical Staff Targetted
<http://www.labournet.net/world/0203/palest3.html>
Report by Julia Wickham, Labournet, March 12, 2002
Petition: US citizens oppose war on Iraq, other countries, and US government militarism
<http://www.PetitionOnline.com/iraq/petition.html>
The Olympia Movement for Justice and Peace, Olympia, Washington, USA, March 2002

Docs on the Barricades:

MDs to cut back service: BCMA president Dr. Heidi Oetter: doctors 'betrayed and angry'
<http://www.canada.com/vancouver/story.asp?id={C7AD5F08-6C09-4796-A3DD-125B32E1D5EB}>
John Bermingham & Jason Proctor, The Province, March 10, 2002
BC doctors contemplate labour action
<http://cbc.ca/stories/2002/03/10/bchealth020310>
CBC News Online, March 10, 2002
Doctors march for pay rise
<http://europe.cnn.com/2002/WORLD/europe/03/10/france.doctors/index.html>
Cable News Network, March 10, 2002
Doctors marching for higher pay in France
<http://www.nandotimes.com/world/story/295334p-2601899c.html>
The Associated Press, March 10, 2002
French Doctors Press for More Pay
<http://www.startribune.com/stories/670/1921871.html>
Jean-Marie Godard, Associated Press, March 10, 2002
Union warns against health reform delay: Doctors are at the front line of primary care
<http://news.bbc.co.uk/hi/english/uk/northern_ireland/newsid_1865000/1865376.stm>
BBC, March 11, 2002
Index: Doctors grow reluctant to work in Bay State
<http://www.businesstoday.com/business/business/docs03182002.htm>
Jennifer Heldt Powell, Boston Herald, March 18, 2002
Work environment for doctors continues to fall
<http://www.boston.com/dailynews/077/economy/Work_environment_for_doctors_c:.shtml>
Associated Press, March 18, 2002

Diversity, Equality, or None of the Above:

Salve, minority groups debate scholarship
<http://www.projo.com/report/html/news/07181951.htm>
Marion Davis, Providence Journal, March 8, 2002
Suffrage or Suffering
<http://workers.labor.net.au/127/b_tradeunion_alison.html>
Workers Online, March 9, 2002
Go Forth and Multiply ­ Unions on Women
<http://workers.labor.net.au/127/news6_women.html>
Workers Online, March 9, 2002
Moves to tackle hospital tension
<http://news.bbc.co.uk/hi/english/uk/northern_ireland/newsid_1865000/1865529.stm>
BBC, March 11, 2002
Belfast hospital calls in hit squad over 'sectarian tensions'
<http://www.ananova.com/news/story/sm_541593.html>
Ananova, March 11, 2002
Study Says Blacks Get Poorer Care
<http://www.washingtonpost.com/wp-dyn/articles/A14985-2002Mar12.html>
Lindsey Tanner, Associated Press, March 12, 2002
Health Experts Mull World's Poor
<http://story.news.yahoo.com/news?tmpl=story&cid=534&u=/ap/20020312/ap_on_he_me/sweden_children_s_health_3>
Kim Gamel, Associated Press, March 12, 2002
Study says blacks get poorer medical care
<http://www.boston.com/dailyglobe2/072/metro/Study_says_blacks_get_poorer_medical_care+.shtml>
Anne Barnard, Boston Globe, March 13, 2002
Study: Medicare HMOs provide more to whites
<http://ledger.southofboston.com/archives>
Sue Reinert, The Patriot Ledger, March 13, 2002
Reader's View: Islamic Center a credit to the community
<http://ledger.southofboston.com/archives>
John P. "Jake" Comer, Quincy, Past National Commander, The American Legion, The Patriot Ledger,  March 13, 2002
Hospitals eye language remedy: Demand rises for translators
<http://www.boston.com/dailyglobe2/073/metro/Hospitals_eye_language_remedy+.shtml>
Cindy Rodriguez, Boston Globe, March 14, 2002
High Gay Dismissal Rate in Military
<http://www.washingtonpost.com/wp-dyn/articles/A25115-2002Mar14.html>
Nancy Zuckerbrod, Associated Press, March 14, 2002
Boost for nursing
<http://www.projo.com/report/html/opinion/07224091.htm>
Providence Journal, Editorial, March 15, 2002
Military's war on gays
<http://www.boston.com/dailyglobe2/078/editorials/Military_s_war_on_gays+.shtml>
Thomas Oliphant, March 19, 2002
Institute of Medicine reports that minorities receive lower-quality health care
<http://www.boston.com/dailynews/079/wash/Institute_of_Medicine_reports_:.shtml>
Randolph E. Schmid, Associated Press, March 20, 2002

Privatization has been increasing, and terrorism is the privatization of war. Nor is terrorism the only issue. Many other important problems that can cause great harm - such as international financial instability, global climate change, or the spread of diseases - are inherently multilateral.  - Joseph S. Nye Jr., Boston Globe, March 16, 2002
 
Massachusetts Activists' Calendar:


Rally to Stop Cuts in Health Care for Children, Seniors and People with Disabilities
Thursday, March 28, 10:30 - 11:30 am, Nurses Hall, Massachusetts State House


MassHealth is a state-funded initiative that provides health coverage to approximately 1 in 6 adults and 1 in 4 children in the Commonwealth. This includes nursing home care, prescription drugs, prenatal care and coverage for unemployed individuals. MassHealth also ensures that almost all children in the state have access to quality health care. The legislature has projected a $2 billion deficit for the coming fiscal year and has targeted MassHealth for cuts. Governor Swift has already cut dental care for adults and we need to keep other programs off the chopping block. For more information, contact Health Care for All or link to their website at <http://www.hcfama.org> or call Aileen Richmond, 617-275-2911.


Statewide Petition Drive for Safe RN Staffing
May 1 - 7, 2002 - April 15th (Boston Marathon Day Petition Drive)


In early May (as we head into Nurses Week),  the MNA is organizing nurses across the state to participate in an effort to gather signatures on a petition calling for passage of HB 1186, our Safe Staffing bill. In order for this to be a success, we need RNs in all areas of the state and from every MNA bargaining unit involved. If every MNA member took home the petition and simply got 10 signatures from family, friends and neighbors, we would have tens of thousands of signatures. If you just took a few minutes during this week to collect signatures outside your local grocery store, at a local youth sports or community event, we would have tens of thousands more. In addition, on April 15, we are organizing a team of nurses to position themselves along the Marathon route to gather signatures for this effort. If you want to participate in this drive or want to learn more, contact the Eileen Norton at enorton@mnarn.org; 781-830-5777.  

Web Directory:

Australian Nursing Federation             <http://www.anf.org.au>
California Nurses Association             <http://www.califnurses.org>
Canadian Federation of Nurses Unions  <http://www.nursesunions.ca>
Irish Nurses Organisation                  <http://www.ino.ie>
LabourStart                                    <http://www.labourstart.org>
Maine State Nurses Association          <http://www.mainenurse.org>
Massachusetts Green Party                <http://www.massgreens.org>
Massachusetts Labor Party                 <http://www.masslaborparty.org>
Massachusetts Nurses Association       <http://www.massnurses.org>
New York Professional Nurses Union     <http://www.nypnu.org>
New Zealand Nurses Organization        <http://www.nzno.org.nz>
PASNAP                                         <http://www.pennanurses.org>
Revolution Magazine                         <http://www.revolutionmag.com>
Seachange Bulletin                          <http://www.seachangebulletin.org>
Southern Arizona Nurses Coalition       <http://SAZNC.homestead.com>
Union Web Services                         <http://www.unionwebservices.com>
United Health Care Workers               <http://www.uhcw.org>

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