• “Power of the collective bargaining unit benefits all nurses”: Fairview Southdale Nurses win staffing victory

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Feature Story

“Power of the collective bargaining unit benefits all nurses”: Fairview Southdale Nurses win staffing victory

M Health Fairview Southdale Hospital nurses are celebrating a staffing victory. After months of pushing back, saying no, and filing Concern for Safe Staffing forms, the employer finally heard the message: One nurse to six patients is not possible! “It’s a long time coming,” said Southdale MNA Chair Ericka Helling, RN. “What we have here is not sustainable. There’s a chronic nursing assistant shortage. Nurses were working in assistant roles and were expected to cover those, and those grids were not sustainable.” Last fall, Fairview forced grid changes on nurses that created unsafe conditions where nurses were managing six patients at a time at certain census points. “We told stories about how that was untenable and unsafe,” Helling continued, “There were lots of tears. They care about their practice. We went through mediation and had a petition go through the house. More than 900 nurses signed.” Nurses gave the signatures to the employer and again, nothing happened. Then nurses notified the employer of an informational picket. “We had a couple of legislators come to the picket line who had conversations with nurses,” said Helling, “And again, the employer moved forward with the grid changes.” In addition to signing a petition and holding an informational picket, nurses also wore stickers and shared emotional patient stories of unsafe events with state representatives and senators, the news media, and the public. Nurses throughout Fairview Southdale also filled out, “untenable amounts of Concern for Safe Staffing forms,” Helling added. “Finally, the message was received,” Helling continued, “Nurses are done risking their licensure. They’re emotionally sick. They’re done. Finally they recognized those grids don’t work.” While Fairview Southdale nurses consider this a big win, “it’s a win where people are exhausted in the middle of a pandemic,” she shares, “We’re not asking for it to be easy, we’re asking for it to be safe. It shouldn’t be so hard that you’re breaking yourself and you’re in tears.” In the end, the many concerted, collective efforts by MNA nurses made the difference. The employer agreed to return three stations that had been previously taken away and returned Observation to a 5:1 ratio for patient care on the night shift. “Your efforts made the difference. Your voices created change, and a positive outcome is the reward for the effort,” Fairview Southdale MNA Chairs said to their fellow nurses in a letter announcing the victory, “Nurses unite and transformation happens. The power of the collective bargaining unit benefits all nurses.” “Anything that’s good isn’t easy to win,” Helling added. Attributing the win to “collective bargaining, sticking it out and going to bat for one another,” she shared one last piece of advice to all nurses: “Keep your eye on the prize and never ever stop. And that’s exactly what we did.”

Minnesota Nursing Accent

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FALL 2021

PUBLISHER Rose Roach MANAGING EDITORS Lauren C. Nielsen Chris Reinke BOARD OF DIRECTORS Mary Turner, President Chris Rubesch, 1st Vice President Doreen McIntyre, 2nd Vice President Jennifer Michelson, Secretary Sandie Anderson, Treasurer Directors Laurie Bahr, RN Angela Becchetti, RN Daniel Clute, RN Heather Jax, RN Susan Kreitz, RN Lynnetta Muehlhauser, RN Stella Obadiya, RN Gail Olson, RN Rui Pina, RN Judy Russell-Martin, RN Angela Schroeder Malone, RN Wendy Wahl, RN Office Hours: Monday-Friday 8:15 a.m. - 4:30 p.m. Subscriptions Published: March, June, September, January Opinions

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Editorial Column

— Carrie Mortrud, RN, MNA Nurse Staffing Specialist

It’s time to demand.

SATISFYING EMPOWERING SAFE MEANINGFUL RECOGNITION SKILLED COMMUNICATION

Do these words describe your unit or work environment? They should. These are just a few buzzwords used to describe a healthy work environment. When’s the last time you left your shift feeling satisfied, safe, or truly recognized for the job you did and the care you gave? I’m guessing it’s been a while. Nurses are always fighting for patients. Your professional education is founded on patient advocacy. Advocating for more or different pain medication. Advocating for patients to have more discussion and education on a scheduled procedure. Advocating for an additional day as an inpatient or for assistance at home because discharges happen so quickly these days. Union nurses expand on that advocacy and fight for health and safety measures, comparable and competitive wages, and safe staffing in hopes of creating a healthy work environment. A healthy work environment for nurses is proven to create better patient outcomes (DOI: 10.1016/j. ijnss.2018.04.010). When nurses fight for workplace rights, it protects patients. Is it easy? No. Is it necessary? YES! For perspective, it’s good to look back and see what we’ve accomplished, what we are fighting right now and what is headed our way. Looking back, nurses’ paychecks were docked if they broke a thermometer—until union nurses fought together to eliminate that ludicrous practice. Women who became pregnant had to resign and get rehired, losing their seniority and benefit hours accrued. Can you believe that? What nurses are fighting now is overwhelming and unwinnable alone. How many times in this past year have you had a shift that was short staffed? Failure to rescue—becoming a norm rather than a rare event? How many times have you been forced to quarantine or use compromised Personal Protective Equipment (PPE)? How many times have you heard about another hospital or clinic closing even though demand is at an all-time high? And how many times have you or a co-worker been assaulted physically or verbally while just doing your job, trying to deliver safe, quality, and therapeutic patient care? Fighting this epidemic of deplorable working conditions alone might seem incomprehensible, but together, as an organized group of professionals armed with real life experience and data, change is possible. Because there is no crystal ball, one can only speculate on what might be coming, what other erosions to professional nursing are just down the hall. It’s safe to say attempts to pull nurses farther away from direct patient care are certain. Truncated training and increased throughput of patients; pressure to work more efficiently which most often results in cutting corners and risking increased errors; attacks to benefits and less than attractive wage proposals—together these can be discontinued, eliminated, or re-written to increase patient safety AND create healthy work environments. Together as a profession, nurses can create what nursing looks like. While you fight every day for your lives and livelihoods and your patients, your employers are proposing more cuts to staffing, more facility closures, and more zeroes at the bargaining table. And at the same time, you see the headlines of hospitals turning a profit and CEOs continuing to make millions. This past year has demonstrated the necessity and obligation to re-write the nursing order for activism. Starting now it is no longer a PRN order but rather a scheduled order. No more “when I feel like it,” or “if I have time”. Nurses have learned this past year that if you don’t have a seat at the table, you are either being served as dinner or you are out back fighting for scraps of leftovers like stray dogs. Having to re-use PPE for multiple hours, multiple shifts, multiple days and yes even weeks, when just two years ago you would have been investigated and possibly disciplined for doing such a thing. The lows that the hospitals and healthcare system(s) have sunk to, risking your and your patient’s safety— all because they were unprepared—demonstrates this so well. Decisions about you, your safety and your work will be made without you. You must claim your place in nursing’s future. As union nurses, there are many tools and resources at the ready to prepare for the fights ahead. File Concern for Safe Staffing (CFSS) forms when short staffing has impacted patient safety, after putting management on notice by calling up the chain of command, ALL the way up. Don’t stop with the first call if it does not resolve the serious unsafe situation, especially when comments like these are the response: “Don’t shoot the messenger, there isn’t anyone”, “Okay”, and “We’ve called everyone”. Who believes they actually called everyone? You’ve certainly had that follow up conversation with a co-worker who said, “I would have come in. No one called me.” Follow up by documenting with the CFSS form. Request this data for meetings with management and hold them accountable to working with you to resolve future unsafe staffing situations. If administration is unresponsive, your ethics guide and direct that you may need to bring the serious concern to an authoritative body such as an accrediting or quality

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President’s Column

Using our collective voice for change

My work on President Biden’s Health Equity Task Force continues, and I’d like to share a little more with you about the work I’ve been doing. The task force is tasked with making recommendations to mitigate health inequities caused or exacerbated by the COVID-19 pandemic. Four subcommittees have been meeting since March: Communications & Collaboration; Data, Analytics and Research; Structural Drivers & Xenophobia; and Health Access & Quality. I serve on two of these committees that meet weekly, the Health Access & Quality Committee and the Structural Drivers & Xenophobia committee. Each month, the committees address a different topic and vote on interim recommendations at a public meeting. The topics have included: • Vaccine Access & Acceptance • Mental & Behavioral Health • Discrimination & Xenophobia • Long COVID-19 • Future Pandemic Preparedness We’ve added many good proposals for nurses and patients to the recommendations, and I’ve spent a lot of time behind-the-scenes organizing other members of the task force to support our positions. Telling nurses’ stories from the frontlines has been crucial for our successes. On the flip side, this is a site of class struggle. The influence of hospital CEOs and others who want to restructure healthcare is very strong on the task force. Without our voice, the recommendations from this task force would have likely included: • Deskilling of frontline care • Breaching scope of practice to enable unlicensed community health workers and others to deliver care • Major increases in telehealth funding • Interstate license portability to allow healthcare workers to practice across state lines (which is a classic union busting tactic) I’ve also experienced many efforts to silence me and block nurses’ collective voice. I’ve faced backroom pressure to change my positions and ‘get in line’ with a more conservative agenda. I learned that other nursing groups, including the American Nurses Association, American Association of Colleges of Nursing and others want to influence the Biden Administration to expand nurse compacts and telehealth. I’ve struggled against efforts to third-party the union, like when a federal staff person called me to tell me that I, a union president, should not let myself be pushed around by the union. Through this all, we have persisted, and we’ve added important recommendations, which we’ll make a final vote on at the end of September. Remember nurses, our voices matter, and when we use our collective voice, we make change.

MNA Visions, Values, and Strategic Pathways for 2021

MNA Mission Statement

1. Promote the professional, economic, and personal well-being of nurses. 2. Uphold and advance excellence, integrity, and autonomy in the practice of nursing. 3. Advocate for quality care that is accessible and affordable for all.

MNA will achieve its vision through six key strategic pathways. • Strengthen the integrity of nursing practice, nursing practice environments, and safe patient staffing standards and principles. • Oppose any attacks on nursing practice and workers’ rights, including any attempts of deskilling the professional nurse’s scope of practice and right-to-work legislation. • Collectively bargain from strength across the upper Midwest • Organize externally and internally to increase MNA membership and continue to increase solidarity and participation of membership locally, regionally, and nationally. • Elect politicians who will implement nurse/worker-friendly public policy, including safe staffing and a healthcare system that includes everyone and excludes no one. • Work in solidarity with the NNU and AFL-CIO and other community allies to advance nursing, health care and worker justice issues.

MNA Purpose

The purpose of the Minnesota Nurses Association, a union of professional nurses with unrestricted RN membership, shall be to advance the professional, economic, and general well-being of nurses and to promote the health and well-being of the public. These purposes shall be unrestricted by considerations of age, color, creed, disability, gender, gender identity, health status, lifestyle, nationality, race, religion, or sexual orientation.

MNA Vision and Values

MNA is a positive, powerful union of professional direct patient care nurses that advances nursing practice, effective, safe staffing and working conditions, patient interests and works to build a healthy community, empowered profession, and fair and just society along the principles of the Main Street Contract: • Jobs at living wages • Guaranteed healthcare • A secure retirement • Equal access to quality education • A safe and clean environment • Good housing • Protection from hunger • Human rights for all • An end to discrimination • A just taxation system where corporations and the wealthy pay their fair share In practice, this means: 1.MNA empowers registered nurses to use their collective strength, knowledge, and experience to advance and enhance safe and professional nursing practice, nursing leadership, and the community health and well-being. 2. MNApromotes effective RN staffing and safe working conditions for both patients and registered nurses in direct patient care, in policy and political arenas, and in our communities. 3.MNA builds its power as a union of professional nurses by increasing its membership and exercises that power through effective internal and external organizing, and member participation, activism, education, and mobilization. 4.MNA actively promotes social, economic and racial justice and the health, security, and well-being of all in its organizational programs and collaborations with partner organizations. 5.MNA works in solidarity with the National Nurses United and the AFL-CIO to build a worker movement that promotes the rights of patients, nurses, and workers across the United States.

Strategic Pathways