ACCENT
MN nursing
In this Issue: • • • •
At the Capitol: 2022 Legislative Recap - page 6 Bargaining & Collective Action Updates - page 10 2022 Nurses Week Recap - page 12 2021 Concern for Safe Staffing Report - page 14
SUMMER 2022 • Vol. 94 No. 2
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Minnesota Nursing Accent Minnesota Nurses Association 345 Randolph Avenue, Ste. 200 Saint Paul, MN 55102 651-414-2800/800-536-4662
SUMMER 2022 PUBLISHER Rose Roach MANAGING EDITORS Lauren C. Nielsen Chris Reinke BOARD OF DIRECTORS Mary C. Turner, RN President Chris Rubesch, RN 1st Vice President Doreen McIntyre, RN 2nd Vice President Jennifer Michelson, RN Secretary Sandie Anderson, RN 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
All opinions submitted are subject to the approval of the publisher, who reserves the right to refuse any advertising content which does not meet standards of acceptance of the Minnesota Nurses Association. Minnesota Nursing Accent (ISSN 0026-5586) is published four times annually by the
Minnesota Nurses Association
345 Randolph Avenue, Ste. 200, Saint Paul, MN 55102. Periodicals Postage paid at Saint Paul, MN and additional mailing offices. Postmaster, please send address changes to: Minnesota Nurses Association 345 Randolph Avenue, Ste. 200 Saint Paul, MN 55102.
On the Cover: MNA member and GAC Commissioner Becky Nelson, RN, speaks at a press conference where nurses shared the 2021 Concern for Safe Staffing report data.
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President’s Column
WE ARE READY, NURSES! On June 1, I visited all 11 picket lines at facilities across the Twin Cities metro. I made speeches at every line and talked to dozens and dozens of nurses. And what did I see? I saw MNA nurses ready and willing to fight for our patients! Throughout negotiations in the Twin Cities metro and Twin Ports this spring, I’ve encountered this again and again. Hospitals’ responses to our proposals are not surprising—we’ve heard “Not interested” more times than we can count. We’ve heard them say that nurses are “drunk on power”. And of course, there are plenty of proposals that hospitals have not responded to. Nevertheless, I’ve seen so many nurse leaders at all stages in their careers stepping up for our patients and our profession. Let me tell you though, it’s not just nurses in the Twin Cities and Twin Ports. It’s happening across our entire membership. After all, we are a union 22,000 strong. Here are just a few examples to note: • Nurses in Marshall, Minnesota ratified their contract in early June after a long, sustained pressure campaign on management. • Nurses in Moose Lake continue bargaining a new contract after Essentia Health took over in 2020 and refused to recognize the nurses’ existing union contract. Throughout it all, nurses continue standing strong together.
• Our nurses in both Marshall town and Council Bluffs, Iowa have also seen successes at the bargaining table despite many existing challenges. • Nurses from Hastings to Pipestone to Duluth to the Twin Cities have stepped up and testified at hearings within all levels of government. We’ve continued building important relationships with elected officials throughout the state and made sure that our elected officials know that nurses are watching, listening, and speaking up for the support they and their patients both need and deserve. • Nurses have recognized the call of our union siblings, showing up to support teachers on strike in Minneapolis, SEIU Healthcare workers fighting for worker and patient safety, and many more. I could certainly keep going. What do each of these things have in common? Nurses collectively acting to support our patients, our allies, and each other. When we all stand up together to fight for our patients, we make waves. When we all speak up and say that our patients should be prioritized first, not the profits of hospital CEOs, we make noise. When we say, “We are ready”— we mean it! Mary C. Turner, RN, MNA President
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WHY WE LEFT: 2022 NURSING WORKFORCE REPORT SUMMARY
There is a staffing and retention crisis in Minnesota hospitals. This crisis was created by the profit-first policies of hospital CEOs, and it can be corrected if patients and nurses are put before the bottom line of corporate boardrooms. Studies conducted by the Minnesota Nurses Association of its current members, former members, and of the general public make this point clear: • Minnesotans understand the nature of the staffing and reten tion crisis, as 85 percent believe it will not be solved without direct action, and two-thirds under stand that hospital executives created the problem before the pandemic. • There is no shortage of registered nurses in Minnesota, as studies and reports by the Minnesota Hospital Association, the U.S. Department of Health and Human Services, and the Minne sota Board of Nursing clearly demonstrate. • In 2021, 63 percent of MNA nurses reported that they had considered leaving their job or the profession altogether, or that they knew someone who had, due to being overworked, understaffed, and demoralized about the quality of patient care they could provide. • In over 80 percent of cases where nurses filed a concern over the impact of short staffing on patient care, the nurses reported no response or inadequate action from hospital management.
• In a survey of MNA nurses who left their bedside nursing positions, the top-cited reasons for their departure were hospital management and chronic short staffing. • Despite the pandemic, over 75 percent of MNA members indicated their desire to stay at the bedside for the near future; of nurses who left the bedside in the last two years, 84 percent indicated that they would not return to the bedside if conditions did not improve. These findings are supported and reinforced by independent research conducted by management consulting firm McKinsey & Company, which found: • 32 percent of nurses surveyed said they “may leave their current direct-patient-care-role”, an increase of 10 percentage points from February to November of 2021.
• Nurses reported “staffing, pay, and lack of support” as the top factors driving their decision to leave. • Of those likely to leave a current nursing position, only 29 percent indicated plans to continue in a direct patient care position. To read the full report, visit http:// mnnurses.org/whyweleft or use your smartphone to scan the QR code.
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“I escaped and it broke my heart…It was not an easy decision, but I had to do it.” - Retired MNA Member Amy Forkner, RN
55% felt they were unable to provide required patient care due to short staffing.
Top reasons for leaving the bedside: hospital management & short staffing.
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AT THE CAPITOL 2022 on the Hill Recap The lead-up to session MNA hit the legislative action planning hard this session with the goal of utilizing our legislative work to build pressure through the parallel campaign structure for contract bargaining and vice versa. Bringing policy and contract language that mirrored each other to the table and the legislature enabled MNA to share strong messaging and build a powerful campaign for safe staffing and nurse retention policies. This also forced hospital management and the MN Hospital Association to split their time and energy as they had to respond and lobby against us at both places. Knowing that the parallel campaign would only be successful if nurse members directed the work, the Governmental Affairs Commission determined two main buckets for legislative priorities: safe staffing and the anti-corporatization of healthcare. With safe staffing as one of the main priorities, staff began the work to organize members of the negotiating teams for a member staffing workgroup. With session fast approaching, the member staffing workgroup met six times between November and January and crafted the Keeping the Nurses at the Bedside Act (KNABA), legislation that focuses on safe hospital staffing and nurse retention. The Keeping Nurses at the Bedside Act would address the crisis of understaffing and retention in Minnesota hospitals with the following provisions: • Establish Nurse Staffing Committees at Minnesota Hospitals – The bill would require all hospitals in the state of
Minnesota to create a staffing committee to put together a core staffing plan for each unit of the facility every year, including a maximum limit on the number of patients that any one nurse should safely care for. • Recruit and Train Nursing Students – This bill would dedicate new resources to ensure we continue to attract and train a skilled and diverse workforce of Registered Nurses in Minnesota. This includes broadening an existing student loan forgiveness program for new
nursing instructors and allocating $5 million to launch a new student loan forgiveness program for nurses working at the bedside in Minnesota hospitals. • Retain and Sustain Minnesota Nurses – The bill provides an annual appropriation of $50,000 for the Minnesota Department of Health to develop and implement violence prevention strategies for nurses and patients in Minnesota hospitals. • Support Mental Health for Healthcare Workers – This bill would provide yearly $1 million
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grants for mental health programs for nurses and other healthcare professionals, administered by the Minnesota Department of Health to hospitals, clinics, and other healthcare facilities and organizations. • Workplace Violence Prevention – This bill includes an ongoing annual appropriation to MDH of $50,000 to continue the preven tion of violence in healthcare programs and create violence prevention resources for hospitals and other healthcare providers to use in training their staff on violence prevention. • Review and Release Hospital Safety Data – The bill includes several provisions to make the decisions of hospital executives more transparent to the public, to hold CEOs accountable when data shows that there are safety or other staffing problems that need to be addressed. After receiving approval and input from the Governmental Affairs Commission, MNA staff began meeting
with legislators, getting the bill drafted, and working to inform the public about nurses’ solutions for ending the nurse staffing crisis to be ready for legislative session to start on January 31, 2022. The beginning of session The beginning of legislative session brought news of a large state budget surplus of around 7 billion dollars. Legislators and advocates began to dream of all the things that this budget surplus could bring, while the state still worked to recover from the pandemic and hospitals were beyond capacity from the surge of omicron cases. As nurses struggled to continue the fight against COVID-19 and to keep our communities safe, politicians and interest groups began making plans for the budget surplus, including things like paid family medical leave, funding reinsurance to cover the risk that medical insurance companies take on when providing insurance to individuals in the MNsure market, and covering the cost of the debt owed to the federal government for the unemployment
trust fund. MNA knew it was time to elevate the nurse staffing crisis to the legislature and governor to ensure that nurses were not forgotten this session. One important piece of that work was to ensure that nurses receive Frontline Worker Fund payments that were promised last year. In the end, the payments were passed, alongside tax relief for businesses, and $500 million was set aside to ensure that frontline workers in a multitude of industries would be covered. If all workers who qualify apply, it is expected that each worker would receive approximately $750 in recognition for their work during the pandemic. Nurses, along with other qualifying frontline workers, are required to apply to receive a check. The application period lasts 45 days beginning in mid-June. It is anticipated that checks will be sent out sometime in September. You can visit the MNA website for more information. KNABA on the move The other important piece was to ensure that the Keeping Nurses at the Bedside Act moved in the legislature. With the help of the chief author in the MN House, Representative Liz Olson, and chair of the House Health Finance and Policy Committee, Rep. Tina Liebling, KNABA moved quickly in the House! Within a couple days of being introduced in the House health committee, KNABA received a hearing. This was the first time that safe staffing received a hearing in the MN Legislature in a decade, and it was quite the hearing. Nurses
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from facilities in the metro and Duluth shared powerful stories about their experiences working short-staffed in hospitals and why it is vital that safe staffing and nurse retention should be the priority for the legislature. Then hospital administration and a lobbyist from the Minnesota Hospital Association rebutted nurse testimony, stating that nurses couldn’t possibly make decisions for safe staffing because they aren’t qualified and that hospitals are already doing the best they can. But these testimonies against nurses did not sit well with Chair Liebling and she rebuked them for “sound[ing] tone deaf”. With the support of Chair Liebling and the MN House DFL Leadership, as well as the hard work from chief author Rep. Olson, KNABA was included in the House health and human services omnibus bill and overcame efforts to strip the staffing language from the bill in both the health committee and on the House floor. MNA made staffing history with the inclusion of safe staffing language in the House health and human services omnibus bill as it moved into conference committee. Unfortunately, KNABA did not receive an official hearing in the Senate, but thanks to the advocacy of
chief author Senator Erin Murphy, it was included in a frontline worker public event and nurses were able to share additional stories about why safe staffing is vital for patient safety and nurse retention. Through nurse lobbying, MNA was also able to convey to Senator Benson the need to push for mental health grants for healthcare workers to help them recover from the trauma and stress of working through the pandemic. MNA hoped this grant would be ongoing and have a higher appropriation, but Senator Benson’s bill is a good start to highlight the need to take care of our healthcare workers. Struggles at the end of session With only a few days left in session, legislative leaders and the Governor agreed to a budget framework; however, the work of ironing out the details of many of the budget bills did not go well. The health and human services budget bill, along with other major bills, like the tax bill and the bonding bill, did not pass before session ended. Rep. Liebling made a last-ditch effort to get something passed for nurses that would help with unsafe staffing in hospitals. She offered an amendment that would have made it illegal for hospitals to retaliate against nurses who refuse
an assignment because of inadequate staffing. (This amendment was conceived through work with the member staffing group and GAC, knowing that staffing language from KNABA would not pass the Senate.) That amendment failed because a majority of the Senators on the conference committee voted against it. While there is still a possibility that the legislature will convene a special session to finish their work, it is highly unlikely that anything related to ensuring safe staffing levels will pass in 2022. However, the legislature did pass a mental health omnibus bill that includes a one-time, $1 million mental health grant for healthcare workers and MNA will work with the Minnesota Department of Health to ensure that MNA members benefit from these grants.
For more information about applying for Frontline Worker Pay checks, please visit the MNA website.
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YOURLEGISLATOR LEGISLATOR SUPPORT DIDDID YOUR SUPPORT OUR STAFFING OUR STAFFING BILL? BILL? REPRESENTATIVE
Patty Acomb Esther Agbaje Kristin Bahner Jamie Becker-Finn Kaela Berg Connie Bernardy Robert Bierman Liz Boldon Andrew Carlson Shelly Christensen Jim Davnie Rob Ecklund Heather Edelson Steve Elkins Sandra Feist Peter Fischer Cedrick Frazier Luke Frederick Mike Freiberg Aisha Gomez Emma Greenman Rick Hansen Jessica Hanson Hodan Hassan Alice Hausman Kaohly Her Athena Hollins Frank Hornstein Melissa Hortman Mike Howard John Huot Sydney Jordan Heather Keeler Ginny Klevorn Erin Koegel Carlie Kotyza-Witthuhn Fue Lee Tina Liebling Leon Lillie Todd Lippert Dave Lislegard Jamie Long Carlos Mariani Paul Marquart Sandra Masin Kelly Moller Rena Moran Kelly Morrison Mary Murphy Michael Nelson Mohamud Noor Liz Olson Gene Pelowski Dave Pinto Laurie Pryor Liz Reyer Ruth Richardson Steve Sandell Julie Sandstede Jennifer Schultz Zack Stephenson Mike Sundin Samantha Vang Ami Wazlawik Ryan Winkler Dan Wolgamott Tou Xiong Jay Xiong Cheryl Youakim
PARTY RUNNING IN 2022? D D D D D D D D D D D D D D D D D D D D D D D D D D D D D D D D D D D D D D D D D D D D D D D D D D D D D D D D D D D D D D D D D D D D D
Yes Yes Yes Yes Yes No Yes Yes Yes No No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No Yes Yes No No No Yes Yes - Different Office Yes - Different Office Yes Yes Yes Yes Yes Yes Yes Yes Yes No Yes Yes - Different Office Yes No Yes No Yes - Different Office Yes Yes - Different Office Yes Yes
MN HOUSE SUPPORTS STAFFING?
ABSENT ABSENT
X
REPRESENTATIVE
Susan Akland Tony Albright Paul Anderson Jeff Backer Cal Bahr Dave Baker Peggy Bennett Matt Bliss Greg Boe John Burkel Brian Daniels Kurt Daudt Greg Davids Lisa Demuth Bob Dettmer Steve Drazkowski Sondra Erickson Keith Franke Mary Franson Pat Garofalo Steve Green Matt Grossell Glenn Gruenhagen Barb Haley Rod Hamilton John Heinrich Josh Heintzeman Jerry Hertaus Spencer Igo Brian Johnson Tony Jurgens Deb Kiel Jon Koznick Ron Kresha Eric Lucero Dale Lueck Joe McDonald Shane Mekeland Tim Miller Erik Mortensen Patty Mueller Jeremy Munson Jim Nash Nathan Nelson Anne Neu Brindley Paul Novotny Tim O’Driscoll Bjorn Olson Marion O’Neill John Petersburg Brian Pfarr Nels Pierson John Poston Duane Quam Donald Raleigh Jordan Rasmusson Kristin Robbins Joe Schomacker Peggy Scott Chris Swedzinski Tama Theis Paul Torkelson Dean Urdahl Nolan West John Thompson
PARTY RUNNING IN 2022? R R R R R R R R R R R R R R R R R R R R R R R R R R R R R R R R R R R R R R R R R R R R R R R R R R R R R R R R R R R R R R R R I
Yes No Yes Yes Yes - Different Office Yes Yes Yes Yes Yes Yes Yes Yes Yes No Yes No Yes Yes Yes Yes Yes Yes No No Yes Yes Yes Yes Yes Yes - Different Office Yes Yes Yes Yes - Different Office No Yes Yes No Yes Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes Unknown No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes
SUPPORTS STAFFING? X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X ABSENT X X X X X ABSENT
Who will represent me?
Did your legislator vote against safe staffing this session? Do you want to make sure MN electedSENATE officials are held accountable to nurses, not hospital executives? Get involved The GOP majority in the Senate refused to take
MN SENATE
with MNA’s 2022Senate electoral program. Contact MNA Political Organizer Cameron Fure to The GOP majority in the refused to take get involved at 651-252-5028 or Cameron.fure@mnnurses.org. up the Keeping Nurses at the Bedside Act.
up the Keeping Nurses at the Bedside Act.
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Bargaining & Collective Action Update NEW CONTRACT AGREEMENTS Marshalltown, IA nurses overwhelmingly ratify new contract
Council Bluffs nurses ratify wage opener In late April, nurses in Council Bluffs, IA came to an agreement on a wage opener. They successfully ratified the agreement for a wage opener of 10% across the board. Grand Marais nurses reach Tentative Agreement
In late March, nurses in Marshalltown, IA reached a tentative agreement during contract negotiations and in early April, overwhelmingly voted to ratify the new contract. The negotiations were not without challenges. The nurses and their community have survived a tornado and derecho in recent years as well as bankruptcy and corporate takeover of their hospital. Additionally, nurses faced a decertification election that emerged two days after bargaining began. Nurses took each challenge in stride and kept showing up. Their dedication paid off with nurses achieving wages of 6% retroactive to January and 2% in the second year. They also won a two-year agreement, did away with a two-tier wage scale, made bonuses retroactive, improved pay to the Weekend Package and more. They successfully fought off several concessions including reduced PTO accrual, doing education on their own time, floating without conditions, and more.
facilities across the state also attended to show their solidarity.
Nurses in Grand Marais reached a tentative agreement at the end of May. They fought off several concessions including moving all 12-hour staff to every other weekend, reducing holiday pay, and no PTO payout upon resignation without notice. Wins at the negotiating table included wage increases of 5% retroactive to January 2022 for the first year of the contract and increases of 4.5% and 4% for subsequent years; increase to on-call pay; expanded information in the confirmed work agreement; increase to ambulance bonus; and more. COLLECTIVE ACTION
After buying Mercy Moose Lake in 2020, Essentia refused to recognize the nurses’ union contract. Essentia staff have lost hundreds of hours of sick time, and the community has lost services including PICC line placement, orthopedics, radiology, and more. Moose Lake nurses continue to ask for Essentia to respect them and bargain in good faith. Negotiations are still ongoing, but after a successful event, nurses are more involved than ever and continue to stand strong and bargain together. MNA nurses in solidarity with striking members of Minneapolis Federation of Teachers
Moose Lake nurses are fighting for a fair contract
MNA nurses from Moose Lake gathered at the Moose Lake Ice Fishing Competition in February to show they are ready to fight for a fair contract from Essentia. MNA nurses from
MNA nurses showed up in support of Minneapolis teachers and Education Support Professionals who went on strike for safe and stable schools. The strike lasted nearly three weeks, with teachers and ESPs winning increased pay, class size caps, improved student mental health resources and more.
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Twin Ports nurses stand up for their right to organize
On Wednesday, March 30 nurses and community allies in the Twin Ports (Duluth and Superior) called on Essentia CEO David C. Herman to pledge to respect union neutrality at their facilities. Nurses are also asking for Essentia to promise that the health system won’t interfere with worker attempts to organize, including at the new outpatient surgical center slated to open in the coming months. Those that spoke about the importance of unionized healthcare facilities included MNA 1st Vice President Chris Rubesch, RN, and Marcia Swanson, RN, who work at Essentia Duluth; Tristin Eastvold, an RN at Essentia Moose Lake; MNA President Mary C. Turner, RN; and Beth McCuskey, President of the Duluth Central Labor Body. “Essentia health is anti-union because they want to take away nurses’ voices.” - Tristin Eastvold, RN at Essentia Moose Lake Marshall, MN nurses hold successful April picket
Nurses at Avera Regional Medical Center in Marshall held an informational picket on Tuesday, April 19, 2022. Marshall nurses began bargaining when their previous contract expired in September of last year. Now, more than six months later, Avera management still has not agreed to a new contract that would address the short-staffing and retention issues at the hospital and would fairly compensate nurses. “We are asking hospital executives to do what needs to be done to attract and retain nurses so we can continue to provide the high-quality care our community expects and deserves,” said Mary McConnell, RN at Avera Marshall Regional Medical Center. “Nurses kept our hospitals running and our patients cared for through the pandemic. Now it is time for hospital management to listen to and value our nurses, and to give us the support we need to continue to provide exceptional patient care at the bedside.” The picket was successful in getting management to back off their aggressive tactics of deadlines, etc. and to start agreeing to several of the nurses’ proposals.
Solidarity with striking SEIU Healthcare mental health workers
On Tuesday, May 24, MNA nurses picketed in solidarity with striking mental health workers. These SEIU Healthcare workers participated in a one-day strike to demand safety for workers and patients, and to be paid a living wage. MNA President Mary C. Turner, RN, spoke at the strike saying, “We nurses at all of the hospitals that are on strike, we know that we can’t do our job without you. We know how valuable you are to the patients. We know that you are valuable to us.”
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NURSES RELEASE 2021 CONCERN FOR SAFE STAFFING REPORT
In early May, nurses shared the results of the annual report on Concern for Safe Staffing (CFSS) forms which paint a bleak picture of the crisis of understaffing by hospital executives in Minnesota healthcare facilities. The report documents an explosive 300 percent growth in CFSS forms filed since 2014, up to a total of 7,857 in the last year. In over 80 percent of cases described by nurses, the hospital managers and executives who created the crisis failed to adequately respond to the concerns for patient safety raised by the nurses. “Even one case of patients not receiving the care they deserve due to understaffing by hospital executives is one too many,” said Mary C. Turner, RN, MNA President. “Hospital executives with million-dollar salaries can afford to make the changes necessary to fully staff our hospitals and put patients before profits. Nurses and patients at the bedside cannot afford to wait for safe staffing.” Nurses submit CFSS forms when they are concerned that short staffing may negatively impact patient care. Nurses document when patients are potentially harmed, or when, in the nurse’s professional opinion, patients did not receive the safe and quality care they required due to under staffing. In 2021, nurses reported 9,381 cases where patient care or treatments were delayed due to short staffing by hospital executives. This can include delays in administering medication, completing a patient assessment, or answering patient call lights. “The problem of short staffing has been going on for as long as I’ve been a nurse. While hospital executives will offer many different phrases to justify
under staffing, the outcome always looks the same: asking fewer nurses to care for more patients with less resources and support,” said Angela Becchetti, RN. “The changes nurses are seeking in our contracts, including fair compensation in recognition of our sacrifices during the pandemic, and safe staffing, will help nurses to stay at the bedside, where we want to be, doing the jobs we love: providing incredible care to our patients. I hope our hospital executives are listening.” Data in the 2021 CFSS report reinforces the trend of “lean staffing” in healthcare, which hospital CEOs with million-dollar salaries have pursued for years, cutting staff levels for the sake of the bottom line. These policies have driven nurses away from the bedside for years, and the consequences of this corporate approach to healthcare were compounded by the effects of the COVID-19 pandemic. Concerns with hospital management and short staffing were the top issues identified by MNA nurses in a 2022 study of why
they left the bedside. “I never thought I would want to leave my career early, but I came to the conclusion that my moral compass no longer aligned with my employer, especially when it came to short staffing in our hospitals and the safety of nurses and patients,” said Jean Forman, Retired RN. “Nurses have submitted Concern for Safe Staffing forms for more than 25 years, as hospital executives have watched reports of unsafe staffing increase and have done nothing to solve the crisis. It is time for action, before more nurses reach the same conclusion I did, that they can no longer care for patients the way they were trained and called to do.” To attempt to paper over the short-staffing crisis they created, hospital executives resorted to methods such as giving new nurses patient assignments before they completed orientation; assigning patients to the role of charge nurse, who is meant to remain flexible to provide assistance to other nurses on a shift; or assigning
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Upcoming Meetings Board of Directors Wednesday, July 20 Wednesday, August 17 Commission on Governmental Affairs (GAC) Wednesday, July 13, 1-4 p.m. Wednesday, August 10, 1-4 p.m. Commission on Nursing Practice and Education No meeting in July Wednesday, August 3, 11:30 a.m.-3 p.m. CARn No meeting in July Wednesday, August 10, 10:30 a.m.-12 p.m. untrained or underqualified staff. As a last resort against the understaffing of our hospitals by executives, units were closed nearly 1,300 times in 2021. “This report underscores the extent of the crisis which is driving nurses away from the bedside,” said Becky Nelson, RN, Chair of MNA’s Governmental Affairs Commission. “Throughout this pandemic, nurses have heard a lot of words: hero, angel, essential. Now it is time for action. Stand with nurses and patients, not healthcare profits, and pass the Keeping Nurses at the Bedside Act.” To address the chronic issue of short staffing in our hospitals, Minnesota nurses championed the Keeping Nurses at the Bedside Act. The bill addresses the short-staffing and retention crisis to protect patient care in Minnesota by establishing local, flexible, hospital-based committees of nurses, direct care staff, and managers who would work together to set staffing levels on a unit-by-unit basis, including a limit on the number of patients for which any one nurse is responsible. The bill is currently under consideration by the Health and Human Services conference committee of the Minnesota Legislature. Minnesota nurses are also seeking solutions to the crisis of understaffing
for nurse retention and patient care in their negotiations with hospital executives for new contracts this year. Right now, 15,000 nurses in the Twin Cities and Twin Ports are bargaining over fair compensation for sacrifices made during the pandemic and for the rising cost of living, as well as for solutions to the chronic understaffing of nurses and its impact on patient care. Today’s report comes as nurses mark Nurses Week 2022, pledging to stand “Ready Together” with nurses and patients for care at the bedside, not the bottom line in the boardroom. The 2021 Concern for Safe Staffing summary report can be found on the following pages. Reports from previous years can be found at https://mnnurses.org/cfss.
Racial Diversity Committee Executive Meetings Thursday, July 21, 4:30-6 p.m. Thursday, August 18, 4:30-6 p.m. Racial Diversity Committee General Membership Meetings Tuesday, July 27, 4:30-6 p.m. Tuesday, August 24, 4:30-6 p.m. Minnesota Nurses Association Foundation (MNAF) Wednesday, July 6, 9 a.m.-2 p.m. Ethics Committee No meeting in July No meeting in August Health and Safety Committee Tuesday, June 28, 3:30-5:30 p.m.
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Concern for Safe Staffing Year-End Report and Findings for 2021 For more than 25 years, nurses of the Minnesota Nurses Association (MNA) have been collecting information on how short staffing impacts patient care and patient safety. Evidence-based studies demonstrate that it is critical to have adequate staffing because it results in better patient outcomes (Dixon, 2021). Studies illustrate that the number of patients a nurse has at one time affects their ability to safely care for patients and ultimately advance their plan of care through to discharge. Nurses are astounded that hospital executives continue to ignore their calls for adequate staffing, despite consistent testimony from hospital administrators that they trust their nurses to know what the staffing needs are at the bedside. In addition, hospitals are frequently cited for staffing deficiencies when the U.S. Centers for Medicare and Medicaid Services (CMS) conducts audits. Clearly, 2021 was a continuation of extraordinary challenges faced in 2020 with registered nurse staffing. • Patients continued to present more acutely ill • Patients presented with high acuity illnesses and symptoms physicians thought we had learned how to treat, only to find out a different variant required different treatment • Policies on care delivery, capacity, safety, and quarantine changed weekly • Management response is minimal at best CFSS Form Evolution Timeline 1990’s Concern for Safe Staffing (CFSS) form was created to collect unsafe staffing data related to the nurses’ work environment 2010 Amended to gather more patient-centered data and an electronic version of the CFSS form was created 2014 Data points were added regarding substandard care, like delayed care, missed patient care, care and anduse useof oflast last-minute solutions 2015 MNA began categorizing the data collected by CFSS forms to enhance our analysis of unsafe staffing 2019 Data points were added regarding violence in the workplace and homecare nurse specifics
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7,857 CFSS forms were submitted in 2021, marking a 108.46% increase from 2020 and producing the following important data: • 1,073 reports of nurses refusing patient assignments due to being under-staffed • 9,381 incidents were reported where care or treatments were delayed by short staffing • 4,434 accounts of staffing issues causing a delay in call lights being answered • 6,414 occurrences of unresponsive management • 2,511 instances of Charge Nurses being required to assume care of patients in addition to Charge Nurse responsibilities Minnesota’s registered nurses are expected to deliver high quality, safe, ethical, and therapeutic care despite the poor conditions executives created in our hospitals. Patients have a right to expect safe care and that the hospital will fulfill its commitment to the community to provide high-quality, safe care.
Category of Safe Staffing Concern
2020 2021
Delays in care or treatments or incomplete assessments Delay in medications Inability to answer call lights Incomplete discharge or rushed teaching Management response - NONE or inappropriate Temporary solution - closed unit Short staffed >25% of what is needed Patient left without being seen or against medical advice Temporary solution - refused the assignment Charge Nurse took patients or took over the grid
2,694 1,965 2,162 337 2,859 610 663 371 657 956
5,556 3,825 4,434 905 6,414 1,293 957 829 1,073 2,511
% Change 70.71% 48.68% 56.43% 11.52% 81.63% 16.46% 12.18% 10.55% 13.66% 31.96%
CFSS forms cited multiple categories of staffing concerns which resulted in the total number CFSS forms to be lower in number than the actual number of complaints. Please contact Carrie Mortrud, RN, Nurse Staffing Specialist with any questions at (651)252.5451 or carrie.mortrud@mnnurses.org Executives continue to foster conditions in our hospitals where nurses face inadequate staffing levels and insufficient resources to provide the quality care patients deserve. These past two years will leave deep wounds in the profession and scar our nurses for years to come. The anguish nurses feel when they do not have the resources necessary to provide patients with the care they deserve is causing moral suffering and distress.
Word Cloud of 2021 CFSS form submissions
Nurses work in a fast fast-paced, paced, highly stressful, ceaselessly demanding environment. The environment is physically dangerous and emotionally draining. Hospital executives created conditions that are disrespectful, unreasonable, and overwhelming for nurses. Hospital CEOs must take responsibility for reckless under-staffing that started before the pandemic and will not be solved without accountability and action. Nurses only want to provide the best level of care to their patients in their most vulnerable time.
#safestaffingsaveslives
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LAUNCH OF THE MINNESOTA HEALTH PLAN CAUCUS
By Senator Jen McEwen, Senator Omar Fateh, Representative Liz Boldon, and Representative Liz Reyer, co-chairs of the Minnesota Health Plan Caucus.
This last January, we were immensely proud to launch the Minnesota Health Plan (MHP) Caucus with 54 of our colleagues, and our support has only grown since then. This bicameral group of legislators from across Minnesota has drawn together in support of the Minnesota Health Plan: a statebased health system that will cover all Minnesotans for all their medical needs. We are united by our belief that healthcare is a fundamental human right, and that no Minnesotan should face out-of-pocket costs for seeking the care they need.
Across Minnesota, the rising cost of healthcare and prescription drugs is a top concern for our residents. There are currently about 250,000 Minnesotans without any health insurance, and at least a million more who have insurance, but still cannot afford their medical bills. For almost all Minnesotans, the prospect of a serious injury, illness, or chronic condition in the family is a major source of economic insecurity and anxiety. From our experience with previous attempts to solve the healthcare crisis, we recognize that universal coverage, affordability, and sustainability can only be achieved through a universal, single-payer system under which pre-
miums are based on ability to pay, access is guaranteed, and care is free at the point of service. The closest analogous programs at the federal level, Medicare and Medicaid, are overwhelmingly popular. Likewise, the MHP is a unifying policy that centers quality care for every Minnesotan in its mission. This means addressing socioeconomic inequity and racial disparities in care. It also means addressing geographic inequity by removing cost barriers currently faced by self-employed Minnesotans, part-time workers, small businesses, and the agricultural community. It will preserve access to healthcare providers statewide by keeping vital community clinics open and combatting profit-driven consolidation. When a policy initiative has the ability to solve one of our toughest issues and improve the well-being of Minnesotans across every corner of the State, we legislators have a responsibility to come together and organize for the purpose of passing that initiative. Thus, we have formed this caucus, open to any member who is committed to supporting the passage of the Minnesota Health Plan, and we will work together to get it passed into law. Visit our website, mhpcaucus.org for more information.
RACIAL DIVERSITY COMMITTEE SHARES NEW RACIAL DISCRIMINATION REPORTING FORM
The Racial Diversity Committee has identified acts of racial discrimination occurring across MNA bargaining units. Our members and leaders realized the need for a tool within our union to document and track these acts of racial discrimination in order to prove they are not isolated incidents, but a systemic problem that needs to be actively addressed. This tool, the Racial Discrimination Reporting Form, is an internal MNA reporting form to be completed after every act of racial discrimination in the workplace. All recorded answers are confidential. Data from this form will be viewed, analyzed, and used for organizing purposes by MNA staff, and both appointed and elected leaders. The information gathered will be a critical first step needed to organize around creating an anti-racist workplace. You can now access the form to report Racial Discrimination at http:// mnnurses.org/rdreport or scan the QR code.
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NURSES WEEK 2022 MNA nurses kicked off Nurses Week 2022, announcing they are “Ready Together” to put patient care before corporate profits in our hospitals. Over the last two years, nurses showed up to take care of Minnesotans on the frontlines of the COVID-19 pandemic. Now, nurses are ready to build power together to improve hospital conditions to retain nurses and prioritize patient care at the bedside. “Nursing has always been a demanding profession, never more so than during the last two years of the COVID-19 pandemic,” said Mary C. Turner, RN, MNA President. “Nurses do not just work hard for patients at the bedside, but at the bargaining table and at the State Capitol, where we fight to put quality patient care before corporate profits in our healthcare system.” Throughout the week, nurses donned pins to encourage patients and all Minnesotans to stand together with nurses to prioritize safe, high-quality and affordable healthcare in our hospitals. Nurses wore the pins through-
out Nurses Week, from May 6 through May 12, 2022, sparking conversations with patients and other Minnesotans about the issues facing nurses and patients in our hospitals and how the two can stand together to improve our healthcare system in Minnesota. Nurses also rallied support for the Keeping Nurses at the Bedside Act at the legislature, and those in the Twin Cities and Twin Ports continued to fight for fair contracts.
Over Nurses Week, we asked nurses what was the most ridiculous thing hospital management has done to celebrate Nurses Week. Here are a selection of nurses’ answers: “They gave us a rock. Because ‘nurses rock.’” “Last year they sent poorquality printed cards with photocopied signatures pasted in. That’s it. It said how grateful they were for us with no mention of the pandemic.” “Sign up for food to bring for a potluck. Glad we get to feed ourselves.” “One year we got a coffee cup that had a pedestal base on it-very tippy. But was not dishwasher or microwave safe. Of course with the hospital logo on it.” “Announced the closure on my unit – Saint Paul PICU.” “We got a blue ink pen that we could not use to chart with.”
Remember your MNA Quick Reference Staffing Card! Know what to do in the moment and what to do after the fact to hold administration accountable for their poor and unsafe staffing conditions. Need a new card? Ask your MNA Steward or bargaining unit chair.
“We got ChapStick last year… the same ChapStick we give to our patients.” “Nothing…our hospital literally does nothing for Nurses Week.” “Ooo! Ooo! Ooo!!! We got half-grilled cheese sandwiches where the bread was burnt and the cheese slice was still cold and not fused to the bread AND a “wetsuit” material lunchbox that smelled intensely of tires. Large metropolitan hospital.”
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MINNESOTA NURSES ASSOCIATION HONORS & AWARDS
I have been a member of the MNA Honors and Awards Committee for several years. While I have served on many committees, this is my favorite. We have the privilege of learning about nurses who excel–individuals who mentor, inspire, encourage, lead, educate, and innovate. As a previous recipient, I cannot overstate how thrilling it is and how much it means to receive one of these awards. Most recipients are unaware of the difference they make and recognition from peers is one of the best honors to receive.
This is a call to all members for nominations!
Get involved with MNA Power & Practice Podcast
The MNA Power & Practice podcast is a tool for education, information, and making your collective voice heard as members of the Minnesota Nurses Association. With the first episode live, members are already working on the development and creation of future episodes. All members are encouraged to submit ideas for and participate in the creation of episodes. Have an idea or want to get involved? Email power. practice@mnnurses.org. Don’t forget to subscribe to the podcast on your favorite streaming service, or listen to the latest episode at https://mnnurses.org/news/ mna-power-practice-podcast/
The following are the awards are available: • President’s Award (selected by Mary C. Turner, RN, MNA President) • Distinguished Service Award • Creative Nursing Award • Nurse Educator Award • Nurse Researcher Award • Mentorship in Nursing Award • Ruth L. Hass Excellence in Practice Award • Paul and Sheila Wellstone Social Justice Award (open to non-MNA members) • Elizabeth Shogren Health and Safety Award • Audrey Logsdon/Geraldine Wedel Award • Sarah Tarleton Colvin Political Activist Award • Public Official Award (open to non-MNA members) Please beat the July 1 deadline for submissions. You may nominate multiple people for one or more of these awards. I am sure that every nurse knows someone who fits one of these categories! You all know someone who inspired you, mentored you, excels in their area of expertise, is a community volunteer/organizer, is a nurse advocate in labor, or is someone you admire or wish to emulate. Please nominate someone to be honored at the MNA convention in October by visiting the link below.
https://mnnurses.org/awards
19 MNA Visions, Values, and Strategic Pathways for 2022 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 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. MNA promotes 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 organiza tional 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 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 welcomes new staff Jack Nobel, Researcher, Prior to joining MNA, Jack was a Research Analyst for the Southwest Regional Council of Carpenters in California. Aaron Brickman, Labor Relations Specialist, Aaron comes to MNA from a position as an Organizer for the Oregon School Employees Association. He has also served as a union representative for UFCW Local 21. Chris Bublitz, Researcher, Previously an MNA Organizer, Chris has transitioned to the role of Researcher. Marco Cruz Blanco, Temporary Political Organizer, Marco is currently pursuing a Masters’ Degree in Advocacy and Political Leadership at Metro State. He has also worked as a Political Organizer for One Arizona, and as a Political Coordinator for Bernie Sanders’ 2020 Presidential Campaign. Elaina Hane, Executive Manager of Governance, Previously an MNA Labor Relations Specialist, Elaina will be transitioning into the role of Executive Manager of Governance later this year. Anna Altmann, Nursing Education Specialist, Previously an MNA Organizer, Anna will be transitioning into the role of Nursing Education Specialist later this year. Hunter Cantrell, Labor Relations Specialist, Hunter is a former Minnesota State Representative for District 56A. Christine Boardman, Temporary Labor Relations Specialist, Christine has over 40 years of experience in the labor movement and most recently was the President of SEIU Local 73. Stephen Fitze, Temporary Political Organizer, Prior to joining MNA, Stephen worked for the Minnesota Teamsters Service Bureau as an administrative assistant. Aaron Woida, Temporary Political Organizer, Most recently, Aaron served as the Campaign Manager for Clayton Howatt’s 2021 campaign for an at-large seat on the St. Paul Board of Education.
Learn how Minnesota hospitals are putting profits over patients. mnpatientsbeforeprofits.com
345 Randolph Ave., Ste 200 St. Paul, MN 55102
2022 Convention October 2-4, 2022 InterContinental Saint Paul Riverfront Hotel
