2021 Concern for Safe Staffing Report

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.

• 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

Clearly, 2021 was a continuation of extraordinary challenges faced in 2020 with registered nurse staffing.

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 2014

Data points were added regarding substandard care, Data points were added regarding substandard care, like delayed care, missed patient care and use of last - like delayed care, missed patient care, and use of last - minute solutions minute solutions

2015 MNA began categorizing the data collected by CFSS forms to enhance our analysis of unsafe staffing

Data points were added regarding violence in the workplace and homecare nurse specifics

2019

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 % Change Delays in care or treatments or incomplete assessments 2,694 5,556 70.71% Delay in medications 1,965 3,825 48.68% Inability to answer call lights 2,162 4,434 56.43% Incomplete discharge or rushed teaching 337 905 11.52% Management response - NONE or inappropriate 2,859 6,414 81.63% Temporary solution - closed unit 610 1,293 16.46% Short staffed >25% of what is needed 663 957 12.18% Patient left without being seen or against medical advice 371 829 10.55% Temporary solution - refused the assignment 657 1,073 13.66% Charge Nurse took patients or took over the grid 956 2,511 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 paced, highly stressful, ceaselessly demanding environment. The environment is physically dangerous and Nurses work in a fast-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. 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 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. accountability and action. Nurses only want to provide the best level of care to their patients in their most vulnerable time.

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 premiums 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.

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 throughout 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.

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. 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.”

“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.”

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/

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!

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

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 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.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 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

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