Minnesota Nursing Accent Spring 2022 by Minnesota Nurses Association

ACCENT

MN nursing

In this Issue:

• Unsafe staffing, moral distress, and adverse patient outcomes - page 8 • Hundreds of Mayo nurses demand action on staffing crisis page - 10 • Keeping Nurses at the Bedside Act - page 18

SPRING 2022 • Vol. 94 No. 1

Minnesota Nursing Accent Minnesota Nurses Association 345 Randolph Avenue, Ste. 200 Saint Paul, MN 55102 651-414-2800/800-536-4662

SPRING 2022 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

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: Taylor Daiello, RN, a nurse at Methodist/Park Nicollet rallies fellow nurses before marching on the boss to deliver petitions.

NURSES AT METHODIST HOSPITAL MARCH ON BOSS TO DELIVER PETITION

MNA nurses of Methodist Hospital/ Park Nicollet marched on the boss on Friday, January 21 to deliver a petition signed by over 600 nurses to demand that the Hospital recognize their sacrifices by implementing solutions affecting their work. Taylor Daiello, an Emergency Department nurse at Methodist, rallied nurses before the petition drop. “We deserve more than this, our patients deserve more than this. And that’s why we’re here today—to demand what we need of the employer, which is retention bonuses to actually recognize us for the work that we’ve done the last two years,” she said. “This is a transaction. We deserve to be compensated for our efforts. We also deserve not to be slogging under the weight of this heavy turnover.” After rallying together, nurses marched to the office of the Chief Nursing Officer Melissa Fritz to deliver the petitions. The petition included the following demands: We demand that the Hospital recognize our sacrifices by implementing the following: • Create an Admit/Transfer/ Discharge Nurse position • Future bonuses will apply to all departments and all shifts and will be available to nurses

•

regardless of whether they have any unscheduled time off in the pay period the bonus is to be paid (example: replaced self, sick or absent) Retention Bonus program of at least a $6,000 bonus paid to each nurse in the first paycheck of January 2022. This $6,000 nurse bonus for every Methodist nurse is around 6.9% of the profits that HealthPartners (the 2nd largest non-profit in the state) made in the last year while nurses carried the burden of the pandemic. “I think we can all agree we live in unprecedented times, but that’s no excuse for the hospital to make our work conditions [worse and worse] and not compensate us,” Taylor added. As of publication, Methodist/Park Nicollet nurses are still awaiting a reply from the employer.

President’s Column

WAKE-UP CALL It’s time for a wake-up call, nurses. Healthcare is being moved out of the hospitals, with telemedicine, outpatient center surgeries, things being done via apps on our phones, and more. It seems like this is the way of the future. And though we may want to bury our heads in the sand and pretend it isn’t happening, that cannot happen. We as nurses must be proactive. As the industry changes, we must be willing to change with it. Our hospital jobs aren’t always going to be there, and they won’t always be the same. What, then, do we do? First, we need to wake each other up, to realize that our jobs in hospitals are not nec-

essarily totally secure for the future. Then, we need to be willing to organize. We need to gather our fellow nurses into our fold, and not simply nurses in our hospitals—nurses from all over. At first glance, it may seem like a lot of this is targeting doctors only. But don’t kid yourselves! Wherever doctors’ jobs are lost, nurses are lost too. Every hospital is doing their best to try to turn our union hospitals into nonunion hospitals. Their intentions are clear, and we need to fight back. We need to organize our fellow nurses, talk to each other, work together, and face the challenges ahead with our

Minnesota Nurses Association

eyes wide open and arms linked. This is no time for a defeatist attitude. This is the time to build power and solidarity together. So, whether you’re a Metro, Duluth or Mankato nurse preparing for upcoming bargaining, or your negotiations are still a ways off, start getting ready now. Remember, nothing is constant but change—and when those changes come, let’s make sure we’re ready for them.

Nominate your colleagues for MNA Honors and Awards DEADLINE JULY 1

We all have colleagues who go above and beyond for our patients and our communities. Take a moment to give them some much-deserved recognition. Visit MNA’s website at www.mnnurses.org for details about the following awards and how to nominate an unsung hero! • President’s Award • Distinguished Service Award • Creative Nursing Award • Audrey Logsdon/Geraldine Wedel Award • Ruth L. Hass Excellence in Practice Award • Nurse Educator Award • Public Official Award • Sarah Tarleton Colvin Political Activist Award • Nurse Researcher Award • Mentorship in Nursing Award • Paul & Sheila Wellstone Social Justice Award • Elizabeth Shogren Health & Safety Award

Mary C. Turner, RN, MNA President

Executive Director’s Column

TIME TO BE BLUNT ABOUT CORPORATIZED HEALTHCARE

The following are remarks I presented at a recent labor roundtable sponsored by Minnesota Attorney General Keith Ellison and I wanted to share them with you, our members.

I want to start by being blunt, and maybe what some might deem as inappropriate, but nothing I have to say comes close to the inappropriate treatment of our nurses and frontline healthcare workers by corporatized healthcare. The insides of our hospitals are a sh*t show. We hear in the news almost daily about the staffing crisis in the hospitals. It impacts nurses, it impacts patients, it impacts each of us. One of the most frustrating things about this crisis is that nurses and healthcare workers aren’t at the problem-solving table. Instead, those at the table are the people who created this crisis in the first place by purposely understaffing hospitals because healthcare inefficiency is lucrative for healthcare corporations. Nurses are suffering from severe moral injury because hospital corporations run healthcare like a business, implementing lean and just-in-time models, used in the auto making industry, but for patient care. It’s an abject failure and it is wreaking havoc with our healthcare system which COVID-19 has clearly exposed. I want to highlight some of the particularly egregious plans our “nonprofit” hospitals have been engaged in: • M Health Fairview:

- Closed and displaced patients at Bethesda, a long-term acute care hospital in St. Paul - Shut down the OB at St. Joseph’s hospital in St. Paul and moved it to a Maplewood facility; then closed the emergency room, then closed inpatient mental health, and then closed St. Joe’s entirely • Allina: - Closed the OB department at Regina Hospital in Hastings - Closed OB and Mental Health departments at a Cambridge hospital • Across northern and southern Minnesota, OBs have been closed, causing women to drive up to four hours to deliver a baby. • In Olivia, MN, the hospital and clinic are to discontinue labor and delivery services in May 2022. It’s worth noting that these are all non-profit hospitals, and a hospital’s non-profit status is dependent on their providing community benefits. They are required to conduct a community health needs assessment and to develop a strategy to meet the community health needs identified in those assessments. Now mind you, our Minnesota non-profit hospitals often carry sig-

nificant Operating Revenue Margins (another term often used for profits), despite being non-profit institutions, including during the pandemic. And yet, throughout this, there have been cutbacks, facility closings, and services moved out to the suburbs and away from those who rely on public transportation and need care in their community. The non-partisan Lown Institute, who conducts research and creates reports in their mission to advocate for a just and caring system for health has rated how well health systems are actually carrying out their required need to fulfill their community benefits. The Lown Institute rates non-profit hospitals on four factors: • Equity, which reflects commit ment to inclusivity, pay equity, and community investment; • Pay equity, the ratio of execu tive compensation to worker wages, reflecting how well hospital staff are paid in comparison to executives; • Community benefit, reflecting how well hospitals invest in community health (charity care spending, community invest ment, Medicaid revenue as a share of patient revenue); and • Inclusivity, meaning how well hospitals serve people of color, people with lower incomes, and people with lower levels of education. Time to be blunt cont. on page 13

FAIR AND JUST TREATMENT IN NURSING HOMES During the 2021 MNA Convention, delegates debated, voted on, and adopted Resolution 4: Fair and Just Treatment in Nursing Homes. With MNA representing six units within nursing homes, the resolution resolved that MNA will advocate for skilled nursing home reform as well as staffing ratios and a living wage for nursing assistants in skilled nursing homes. MNA nurses also resolved to support the use of the RN in nursing homes and stand with them as they advocate for their patient populations. The Nursing Home Reform Act & Minnesota regulations The Nursing Home Reform Act (NHRA) of 1987 sets the federal quality standards for nursing homes. Nursing homes are obligated to meet these standards if they receive Medicare or Medicaid. The goal of the act is to ensure that seniors in nursing homes receive high quality care. The act protects seniors from physical, emotional, and social abuse and neglect. With that being said, Minnesota has a long legacy of nursing home oversight and regulation. Minnesota has its own Resident Bill of Rights that goes beyond what is required by federal law. The 30-page document starts with the statement that the resident has a right to a dignified existence, self-determination, and communication with and access to persons and services inside and outside the facility. It goes on to state that facilities must: • treat each resident with respect and dignity and care for each resident in a manner and in an environment that promotes maintenance or enhancement of his or her quality of life; • protect and promote the rights of

the resident; • provide equal access to quality care regardless of diagnosis, severity of condition, or payment source; and • establish and maintain identi cal policies and practices regarding transfer, discharge, and the provision of services under the State plan for all residents regardless of payment source. Additionally, every nursing home in Minnesota must have a state license from the Minnesota Department of Health (MDH) to operate. MDH conducts surveys of nursing homes and assisted living facilities to check whether they are following state and federal rules. MDH and the Minnesota Department of Human Services also jointly created a nursing home report card. The report card allows consumers to compare nursing homes on eight quality measures: • Resident quality of life; • Family satisfaction;

• Quality indicators—clinical quality; • State inspection results; • Hours of direct care; • Staff retention; • Use of temporary nursing staff; and • Proportion of beds in single bedrooms. A nursing home can receive one star to five stars on each measure. Consumers can search nursing homes by area of the state and the three measures most important to them. MNA legislation MNA has played an important role in getting legislation passed that promotes fair and just treatment of residents in nursing homes. In 2007, MNA helped pass the Minnesota Safe Patient Handling Act that requires: • Every nursing home to maintain a written safe patient handling program and committee; and • Employers to provide assis tive equipment, such as Hoyer

at Colonial Manor in 2014 and then became a nurse a few years back. “I enjoy working there,” she continued, “especially when you have a union. It can be really traumatic, but you know, everywhere you go, every place has its own challenges and good things.” Having a union, she says, “does help a lot. They can’t do anything or make us do anything that’s not right… because they know that we’re the union. They should never exploit us.” Summing up the importance of being in a union, Eznah added, “If you don’t have a voice to talk, then you’re in trouble, nobody will listen to you.”

and sit-to-stand lifts, to minimize manual patient-handling. While designed to help reduce worker injury, the law has also worked to keep nursing home residents safer. Since the law was passed, 55 percent of nursing homes reduced patient handling injury claims. MNA has also worked to ensure that people who work in nursing homes are adequately paid. In 2013, we helped advocate for legislation that increased funding for nursing homes and other long-term care facilities by 5 percent over two years. Most importantly the legislation mandated that 75 percent of that 5 percent increase had to go to workers’ wages, which had been frozen for years. Lastly, while not directly related to nursing homes, but nonetheless important for Minnesota’s seniors, MNA was involved in the effort to pass the Assisted Living Licensure Law in 2019. The law established regulatory standards governing the provision of housing and services in assisted living facilities and assisted living facilities with dementia care to help ensure the health, safety, well-being, and appropriate treatment of residents. It also authorized the commissioner to adopt rules for all assisted living facilities

that promote person-centered planning and service delivery and optimal quality of life, and that ensure resident rights are protected, resident choice is allowed, and public health and safety is ensured. The law went into effect on August 1, 2021. Recent nursing home bargaining win In early December 2021, nurses at Colonial Manor in Lakefield, MN reached an agreement with the employer after only two hours of bargaining. During this negotiation, nurses won a three-year contract with ATB wage increases of 5%, 4%, and 3.75% for each respective year of the contract. Nurses also won a relief shift differential for those working shifts that begin at 2 p.m. or after and end by 11:30 p.m. The Trained Medical Assistant differential also increased from $2 to $4 per hour. Eznah Ombasa, RN, LPN, one of the Chairs at Colonial Manor, shared about the recent win and working at a nursing home facility. “[Negotiations] went really well. We had a successful meeting,” she began. And although she said that it can be exceptionally hard working in healthcare, she enjoys working at the nursing home and with her patients. Eznah started as a CNA

Governmental Affairs Unsafe staffing, moral distress, and adverse patient outcomes Nurse shortages are a deliberate cost-cutting measure used by hospitals at the expense of patients’ and nurses’ safety By Priyanka Roy, RN, GAC Member

No health system can function without nurses. Nurses are the most significant part of the health workforce, at the frontline delivering direct patient care. Yet nurses are the favorite target for hospitals and care facilities to cut costs. These cuts, however, come at the expense of patient and nurse safety. Nurses across Minnesota are reporting unsafe staffing, being pushed to sacrifice their patients’ care, risking prescription errors, hospital-acquired infections, and patient deaths, as well as having their ideals destroyed and developing moral distress as a result of missing patient care. Inadequate nurse staffing affects everyone—patients, nurses, and the hospitals. When nurses work for an extended shift, there is a greater risk for errors. A high nurse-to-patient ratio is directly responsible for moral distress, poor patient outcomes, and job dissatisfaction in nurses.

A safe nurse-to-patient ratio is proven to reduce the patient mortality rate by more than 50%. The impact of nurse-to-patient ratios on patient mortality was studied by researchers at the University of Pennsylvania. With each additional patient allocated to a nurse, they discovered a 7% increase in the likelihood of death within thirty days of admission, as well as a 7% increase in failure-to-rescue incidents. The researchers found that hospitals with a nurse-to-patient ratio of 1:6 had 2.3 more fatalities per 1,000 patients than hospitals with a ratio of 1:4, and 8.7 more deaths per 1,000 patients with problems. Furthermore, if the ratios had been 1:4 across the board, hospitals would have saved about 1,000 lives. Another study by Harvard School of Public Health researchers explored the correlation between patient outcomes and nursing care. The study analyzed administrative data from five million medical patient discharges from 799 hospitals in eleven states. The researchers concluded that more hours of nursing care per day were associated with lower rates of urinary tract infections, cardiac arrest, pneumonia, upper gastrointestinal bleeding, failure-to-rescue, and shock, as well as shorter hospital stays. In Minnesota, nurses have been on the frontlines of the COVID-19 pandemic, providing direct treatment to patients in close contact. Nurses are continuously exposed to the virus because of their employment and are at a high risk of contracting COVID-19. According to data, nurses are also

likely to get infected with COVID-19 at a high rate. While nurses maintain their ethical obligation to care for the community during a pandemic, they are also experiencing high levels of stress, physical injuries, and moral distress due to inadequate staffing. Is it due to higher cost that hospitals are unable to hire enough nurses? The COVID-19 pandemic certainly doesn’t appear to have had an effect on CEO pay. According to data from the Minnesota attorney general’s office, hospital executives and CEOs earned millions of dollars during the pandemic. Fairview Health Services’ president and CEO, James Hereford, received $3.6 million in compensation, a 91 percent increase. Gianrico Farrugia, President and CEO of the Mayo Clinic was paid $2.8 million. Other hospitals are following a similar pattern. Minnesota has received a total of $2.8 billion in direct funding from the federal government as part of the American Rescue Plan, plus billions more in program-specific funds. The Minnesota Legislature has approved $200 million in healthcare funding to help with the costs of planning, preparing for, and responding to the COVID-19 outbreak. In addition, Governor Tim Walz has approved $50 million in hiring and retention awards in the healthcare industry. There is enough money to go around. However, the money isn’t being utilized to hire and retain nurses; instead, it’s being used to pay bonuses to the presidents and CEOs. Unsafe staffing cont. on page 15

Nursing Practice & Education Lateral Violence

By Mischelle Knipe, RN, with input from a fellow MNA member

The next few months are very important for the future of MNA Nurses. We need to be strong for each other to push back on the external threats we will experience. Being strong together means holding our fellow nurses in positive regard and preventing in-fighting. How do we do that? The first way is understanding the types of workplace violence. Four types of workplace violence are defined by the National Institute for Occupational Safety and Health (NIOSH). All types are important for Nurses to know, and each have different sources and prevention tactics. • Type 1 Criminal Intent: The perpetrator has no legitimate relationship to the business or employees and commits a crime in conjunction with the violence. Examples include an assault in the parking structure while being robbed. • Type 2 Customer/Client: This is the most common in health care settings. Customer/client includes patients, their family members, and visitors. A free course is available through NIOSH: https://www.cdc.gov/ niosh/topics/violence/training_

nurses.html • Type 3 Worker-on-Worker: Violence between coworkers is commonly referred to as lateral or horizontal violence. This includes bullying and verbal and emotional abuse that is unfair, offensive, vindictive, and/or humiliating. This type of violence is often directed at persons perceived to be “lower on the food chain.” • Type 4 Personal Relationship: The perpetrator has a relation ship to the nurse outside of work that spills over into the work environment. MNA has led the way in promoting safety for nurses through legislation and contract language. We have an opportunity to strengthen our prevention of Type 3 Worker-on-Worker violence. This is what may be used against us in upcoming contract negotiations. Have you experienced or unknowingly perpetrated worker-on-worker violence? Rolling eyes, turned back, or tossing of hair and walking away. Not helping student nurses, new staff, or each other. Ignoring others. We know that stress, overwork, and fear of burdening coworkers may lead to lashing out at each other. The pandemic has placed insurmountable pressure on us all with little, if any relief from that pressure. That pressure may manifest as lashing out at others through gossip, bullying, cynicism, and at the worst, racism. Pressure can continue to build and may result in a blow up between nurses which then results in a Human Resources (HR) action. When

this cycle occurs in the workplace, it is difficult to trust others and can make you feel very isolated and fearful. What are the risks that go along with this fear? To the nurse, to the patient? There is the additional stress and power to drive individuals away from the profession. Any time, but especially now, this is a problem. We all have a responsibility in finding a solution to this problem. Supporting and lifting one another up will help.

HUNDREDS OF MAYO NURSES DEMAND ACTION ON STAFFING CRISIS In late January, 672 nurse members of the Minnesota Nurses Association filed a petition with hospital management at six Mayo Clinic facilities, demanding action to curtail the worsening staffing crisis and recognize nurses’ sacrifices throughout the pandemic. The petition drew signatures from more than 70 percent of all MNA members at the six facilities located in Albert Lea, Austin, Fairmont, Lake City, Mankato, and Red Wing. Nurses’ demands are focused on retaining workers and call for the following: • Wage Fairness: To ensure fair wages are paid to both local and travel nurses, Mayo MNA nurses are asking to be paid triple time for all hours worked while travel nurses are being utilized. • Retention Bonuses: To honor the sacrifice of nurses who continue to work through the current hospital crisis, Mayo MNA nurses are calling for a $4,000 bonus to be paid for every three months that nurses remain on the job. “Nurses continue to work under extremely difficult circumstances to care for our patients while Mayo CEOs make millions off our hard work,” said Kelly Rosevold, a nurse at Mayo Clinic Health System – Mankato. Throughout the state, Minnesota nurses are overworked, hospitals are understaffed, and patients are overcharged by hospital executives trying to boost their bottom lines. Minnesota nurses are quitting at a record rate be-

cause of the terrible conditions hospital executives have created by putting profits before patient care. “As nurses continue to face down a pandemic, a work environment that feels unsafe, and unresponsive management, our demands will help to sustain nurses who are providing quality patient care at the bedside,” Kelly continued.

“Nurses continue to work under extremely difficult circumstances to care for our patients while Mayo CEOs make millions off our hard work.” – Kelly Rosevold, RN MNA nurses are fighting to make changes to fix the under-staffing crisis and improve the quality of care patients receive at Minnesota hospitals. Hospital CEOs with million-dollar paychecks can afford to make these changes for nurses and patients at the bedside. At the time of publication, nurses have not received a response from management, but are continuing to stand strong and unite in their demands.

NURSES AND COMMUNITY OBJECT TO ALLINA CONSOLIDATION PLAN First-of-its-kind public hearing is the result of a new law championed by MNA In late November, MNA members joined more than 60 participants in a virtual public hearing on Allina Health’s plan to close labor and delivery services at Regina Hospital in Hastings. This cost-cutting move by Allina will negatively impact patient care and the community, as people going into labor will now need to travel an additional 23 miles to St. Paul to receive care at United or Children’s Hospitals. The public hearing was the first of its kind under a new state law championed by MNA and passed by the legislature in June 2021, which requires public notice and a public hearing before a hospital closes or relocates or ends certain services. Among those who raised concerns about the move were an Obstetrics doctor from the Allina Health Hastings Clinic, along with former patients and other community members who will be impacted by the unit closure. “I am proud of the work the Minnesota Legislature did to pass this new law, with the support of Minnesota nurses, to provide greater transparency about hospital decisions,” said State Senator Karla Bigham, whose district includes Hastings. “While the relocation of labor and delivery services is unfortunate, I hope this hearing provided valuable information for the community and for hospital administrators. It is essential that people

know what kinds of services will be available to them in the future.” While this law was designed to bring community and employee concerns into consideration when hospitals make these decisions, Allina officials announced before the hearing even took place that: “The decision is already made. And, we will not be reversing our decision based on the public comment.” “I am incredibly upset by Allina’s decision to close labor and delivery services at Regina,” said Heidi Deutsch, an Obstetrics RN at Regina Hospital. “Our patients chose us because we are in the community, because they know the nurses and doctors who have been here for years. For the nurses who have worked through the pandemic it feels awful to be displaced without concern from the administration for the staff and especially our community. Leaving such a large gap in Obstetric care is unfair and not safe for our patients.” Nurses at United and Children’s in St. Paul, where labor and delivery services will be moved, are already straining to do more with less under poor working conditions and understaffing by Allina. In the middle of the COVID-19 pandemic, Children’s Hospital laid off 180 nurses, or around 17 percent of its nursing workforce, and later laid off or left unfilled another 300 hospital positions. In downtown St. Paul, hospital closures have put additional pressure on nurses managing surging caseloads at remaining facilities.

“As COVID-19 cases surge again and we see a significant increase of pediatric cases, patients who need inpatient care are being held in our emergency rooms, decreasing timely access to emergency and critical care,” said Sydney Pederson, a nurse at Children’s Hospital. “Directing more patients to facilities where nurses are already working beyond capacity will place a further burden on the health and safety of our nurses, patients, and community.”

“I am incredibly upset by Allina’s decision to close labor and delivery services at Regina... Leaving such a large gap in Obstetric care is unfair and not safe for our patients.” – Heidi Deutsch, RN

Bargaining & Collective Action Update NEW CONTRACT AGREEMENTS Chippewa County nurses ratify Tentative Agreement The MNA Negotiations Team for Chippewa County Montevideo Hospital (Now CCM Health) ratified a Tentative Agreement in mid-December 2021. Highlights include a 10% across the board (ATB) wage increase over the life of the contract. Retroactive to November 1, 2021, nurses will receive an ATB of five percent (5%); a three percent (3%) wage increase effective November 1, 2022; and a two percent (2%) wage increase effective November 1, 2023. Nurses will also receive differentials and bonuses, retroactive to November 1, 2021 and the differentials increase based on the ATB for the life of the contract. Additional Features of the TA include an FTE-pro-rated $5,000 Retention Bonus for nurses who are willing to sign a two-year agreement, and Christmas holiday pay will increase to include hours starting at 3 p.m. on December 24. TA reached at Colonial Manor Nurses at Colonial Manor in Lakefield, MN were excited to announce that they reached a Tentative Agreement in early December 2021. The contract will have a duration of three years with ATB wage increases at 5%, 4%, and 3.75% for each respective year, effective the first full pay period of each year. Nurses also won a relief shift differential for shifts that begin after 2 p.m. and

end by 11:30 p.m., and increased their TMA differential from $2 to $4 per hour. Essentia Sandstone nurses ratify TA The nurses at Essentia Sandstone ratified their tentative agreement in early December 2021. They reached the three-year agreement after mediation and won a new wage grid, a 2% increase in pay for each year of the contract, an increase in BSN differential, a $500 signing bonus, and workplace violence language, among other things. COLLECTIVE ACTION Methodist Emergency Center nurses collectively take action against workplace sexual harassment By Taylor Daiello, RN

In December 2021, Methodist Emergency Center (EC) staff delivered a petition to their unit director and supervisors. A nurse in the EC had been experiencing sexual harassment from one of the EC providers and, after taking their concerns to HR, the nurse was told that they had support from HR and management. When HR asked how the nurse could be supported, they stated that they could not work with the provider who had been harassing them, and HR/management refused to accommodate this, instead

recommending that the nurse try to bid into a different position within the hospital or use vacation time to avoid working with their harasser. Feeling alone, the nurse chose to speak candidly to coworkers about their harassment and discomfort working with their harasser. Management retaliated by sending an email to all staff to “stop gossiping” and pulled the affected nurse into private meetings with HR while at work. EC MNA leaders worked with the affected nurse to write a petition demanding that staff experiencing sexual harassment not be required to work with their harasser and that staff would not experience retaliation from management for speaking out against sexual harassment or trading care assignments in order to create a safe workplace for victims of sexual harassment. SEIU supported the petition, and 98 EC staff signed, including non-union staff! Eight EC staff marched on the boss and delivered the demands to management on December 9. An email version of the petition and signatures was forwarded to the CNO, head of HR, and Methodist Hospital Medical Director as well. The petition action demonstrated the strength of solidarity and provided the affected nurse with much-needed support. Pictured are six of the eight staff who delivered the petition celebrating this victory! Solidarity! Upcoming Negotiations Duluth and Metro Bargaining is set to begin on March 15, 2022 as nurses and management exchange initial proUpcoming negotiations cont. page 17

Time to be blunt from page 5

Based on these factors, here’s what they have to say about some of our MN Hospitals:

Hospital

Pay Equity

National ranking (of 3,699 hospitals)

Community Benefit

National ranking (of 3,641 hospitals)

Inclusivity

National ranking (of 3,548 hospitals)

Allina Abbott

3,057

3,517

3,076

Allina Mercy

3,273

3,451

635

Allina United

3,193

3,480

2,003

FV UMMC

3,213

1,813

2,252

FV Southdale

1,241

2,949

3,137

FV St. Joe’s

2,777

2,930

2,324

Methodist

2,971

3,003

3,242

North Memorial

2,356

2,488

632

Hospital

CharityCare Spending

Community Investment

Medicaid Revenue as a Share of Patient Revenue

Allina Abbott Allina Mercy Allina United FV UMMC FV Southdale FV St. Joe’s Methodist North Memorial This needs to change. We need our elected officials and the public to help us hold them accountable—for the sake of our nurses and frontline healthcare workers, for the sake of patients, and for the sake of us all.

Rose Roach, MNA Executive Director

NURSES CALL FOR ACTION TO PROTECT PATIENT AND WORKER SAFETY

In mid-December, MNA nurses shared their experience of the ongoing crisis in Minnesota hospitals. The nurses described the unsustainable conditions in their workplaces and called on hospital CEOs and public officials to take action to ensure hospitals are safe and welcoming to patients and workers. “To our patients, I want to say this: nurses will be here when you need us,” said Mary C. Turner, RN, MNA President and a COVID-19 ICU Nurse at North Memorial Hospital. “To our hospital CEOs and elected officials, please hear us: nurses need more than words, we need action to address the crisis of staffing and retention in Minnesota hospitals.” In their remarks at the press conference, nurses described the crushing conditions in Minnesota hospitals as COVID-19 cases surged, including full Intensive Care Units and Emergency Departments which pushed patients into hallways and waiting rooms. At the start of the pandemic, Minnesota nurses kept themselves and their patients safe even when hospitals could not provide enough PPE. Now, nearly two years later, the situation is just as bleak. “For the last two years, our employers have relied on our sense of duty and our love of the job, each other, and our patients to push through surge after surge,” said Kelley Anaas, RN. “Nurses want to keep showing up to provide our expert care, but the current patient care environment and our working conditions are making it increasingly hard for us to do just that.” Nurses described steps elected officials and hospital executives can take to improve their retention and staffing

“Corporate healthcare choices are what have brought us to the breaking point. Corporate healthcare’s business model has been exposed by COVID-19.”

– Wendy Wahl, RN

levels, including efforts to schedule nurses at preferred times, meet equitable pay and bonus compensation levels, provide more ICU training to nurses, and approve leave requests for paid sick and vacation time. As hospital executives continue to make millions in compensation—like the $49.5 million “golden parachute” recently paid to Sanford CEO Kelby Krabbenhoft, who spread misinformation about COVID-19 management can afford to make the necessary improvements to put the well-being of

workers and patients first. “More and more often, I see that I am fighting to get enough staff to care for these patients,” said Lynnetta Muehlhauser, a nurse at Abbott Northwestern. “There are a lot of patients that need to be in the hospital. Let us care for them and let us do the best that we can.” Nurses continue to urge all Minnesotans to take the pandemic seriously and to take steps to protect themselves and their families. But COVID-19 is not the only crisis nurses are facing. Since before the pandemic, hospital CEOs have hired and scheduled nurses at low levels to cut costs, leaving fewer nurses to try to care for more and more patients. A recent study from National Nurses United surveyed the crisis of hospital short staffing and proposes solutions which hospitals and legislators can enact. “The community can help mitigate the current COVID-19 crisis by getting vaccinated, wearing masks, and making conscious choices when gath-

Unsafe staffing from page 8

ering outside of their family unit,” said Trisha Ochsner, a nurse at Children’s Minneapolis. “But the reality is that COVID-19 has shed a light on a systemic problem related to unsafe staffing across the metro and state. We need appropriate staffing levels today and remediation of past shortcomings by hospital executives now.” Hospital executives continue to short-staff workers, deny paid COVID leave, and put up roadblocks to nurses’ requests for sick leave. When hospital executives fail to provide adequate staff levels, nurses feel pressure to accept unsafe work assignments, and patients may not receive the care they expect and deserve. “We became nurses to heal, help, and provide for our communities,” said Wendy Wahl, RN at Sanford Medical Center in Thief River Falls. “Corporate healthcare choices are not just hurting nurses. Corporate healthcare choices are what have brought us to the breaking point. Corporate healthcare’s business model has been exposed by COVID-19.” Minnesota continues to train enough nursing students to meet the state’s needs. But no matter how many new nurses enter the profession, this crisis will continue as long as executives continue to create conditions that drive them away. In some Minnesota

hospitals, recent graduates last just a few months before being pushed out of the profession by unsafe and unsustainable conditions. This problem is compounded by more experienced nurses taking early retirement or being stretched thin with patient care, leaving less time to mentor, train, and coach new nurses. “It is absolutely true that we are overwhelmed. It is absolutely true that we are heartbroken,” said Emily Wright, RN at M Health Fairview Southdale. “It is also true that the executives making a plea to the public are the ones who have the most power to help their staff and patients.” This is not a crisis of nursing; it is a crisis of management. Until CEOs solve the crisis in their hospitals, these untenable conditions will continue to drive nurses away from patients at the bedside. Minnesota nurses are at a breaking point.

The pandemic’s impact on the State of Minnesota has brought the realities of our existing nursing shortage to light. Hospitals and healthcare organizations can avoid needless patient mortality and improve nurse turnover by investing in proper staffing. Now, more than ever, we need a safe patient standard. The Minnesota Nurses Association is now collaborating with other unions and organizations to adopt a safe patient standard policy or a safe nurse-topatient ratio for all hospitals, ensuring that every patient, regardless of age, color, gender, or income, receives safe and high-quality care.

References

Callaghan, P. (2021). The Minnesota Legislature approved $250 million for pandemic worker bonuses. Should the state give away more than that? MINNPOST. https://www.minnpost. com/state-government/2021/08/the-minnesotalegislature-approved-250-million-for-pandemicworker-bonuses-should-the-state-give-awaymore-than-that/ Kennedy, P. (2021). The 25th annual Star Tribune list of largest nonprofits in Minnesota. https:// www.startribune.com/minnesota-top-nonprof its/600006951/ Kuwata, K. (2017). Spread too thin: The case for federally mandated minimum nurse-to-patient ratios in hospitals. Loyola of Los Angeles Law Review, 49(3), 635–659. Martin, C. J. (2015). The Effects of nurse staffing on quality of care. Medsug Nursing, 24(2), 4–6. Minnesota Department of Health. COVID–19 Response Funding. https://www.health.state. mn.us/facilities/ruralhealth/funding/grants/ covidgrant.html Minnesota Nurses Association. Virtual Week on the Hill. https://mnnurses.org/events/?even tID=3090

HUNDREDS OF NURSES JOIN TELE-TOWNHALL TO DEMAND ACTION AHEAD OF LEGISLATIVE SESSION On Thursday, January 13, MNA nurses hosted a tele-town hall with members of the Minnesota Legislature to demand action on the crisis of nursing in Minnesota hospitals. In December, nurses held a press conference to highlight the dangerous and unsustainable conditions inside Minnesota hospitals. With the 2022 Minnesota Legislative Session approaching, nurses organized and continue to organize to demand that elected officials commit to take action to hold hospital CEOs accountable to patients and workers. MNA President Mary C. Turner, RN, spoke along with fellow registered nurses from across Minnesota including, Chris Rubesch, Sue Schroeder, Doreen McIntyre, Adiam Midekssa, Ali Marcanti, Daniel Clute, and Venessa Soldo-Jones. Each shared stories about their experiences and the unsustainable conditions inside hospitals. Ali Marcanti, a Registered Nurse at United Hospital in St. Paul, shared the following remarks during the town-hall: I’ve been a nurse for six and a half years in the hospital setting. I’ve worked primarily in the post-surgical/ medicine setting at United Hospital. I want to thank everyone for this opportunity to speak to you today. Nursing has been the most rewarding and simultaneously challenging career decision I’ve ever made. I have been privileged to work with and learn from nurses that are incredibly passionate, intelligent, and professional.

I’ve also watched so many of these amazing individuals leave hospital nursing, because they just couldn’t take it anymore. We are tired of delivering substandard care and putting patients at risk due to lean staffing. Hospital administration has been cutting back on staff year after year with staffing grid changes that take very little patient acuity into account. Basically, this amounts to more patients to less nurses. These patients that are on my unit are sicker than they ever have been, and yet the focus still from the moment a patient enters a hospital is: how can we get this patient discharged? It’s a constant revolving door and staff and patients are treated as numbers and dollar signs. I can’t recall a recent shift where I haven’t worked short, either nurses or nursing assistants or both. We’re not able to address basic hygiene needs or the needs of patients that really make the job worthwhile such as talking a patient through the surgical process and reassuring them or holding the hand of someone’s loved one while they’re going through the dying process. This is what I got into nursing for. To stand beside you or your family and help you navigate through this incredibly difficult time. None of that is happening. Nowadays your loved one’s body isn’t even cold before they’re pushing more patients on nurses because the ED is always full. COVID-19 has highlighted the long-standing issues within healthcare. We have seen a lot of death this

year. Our morgue has typically been full and on nights there are no transport aides, so nurses are now responsible for taking the deceased to the trailer outside where we have stacked shelves (floor to ceiling) to hold the deceased. We were informed by a piece of paper taped to a huddle board that transporting patients on nights to the morgue, or more likely the trailer outside, was now nurses’ responsibility. It wasn’t even an email or a statement from my manager, but an impersonal piece of paper. ‘This is the new normal, deal with it’. Nurses are all suffering from some level of trauma and will continue to for years to come. Hospital companies make these grand claims of “patient-centered care”, and “putting patients first”. I’m here to remind everyone that that reputation for excellent patient care is not garnered in a board room or on a hospital administration zoom meeting. That reputation for excellent patient care is built on the backs of the respiratory therapists and doctors, the nurses and the pharmacists, the unit clerks and the nursing assistants that provide excellent direct patient care in spite of staffing constraints. Management is constantly trying to squeeze more and more out of their employees while cutting the number of staff or doing little to nothing to improve employee retention. Management and hospital administration has zero compassion for patients or their employees. Ahead of legislation cont. on page 17

17 Ahead of legislation from page 16

Burnout was always a word floating around at the beginning of my career six years ago and much longer before that. I’m telling you now that that word doesn’t scratch the surface of the unsafe, impersonal world of corporate Healthcare. Minnesotans deserve better, you and your families deserve better. Every day we go home after a full 8-16 hour shift of providing substandard care, it takes a little piece of us. Every day we walk out that door knowing we could have done so much more for you, if we were adequately staffed. The current environment in the hospital is completely unsustainable and ultimately it is the patient that suffers.

2022 CALL FOR BYLAWS AMENDMENTS, RESOLUTIONS, AND MAIN MOTIONS Deadline for submitting written proposals: 11:59 p.m. on July 15, 2022 All proposed Bylaws Amendments, Resolutions, or Main Motions for consideration at the 2022 MNA House of Delegates on October 3 require a statement of rationale explaining the significance and anticipated consequences for the Association, the profession, and the public. Bylaws: Spell out the rules by which the Minnesota Nurses Association governs itself, including the powers of the House of Delegates, Board of Directors, and other structural units. In addition, they include rules regarding membership criteria and conducting our elections. • Amendments must identify the Article and Section of the Bylaws to be amended. Resolution: A formal expression of an opinion to be adopted by the organization. • Must deal with one topic and be accompanied, when appropriate, by a proposed action plan in sufficient detail

to allow a financial impact statement to be determined. It shall also include citations for facts and figures referenced. • Must identify the current association position to be amended, if any. Main Motion: Used to propose a change to an MNA House of Delegates Policy. • Must identify the MNA House of Delegates Policy to be amended. Once the July 15 deadline has passed, the Committee on Bylaws, Resolutions, and Main Motions will review the proposals for completeness. Submission forms can be found on the Member Center under the Forms tab https://mymna.mnnurses.org/Clients/ MNA/content/9/forms.aspx. If you have any questions or would like to submit your proposals, please contact: Jodi Lietzau at Jodi.Lietzau@ mnnurses.org. Upcoming negotiations from page 12

posals. Negotiating Teams and CATs have been meeting and planning how to win...contact your NT, CAT, or steward to get plugged in.

Upcoming Meetings Board of Directors Wednesday, March 16 Wednesday, April 20 Wednesday, May 18 Commission on Governmental Affairs (GAC) Wednesday, April 13, 1-4 p.m. Wednesday, May 11, 1-4 p.m. Commission on Nursing Practice and Education Wednesday, April 6, 11:30 a.m.-3 p.m. Wednesday, May 4, 11:30 a.m.-3 p.m. CARn Wednesday, April 13, 10:30 a.m.-12 p.m. Wednesday, May 11, 10:30 a.m.-12 p.m. Racial Diversity Committee Executive Meetings Thursday, March 17, 4:30-6 p.m. Thursday, April 21, 4:30-6 p.m. Thursday, May 19, 4:30-6 p.m. Racial Diversity Committee General Membership Meetings Tuesday, March 23, 4:30-6 p.m. Tuesday, April 27, 4:30-6 p.m. Tuesday, May 25, 4:30-6 p.m. Ethics Committee Thursday, March 17, 4-5:30 p.m. Thursday, May 19, 4-5:30 p.m. Health and Safety Committee Tuesday, March 22, 3:30-5:30 p.m. Tuesday, April 26, 3:30-5:30 p.m. Tuesday, May 24, 3:30-5:30 p.m.

MNA welcomes new staff Christy Harriman, Labor Relations Specialist. Christy comes to MNA from AFSCME Council 5. She served as both a member leader and field representative during her time at AFSCME Council 5. Kara Osterman, Governmental Affairs Administrative Assistant. Kara has over seven years of administrative experience. Prior to joining MNA, Kara worked as a legislative assistant for a law firm in St. Paul. Katrina Stubson, Labor Organizer. Katrina’s past organizing experience includes stints with SEIU Healthcare Minnesota, AFSCME Council 75 in Oregon, and AFSCME Local 2822. Most recently, Katrina was an organizer for the St. Paul Federation of Teachers. Amanda Prince, Lead Labor Relations Specialist. Previously a MNA Labor Relations Specialist, Amanda is transitioning into the position of Lead Labor Relations Specialist.

KEEPING NURSES AT THE BEDSIDE

Solving the Hospital Short-Staffing and Retention Crisis

In the last six months, has hospital short-staffing hurt patient care? 60% 50%

Minnesota nurses and patients know the hospital short-staffing crisis started before the pandemic, and they know the problem will not go away unless the hospital executives who created it are held accountable. The Keeping Nurses at the Bedside Act will stop the flood of nurses leaving the profession. To do this, the bill would: • Set a limit on the number of patients any one nurse is responsible for and establish committees of nurses and management to set staffing levels at Minnesota hospitals • Protect nurses and patients from violence and improve hospital transparency • Fund new efforts to recruit and retain Minnesota nurses including stronger mental health support and student loan forgiveness for nurses

40% 30% 20% 10% 0%

2014

2021 Yes

Survey of MNA Members conducted March 2021

Considering leaving the bedside, or know someone who has, because of short staffing

Minnesotans know that when nurses are supported, hospitals are safer for everyone and provide better patient care. As hospital CEOs continue to make millions in compensation and bonuses during the pandemic, they can afford to make changes to protect workers and patients. DRIVING NEW NURSES AWAY: increase in the last year of brand-new nurses being pulled off orientation to care for patients

213%

Yes

Don't Know

Survey of MNA Members conducted March 2021

IF NURSES’ REQUESTS ARE MET:

92%

Better nurse retention

86%

Patient care improves

89%

Hospital CEOs making millions can afford these changes MNA public poll conducted January 2022.

82%

In the last five years, hospital patient safety has:

short-staffing cases, nurses reported NO RESPONSE or inadequate action by hospital management

50% 40% 30% 20% 10% 0%

2014 Improved

2021 Gotten Worse

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.

NURSES MEET WITH LEGISLATORS FOR VIRTUAL WEEK ON THE HILL

During the week of February 14, 91 MNA members from 23 different MNA facilities across Minnesota took part in the 2022 Virtual Week on the Hill. This powerful week started with a training on How to Tell Your Story using SBAR as well as a walkthrough of what to expect throughout the week. Immediately following the training, a forum was held with Governor Tim Walz, Senator Erin Murphy, Representative Liz Olson and members of the media. Governor Walz talked about Minnesotan’s appreciation for its nurses and healthcare workers and stated his opposition to the Nurse Licensure Compact (NLC) and support of the Keeping Nurses at the Bedside Act (KNABA). Representative Olson and Senator Murphy are chief authors of KNABA in the Minnesota house and senate and spoke about ways nurses can stay engaged in the legislative process throughout the 2022 legislative session. After the Monday morning events, members had the opportunity to talk with elected officials about issues they face on the job. Meetings with 72 legislators took place and covered districts from all over the state. The meetings included a game planning session where nurses decided who would tell what story, the meeting with legislators, and then a debrief session where members talked about next steps. MNA member advocacy is what makes a difference when elected officials are weighing decisions on legislation. If you’d like to meet with your legislators or are interested in how to get involved with advocacy beyond the bedside, contact MNA Political Organizers Cameron Fure or Zach Sias. They can be reached at Cameron. Fure@mnnurses.org and Zach.Sias@ mnnurses.org.

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/

Share Your Feedback Have feedback on the Accent’s new look? Would you like to share an idea or submit an article? Get in touch at accent@mnnurses.org.

345 Randolph Ave., Ste 200 St. Paul, MN 55102