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Minnesota Nurses Push National Agenda

 |  By John Commins  
   May 24, 2010

National Nurses United at its founding convention last December vowed to create a unified agenda and push for staffing ratios at every local affiliate. They're making good on that pledge in Minnesota, and they are showing themselves to be formidable. Pay attention to this fight, because it may soon come to a hospital near you.

Last week, 12,000 members of the NNU-affiliated Minnesota Nurses Association at 14 Minneapolis-area hospitals overwhelmingly voted to authorize a one-day walkout on June 1 unless their contract demands are met. Linda Hamilton, president of the MNA, says the fight is about patient safety, not money.

"What are we fighting for? The simple answer is this: We're fighting for you. We're fighting for any patient who ever walks through the doors of one of our hospitals," Hamilton wrote in a May 15 editorial in the Pioneer Press.

"The math doesn't lie: The thinner nurses are spread in hospitals, the greater number of patients who die… Despite what the Twin Cities hospital systems want readers to believe, this contract fight is not about economics. For nurses, this is much more personal than a paycheck or a pension benefit. This is about our patients," Hamilton wrote. "Everybody knows a nurse, and everybody knows nurses are not greedy."

Hamilton may be sincere. Or, you can argue that staffing ratios are just a clever way for nurses' unions to protect jobs and increase membership under the guise of "patient safety." Whether or not a specific level of nurse staffing has any affect on patient safety or quality of care is one of the most hotly contested issues in healthcare.

There is also the blatant contradiction of a walkout in the name of patient safety. How can the MNA say that staffing ratios are critical to patient safety, and then threaten to abandon the patients they claim to be "fighting for?" Who bears the responsibility if a patient is harmed by this walkout? Is this about patient safety, or isn't it?

Still, Hamilton's argument is compelling for the general public because the union has made its grievance a fight for the little guy. The cause of patient safety is something that resonates with everyone. Who hasn't been either a patient or visited a loved one in a hospital, in pain, at their most vulnerable? This chord strikes deep.

The local news videos of rank-and-file MNA nurses marching in front of their hospitals, wearing their uniforms, waving picket signs, and demanding patient safety gets prime air time. Nice visuals! Very powerful!

Hamilton skillfully works the corporate greed angle when she complains that the six "nonprofit" (quotations hers) health systems made a combined $700 million in profits during recession-wracked 2009, and spent money on huge executive pay hikes and frivolous projects that add nothing to patient care.

The 14 Twin Cities hospitals have mounted their own media counteroffensive, and they've done an admirable job. They make themselves available to the media. They've set up a website and posted the union's contract demands with each health system, and each health system's counter-offer. They've banded together to get their message out, using amiable spokeswoman Maureen Schriner to quickly address media queries. (Their first spokeswoman was fired earlier this month after local news reported that she had pleaded guilty in 2006 to the misappropriation of about $15,000 at a South Dakota hospital. D'oh!)

Schriner's arguments are also compelling, but they're harder to fashion into an easily digestible sound bite. She says full-time nurses average about $79,000 a year plus benefits at the 14 hospitals, which is hardly chump change. She notes that Minnesota hasn't needed strict staffing ratios to score among the best states in the nation when it comes to patient safety, quality outcomes, and efficiencies. "Minnesota is a national leader. We have a reputation for quality patient care and innovative initiatives on patient safety," Schriner says. "For us to go to a national standard, why would we want to do that? We are above the national standards in so many areas already. We want to look to the future."

Technology is another issue.

"The union is asking for the contract to say you cannot introduce any new technology if it is going to reduce staff," Schriner says. "Of course we want to introduce new technology if it's going to benefit patients. Is the deciding factor of whether or not we use technology based on how it affects (full-time employees)?"

Despite their efforts, Twin Cities Hospitals' fight for public opinion will be an uphill slog. The hospitals' message is about economics. The nurses' message is also about economics, but they're calling it patient safety—easily identifiable, succinctly encapsulated, with an immediate emotional connection with the public. Plus, they control all the compelling video.

A hospital executive in a business suit explaining proposed pension reductions as a percentage of overall payroll expenses, or a website detailing contract specifics on "mandatory low need days," "unit closures," and "flex time summer deferral bonuses" cannot compete for the public's heart with video of a uniformed nurse holding a picket sign looking earnestly into a camera and saying she is fighting for you.


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John Commins is a content specialist and online news editor for HealthLeaders, a Simplify Compliance brand.

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