Nurse staffing bill faces roadblock in the House

Posted at 7:00 AM on March 10, 2013 by Tom Scheck (11 Comments)
Filed under: MN Legislature, Mark Dayton

A bill that would require Minnesota hospitals to meet national standards on nurse staffing appears headed for a roadblock in the Legislature.

The chair of the House Health and Human Services Policy Committee says she doesn't intend to hold a hearing on the bill unless the Minnesota Nurses Association and the hospitals start getting closer to a compromise on the issue.

The union is lobbying hard for the legislation because it says nurse staffing levels in some hospitals are too low and could put patients in danger.

The House Government Operations Committee approved the bill last week and referred it to the House Health and Human Services Policy Committee. But Rep. Tina Liebling,DFL-Rochester, said she's not planning to hold a hearing on the bill this year. She said she's not sure creating staffing standards is the best answer.

"I think it goes way too far in that respect because we don't measure inputs anymore," Liebling said. "We measure outcomes. We have hospitals that are very different across the state and one sized fits all really doesn't work."

Liebling said she intends to push the union and the hospitals to reach an agreement on the matter.

Rep. Joe Atkins, DFL-Inver Grove Heights, said he'll keep pushing for a hearing on his bill.

"I think we gain a great deal on not just this bill but on all bills by getting a good amount of public input and input from both sides and it contributes to a better solution," Atkins said.

Nurse staffing standards have been debated in the Legislature for roughly a decade. The bill has made little traction in past years, but the DFL-controlled Legislature has made the nurse's union more hopeful about their chances.

The union's political fund spent $450,000 to help Democrats win control of both chambers of the Legislature in 2012. The union also gave $50,000 to the Alliance for a Better Minnesota to help Democrats win.

The Minnesota Hospital Association spent $65,000 to help elect DFL and GOP candidates to the Legislature in 2012.

The Senate sponsor of the bill, Sen. Jeff Hayden, DFL-Minneapolis, said he thinks a committee in the Senate will hold a hearing on his bill this week.

He said the Legislature still has a solid chance of passing the bill this session.

"I'm going to move the bill and hopefully give both sides enough room to know that the bill is moving and they hopefully get behind closed doors and come to some resolution on the issue," Hayden said.

Hospitals have been lobbying heavily against the bill because they say it would add to cost of health care.

Comments (11)

I'm an RN at Fairview and our staffing ratio is just fine... if it wasn't I'd exercise my free market choice to work at a different hospital. I'm glad I don't have a union to steal my money out of my family's paycheck to give me something the market provides for free. I hope the bill dies. You can research that in California a similar bill raised the cost of healthcare and didn't improve anything!

Posted by Matt B | March 10, 2013 8:30 AM

If you can follow Rep. Atkin's logic, it would seem he should agree to hear the "Home Owners Bill of Rights" bill HF 83 when it is send to his Commerce and Consumer Protection Committee. He is saying that he will not hear it unless the banks first sign off on the legislation.

Posted by Tom Marver | March 10, 2013 8:44 AM

Funny thing is I am also an RN at Fairview and the hospital I work at in particular does not have a union. I don't think mandated ratios are the way to go however, there is inconsistency across facilities. Our ratios (nurse to patient) went up twice in less than a year between 08-09. Safety has taken a backseat and I think this issue should be featured more prominently in the media. We are non-profit, yet it seems profits have taken priority over safety...

Posted by Christa | March 10, 2013 9:57 AM

I have contacted my representatives to say that I do NOT support this bill. This will cost hospitals millions of dollars collectively for no gain. Government intrusion is rarely a good thing. With HCAPS on the horizon as part of our already decreasing reimbursement, hospitals aren't going to risk an unsafe or dissatisfying experience. And seriously, an OR nurse mandating beside ratios? Come on.

Posted by Lori K | March 10, 2013 11:00 AM

Quid pro quo? This seems to go a bit beyond that realm.

Posted by Jim | March 10, 2013 12:02 PM

Translation: the hospital lobby got to the committee chair before the nurses union did.

Posted by Disco | March 10, 2013 12:50 PM

I have been an RN for30. years. I worked at Mayo Rochester where our ratio was 1:4. Since this was the only place I had ever worked, I thought all healthcare was like that wonderful utopia. Then my husband talked me into moving to Arizona. The culture shock was so overwelming that I wanted to move back to Rochester and get back my old job. We had 6-8 patients, maybe two,but usually one, CNA. The disrespect from the patients, doctors, even the visitors, was unbelievable. The quality of the patient care is so much lower, the time a nurse actually gets to spend with a patient is minimal, and the lack of job satisfaction is total. If there is any way for MN to legislate a patient ratio, you must embrace it now, because very soon the reality of down and dirty business-only healthcare will take hold and you won't have a chance. We are told, if you don't like it, go somewhere else, there's a hundred out there who want your job. Nurses are nothing more than a cost unit here. Even if you don't think you need a mandated ratio now, please look to your future and support it. The day is coming when you won't have any power over your working conditions. Even if you don't believe in unions, at least let the government do you a favor and mandate patient ratios. Your patients' and your family's lives may depend on it.

Posted by Sandy | March 10, 2013 1:23 PM

It's quite helpful that Mr Scheck included the campaign donations by the interested parties, but there are still a few facts missing. MNA is no longer an independent union--it is part of the National Nurses Union, a big outfit that could donate a lot of money and buy political influence. Moreover, there are no national standards for staffing. While some studies suggest lower ratios help provide a safee patient environment, the data from California shows no benefit. Why? Likely because the hospitals, with fixed budgets, had to divert resources from other areas to pay for more nurses.

http://www.chcf.org/~/media/MEDIA%20LIBRARY%20Files/PDF/A/PDF%20AssessingCANurseStaffingRatios.pdf

This law won't make patients safer, just drive up the cost of healthcare. If nurses were really interested in patient safety, maybe they should be required to get flu shots, something the union opposes. The NNU--MNA is interested in two things--money and power. The rest is a sideshow.

Posted by Pete | March 10, 2013 8:55 PM

How could a state legislature mandate how many employees work in an industry...any industry? That is just crazy...forget about free enterprise. This is nothing but the MNA trying to up their membership...more money..that's always what it's about...not about patient safety. If they really believed in patient safety they would mandate all nurses to get flu shot instead of opposing it.

Posted by Samantha | March 11, 2013 8:58 AM

REally? Seriously? Nurse to patient ratio is the only way to obtain safer environment for your patients! It is ridiculous to expect and require nurses to further their education but continue to treat them worse than housekeeping - 12 hour shifts with hardly time to go to the restroom, no relief for lunch, but don't clock out no lunch or your in trouble. While housekeepers have scheduled breaks and lunches despite what is going on with the unit - specifically the ER. I am tired of having patients shovel into the ER but hearing how dangerous it is on the floor. But it is okay for us to struckle with critical patients and have a four or five patients, working short handed, no techs or lvns. Go union and look at the benefits of nurse patient ratio! Increasing nurse-to-patient staffing is recommended to improve patient safety and reduce adverse advents. A recently published simulation study shows that increased registered nurse (RN) staffing was associated with lower hospital-related mortality and adverse patient events. This approach can result in societal net savings, depending on the area of the hospital. Decreased burn out, increase retention of RNs in the profession are a few additional benefits.

http://www.nursezone.com/nursing-news-events/more-news/Study-Finds-Lower-Nurse-to-Patient-Ratios-Save-Lives-Help-Nurses_33960.aspx

http://www.ahrq.gov/news/newsletters/research-activities/jun10/0610RA21.html

Posted by Audra LaFitte | March 11, 2013 9:37 AM

As a professional nurse having over 30 years of practice, I take pride in the autonomy of my vocation. I have worked caring for as many as 5-6 patients in the past. I did it because I'm a professional and tried to place the needs of my patients before my own as many of my colleagues have done and do today. As a professional, I never wish to represented by collective bargaining who in my opinion do not have the patient and nurses best interest at heart.

Posted by Dale | March 11, 2013 10:13 AM

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