Keeping Nurses at the Bedside Act
The conditions that hospital CEOs have created are driving nurses away from the profession and hurting patient care. The Keeping Nurses at the Bedside Act, chief authored by Senator Erin Murphy (DFL-St. Paul) and Representative Liz Olson (DFL-Duluth), puts patients and workers before profits to fix the under-staffing and retention crisis while improving the quality-of-care patients receive at Minnesota hospitals.
The bill would set a firm upper limit on the number of patients any one nurse can be responsible for in the State of Minnesota. The bill would further establish committees of nurses and management at Minnesota hospitals to set staffing levels for units at those facilities. At least sixty percent of all members on these committees would be nurses to help ensure staff levels are sufficient to put patient care before CEO profits.
While the ultimate solution to the hospital retention crisis requires holding hospital CEOs accountable to provide safe staffing and workplaces, additional measures can help support nurses working at the bedside. The bill includes new measures to recruit and retain workers. These measures include $5 million to launch a new student loan forgiveness program for nurses working at the bedside in Minnesota hospitals and another $5 million for grants to hospitals to establish new mental health programs for nurses and other health care professionals.
To ensure hospital CEOs are being held to safe staffing standards which put patients before profits, the bill would improve hospital transparency about staffing and patient care. The bill would establish a new mandate for the Minnesota Department of Health to conduct studies on the state of nursing in Minnesota, including on nurse staffing and retention, the workplace environment, and ability to provide quality patient care.
If the Keeping Nurses at the Bedside Act is passed into law, nurses will stay on and return to the job, and patient care will improve. There is no shortage of Minnesota nurses who want to provide safe, high-quality care to their patients; there is a shortage of nurses willing and able to work under these conditions. Hospital CEOs making millions in compensation and benefits can afford to make changes to protect workers and put patients before profits.
COVID-19 Emergency Leave for Essential Workers
Nurses and many other essential workers were left out of COVID-19 related leave bills passed by the federal government early in the pandemic. They were either exempted from receiving federal COVID-19 leave covered by the Families First Coronavirus Response Act (FFCRA), or their employers were not subject to FFCRA due to their size.
The Essential Workers Emergency Leave Act (EWELA) would ensure that nurses and other frontline workers during this pandemic can quarantine, care for a loved one with COVID-19, or care for a child who is distance learning or whose childcare provider is closed due to COVID-19, without financial burden. Chief authored by Rep. Cedrick Frazier (DFL-New Hope), HF 41 was introduced in the Minnesota House on January 12, 2021. The Senate version of the bill, SF 331, was filed on January 25, 2021, by chief author Senator Erin Murphy (DFL – Saint Paul).
For workers considered full-time by their employer, the bill would provide 80 hours of retroactive emergency paid leave for leave taken between March 13, 2020 to March 31, 2021 and an additional 80 hours of emergency paid leave going forward from April 1, 2021 to September 30, 2021. Part-time workers would receive hours that are commensurate to what they work in an average two-week period and contract workers would be eligible for an amount of leave relative to the hours worked in a 6-month period. This leave would cover nurses who have either been instructed to quarantine or exhibit symptoms while waiting for test results but later test negative. It would also cover caring for a family member that contracts COVID-19 or for childcare if their school is closed.
Workplace Violence Prevention
Nurses are experiencing violence ranging from death threats and sexual harassment to kicking and punching from patients and their visitors at an alarming and unconscionable rate. Meanwhile, many hospitals refuse to take action to increase security or staffing requests and there is little data available to the public about the rates of these incidences in Minnesota’s hospitals.
Currently, there is no standard for defining and documenting workplace violence incidents in Minnesota Hospitals. It’s essential to have a standardized, simple system for defining and reporting workplace violence incidents in hospitals and ensure that data is reported to the Minnesota Department of Health. This will ensure we can gather accurate data and develop the proper preventative and corrective measures to keep nurses, patients, and communities safe in all Minnesota hospitals.
The issue of workplace violence against nurses, doctors, and healthcare workers is not unique to Minnesota. Nurses all across the country are facing similar threats and acts of violence, which is why MNA’s national affiliate, National Nurses United (NNU), has introduced a workplace violence prevention bill in Congress.
The Workplace Violence Prevention for Health Care and Social Service Workers Act (HR 1195) was introduced on February 22, 2021, by Rep. Joe Courtney (CT-2). Per NNU, “the bill, introduced with bipartisan support, would mandate that the federal Occupational Safety and Health Administration (OSHA) create a national standard requiring healthcare and social service employers to develop and implement a comprehensive workplace violence prevention plan. This legislation is especially important given that healthcare and social service workers face one of the highest rates of injuries caused by workplace violence, with signs that the rate of violence may be increasing during COVID-19. In a November 2020 NNU survey of 15,000 registered nurses across the country, 20 percent of RN respondents reported an increase in violence during the pandemic.”
Patients Before Profits
Minnesotans should have access to safe, community-based care regardless of race, income, or neighborhood. However as large hospital systems take over community hospitals, and the bottom-line drives facility and unit closure, too many are left without access. We need a healthcare system that puts patients before profits and ensures that people have access to quality, affordable care in the community in which they live. In the current system, health insurance companies and hospitals make decisions through a financial lens rather than a patient care lens. Minnesota has seen reductions in access to care through hospital closure in both rural and urban areas while hospitals and health insurance companies make record profits, and executives make exorbitant salaries. We need a system that puts patients first.
Healthcare for All: Nurses see the devastating impact illness and injury can have on patients. Beyond the physical life-changing experience, it can also affect their finances. Many patients have trouble affording both their premiums and deductibles, prohibiting them from taking a proactive approach to seeing their doctors and receiving the care they need.
To address the need for access to quality affordable healthcare for all Minnesotans, the MN Health Plan (SF 1643/HF 1774) was introduced in the Senate by chief author Senator John Marty (DFL- Roseville) and in the House by chief author Rep. Cedrick Frazier (DFL- New Hope). The Plan would put Minnesota on a path toward a publicly financed but privately delivered system of care.
Hospital Closures: Policy solutions include increased transparency around the proposed closing of healthcare facilities and requiring hospitals to obtain permission to close beds or facilities. In order to ensure that patients still have access to care in their communities, Minnesota could require advance notice of any closure to the legislature, municipal officials, and impacted communities so that they can be part of the conversation about how this will affect their community. Other states give oversight authority to the Attorney General. Current Minnesota law requires legislative approval before increasing hospital beds or opening a new hospital facility. In order to ensure that hospital closures are indeed, in the best interest of patients, Minnesota could create a process in which the legislature must review and approve proposals to close hospitals or reduce the number of beds.
Non-profit status: Minnesota hospitals benefit from many tax breaks in the form of exemptions from state income tax, sales tax, and property tax. In return, they are expected to give back to their communities in the form of community benefits that can include direct patient care; research and education; financial and in-kind contributions; and community activities. Minnesota has community benefit reporting mandate for hospitals, but not clinics. Most community benefit (75%) goes to offset care that is paid at lower rates or provided for no cost or to maintain needed services. Traditional “community care” accounts for about 1.6% of total community benefits. Minnesota needs more oversight into whether these benefits are commensurate with the tax benefits their receive.
Capping Hospital and HMO CEO pay: In 2018, non-profit healthcare companies made up the top 10 spots on the largest non-profits in Minnesota. Those companies made millions of dollars in profits and their CEOs were paid millions of dollars to run those companies. Minnesotans’ need assurance that their healthcare dollars are going to care, not CEO salaries.