Keeping Nurses at the Bedside Act Headed to House Vote


Contact: Sam Fettig
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Lauren Nielsen
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Bill clears final committee as part of House Health and Human Services Omnibus Bill

(St. Paul) – April 27, 2022 – After clearing a vote in the Minnesota House Ways and Means Committee today, Minnesota nurses celebrated as the Keeping Nurses at the Bedside Act heads to a vote on the floor of the Minnesota House of Representatives. The act, designed to retain nurses and protect patient care, is included in the combined House Health and Human Services Omnibus Bill as priority legislation for the Minnesota House Majority. The bill also has the support of the Senate Minority Caucus and Governor Tim Walz.

“We are at a critical moment for our healthcare system in Minnesota. There is a crisis in our hospitals. Nurses are overworked and overwhelmed, hospitals are understaffed, and patients are overcharged because hospital CEOs are putting patient care in the backseat to their bottom lines,” said MNA President Mary C. Turner, RN, in a letter to committee members today. “The Keeping Nurses at the Bedside Act is our best chance to stabilize our healthcare system in Minnesota. It is not a one-size-fits-all solution; it is a hyper-local proposal that would put nurses and hospital managers at the table together to set staff levels that will help nurses stay on the job to provide safe, excellent care that patients deserve.”

The Keeping Nurses at the Bedside Act addresses the short-staffing and retention crisis to protect patient care in Minnesota by establishing local, flexible, hospital-based committees of nurses and managers who would work together to set staffing levels on a unit-by-unit basis, including a limit on the number of patients for which any one nurse is responsible. The bill would also fund grants to support mental health for healthcare workers and to prevent workplace violence. It would help recruit and retain the next generation of nurses with new funding for loan forgiveness programs.

“I thank Chair Liebling for making the Keeping Nurses at the Bedside Act a priority in the Minnesota House this session,” said Becky Nelson, RN, Chair of MNA’s Government Affairs Commission. “Nurses are leaving the bedside due to understaffing, unsupportive management, and unsustainable working conditions. It is time to act to address the crisis of retention and short-staffing and to put patient care first in our hospitals.”

Even as nurses and patients suffer understaffing and high healthcare costs, hospital CEOs continue to make millions in compensation and benefits as they focus on the bottom line. In the last two years, as the pandemic raged, many Minnesota hospital systems remained profitable with millions in revenue. In 2020, one hospital CEO was paid a $50 million golden parachute after spreading medical misinformation; the year before, another Minnesota hospital CEO received a raise of more than 90 percent, bringing his total compensation to $3.6 million per year. Hospital executives can afford to make the changes needed to fully staff our hospitals, protect workers, and put patients before profits.

Forms submitted by Minnesota nurses in 2021 who were concerned that understaffing was negatively affecting patient care reported comments including:

“Our facility earlier this year had only 7 RNs scheduled for a shift on a birth center and needed 11 RNs. The nurses had to work doubles and extra hours beyond their scheduled shift in order to meet the patients’ needs because the hospital did not schedule enough nurses and left them to figure it out.”

“Nurses experiencing high acuity/illness of their patients and requested additional RNs to provide care that was safe and sufficient to meet the patients’ high needs and to NOT take any additional patients at the moment. Supervisors’ response was: you still have to fill up the unit according to the grid.”

“Our facility recently was short staff to fulfill a 1:1 which is assigned when a patient is at risk for falls or injury to self. The facility was short assistive personnel and did not fill the 1:1, and a patient was injured because of it.”

The conditions executives created in Minnesota hospitals are driving nurses away from the profession, hurting patient care. A new report just released by the Minnesota Nurses Association in March documents the reasons nurses are leaving the bedside and identified poor management practices and chronic under-staffing as the top concerns. Minnesota continues to train more than enough nurses to meet needs here, and the state now has a record-high number of RNs, totaling 120,000 statewide. It will not matter how many nurses are trained or recruited if hospital CEOs continue to foster conditions that push nurses away from the bedside.

About the Keeping Nurses at the Bedside Act
The act was introduced in February as HF 3242, chief authored by Rep. Liz Olson. That month, the bill was heard by Rep. Tina Liebling, Chair of the House Health Finance and Policy Committee, where nurses shared their stories of the effects of under-staffing by hospital executives. The bill was included in the House Health Omnibus bill, and today, it cleared its final committee hearing as part of the combined House Health and Human Services bill. Provisions from the Keeping Nurses at the Bedside Act can be identified in this House Research spreadsheet and found in the full text of the omnibus taken up by the House Ways and Means Committee today.

The bill includes the following provisions.

  • Establish Nurse Staffing Committees at Minnesota Hospitals – The bill would require all hospitals in the state of Minnesota to create a staffing committee of nurses, direct care staff, and management. This committee will put together a core staffing plan for each unit of the facility every year and will meet quarterly to determine if the staffing plan is still adequate to meet the needs of patients. Each staffing committee will be composed of at least fifty percent direct care nurses and staff.
  • Set Limits on the Number of Patients Per Nurse – While providing flexibility across hospitals and units, under the bill each staffing committee plan must set a maximum limit on the number of patients that any one nurse should safely care for. Each staffing plan will also establish criteria for when a lower patient assignment would be appropriate.
  • Recruit and Train Nursing Students – While Minnesota continues to train more than enough nursing students to meet the state’s need, this bill would dedicate new resources to ensure we continue to attract and train a skilled and diverse workforce of Registered Nurses in Minnesota. This includes broadening an existing student loan forgiveness program for new nursing instructors and allocating $5 million to launch a new student loan forgiveness program for nurses working at the bedside in Minnesota hospitals.
  • Retain and Sustain Minnesota Nurses – The solution to the hospital retention crisis requires holding hospital CEOs accountable to safe staffing levels, but additional measures can help to support nurses working at the bedside. The bill also provides an annual appropriation of $50,000 for the Minnesota Department of Health to develop and implement violence prevention strategies for nurses and patients in Minnesota hospitals.
  • Support Mental Health for Healthcare Workers – One significant effort funded by this bill would provide yearly $1 million grants for mental health programs for nurses and other healthcare professionals. The grants would be made available by the Minnesota Department of Health to hospitals, clinics, and other healthcare facilities and organizations to fund new or existing efforts to make mental health services available to healthcare workers, especially those with barriers to accessing care.
  • Review and Release Hospital Safety Data – The bill includes several provisions to make the decisions of hospital executives more transparent to the public, to hold CEOs accountable when data shows that there are safety or other staffing problems that need to be addressed. The bill would require the hospital staffing committees to review all Concern for Safe Staffing forms filed by nurses and patients to consider changes based on the data. The bill would also establish an annual report from the Minnesota Department of Health on Nursing Data. This new effort would conduct studies on the state of nursing in Minnesota, including trends in retention and why nurses are leaving direct care positions at hospitals.