ST PAUL, Minn. — The issues behind the largest nurses strike in Minnesota history are now at the heart of legislation to ease what sponsors say is a crisis that is creating "unsafe and unsustainable conditions" at hospitals across the state.
State Senator Erin Murphy (DFL-St. Paul) is chief senate author of the Keeping Nurses at the Bedside Act, which she says aims to solve the crisis of short staffing, (nurse) retention and patient care in Minnesota hospitals. On Monday, Murphy and members of the Minnesota Nurses Association held a press conference at the state capitol, alleging that "chronic understaffing" has half the respondents of a recent poll of nurses considering leaving the profession.
The Keeping Nurses at the Bedside Act would establish committees of direct care workers and management at Minnesota hospitals to set safe staffing levels on a hospital-by-hospital, unit-by-unit basis. Those levels would include a limit on the number of patients any one nurse should safely care for.
Sponsors say this approach would allow individual hospitals to set and adjust staffing levels on a local level, based on the expertise of bedside nurses at that hospital.
“We have heard from nurses about staffing shortages for years, and our legislature must act with urgency," Murphy said in a statement. "Our nurses are instrumental to providing the highest standard of care possible in our state."
“This bill is about all of us. As a mother, I think of my daughter. As a daughter, I think of my parents. This is about our families. This is about all patients in Minnesota,” added Rep. Sandra Feist (39B, DFL), chief author of the bill in the House. “Safe staffing is the best way to retain nurses and bring nurses back, as well as decrease violence and prioritize quality patient care.”
Besides staffing levels, the Keeping Nurses at the Bedside Act also includes protections against workplace violence and measures to recruit and retain workers, including student loan forgiveness for nurses and mental health grants for healthcare workers.
The Minnesota Hospital Association (MHA) reacted to the proposed legislation Monday afternoon, insisting it would have a "drastic, negative impact" on patient care.
"Minnesota's hospitals and health systems are already managing an unprecedented crisis in workforce shortages, financials, volumes, and discharge backlogs," said the MHA statement. "Introducing the unnecessary mandates called for in this bill on hospital operations will inevitably lead to unit closures, rising costs, longer wait times for patients, and the loss of vital services that communities rely on. Moreover, this legislation will add an unnecessary bureaucratic burden on hospitals and health systems that will have a negative impact on patient care quality."
MHA also asserts that the Keeping Nurses at the Bedside Act only prioritizes the interests of part of the care team (registered nurses), which also includes nurses' aides, respiratory therapists, physical therapists, pharmacists, and physicians.
"Let us focus on meeting the ever-changing needs of patients by promoting collaboration and innovation within the care team, without adding unnecessary bureaucratic red tape that hinders hospitals and health systems' ability to provide the best care possible," the MHA statement concluded.
An estimated 15,000 nurses from 15 hospitals across the Twin Cities and Twin Ports walked off the job in September, asking for higher wages and a voice in setting staffing limits. Nurses accused administrators of valuing profits over patients, and were set for a second work stoppage when they announced a new contract agreement in December, with wage increases of up to 18%.
Here is the full statement from the Minnesota Hospital Association, responding to the Keeping Nurses at the Bedside Act:
If enacted, this proposal would have a drastic, negative impact on patient care. Patient needs are continually evolving, and the COVID-19 pandemic has further highlighted the importance of flexibility at the bedside. Quality patient care depends on more than just the number of registered nurses. Creating a customized care plan for each patient requires an entire care team that includes nurses' aides, respiratory therapists, physical therapists, pharmacists, and physicians - each possessing a unique skill set.
However, the bill in its current form prioritizes the interests of only part of the care team, which can hinder the ability of hospitals and health systems to provide high-quality care and maintain access to care. The bill strips away the capacity and flexibility of on-the-ground care team leadership to make real-time decisions, transferring the authority to two bureaucratic committees.
Minnesota's hospitals and health systems are already managing an unprecedented crisis in workforce shortages, financials, volumes, and discharge backlogs. Introducing the unnecessary mandates called for in this bill on hospital operations will inevitably lead to unit closures, rising costs, longer wait times for patients, and the loss of vital services that communities rely on. Moreover, this legislation will add an unnecessary bureaucratic burden on hospitals and health systems that will have a negative impact on patient care quality.
The Minnesota Hospital Association certainly supports provisions in the bill funding mental health services for our care teams and the expansion of loan forgiveness programs. While there are elements in the violence prevention section of the bill that are good faith efforts at advancing collaboration, the staffing provisions unfortunately penalize hospitals and health systems who are working tirelessly to meet patient care needs.
We urge policymakers to reconsider this bill and prioritize the needs of patients above all else. Flexibility and real-time decision making are essential elements of providing access to high-quality care, and this bill would unnecessarily restrict those capabilities. Let us focus on meeting the ever-changing needs of patients by promoting collaboration and innovation within the care team, without adding unnecessary bureaucratic red tape that hinders hospitals and health systems' ability to provide the best care possible.
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