As nurses on the frontlines fight for safe staffing, an end to mandatory overtime, and real improvements in working conditions to save the nursing profession, it is interesting to hear what is being said by nursing administrators on these issues. Two interesting examples came to light in the last few weeks.

Following Lobby Day, MNA members and staff, including MNA executive director Julie Pinkham were invited to the offices of Rep. Harriett Stanley of Gardner, who is the new chair of the Joint Committee on Health Care to engage in a discussion over the nursing shortage and the issue of unsafe nurse staffing conditions. The meeting also involved representatives from the Massachusetts Medical Society, the Massachusetts Hospital Association and the Massachusetts Organization of Nurse Executives. The discussion quickly turned into a Lincoln/Douglas style debate between the MNA representatives on one side (touting the staff nurse view) against the other players (who were touting the industry party line).

After the meeting, Pinkham met briefly with a leader of MONE and engaged her in a frank discussion as to what in her opinion a safe nurse-to- patient ratio would be for a nurse in a community hospital on a medical-surgical floor. Pinkham asked her to answer as a nurse, not an administrator. She asked her to give her a safe patient assignment for a community hospital medical surgical nurse, where there is a pyxis medication system in place. The answer: a ratio of one nurse to five patients. This is not what the administrator said when wearing her MONE hat. The MNA would ask why not?

At another meeting, this time a forum held by the Board of Registration in Nursing to present their new disciplinary regulations for nurses, the subject of the Board's policy on patient abandonment was discussed. Encouragingly, the Board publicly stated that refusing mandatory overtime did not constitute patient abandonment. Upon questioning from an MNA member, the BORN publicly stated that they consider a nurse accepting an assignment at the beginning of her shift as appropriate notice that she will be leaving at the end of that shift, and that it is up to management to ensure there is a nurse at the end of that shift to replace her.

A manager from Worcester Memorial Hospital in the audience became indignant at that point, stood up and said, "How can you do this, you're taking away the only thing we have to hang over their heads."

This is a direct quote. Kudos to board for taking this correct position on this issue. Shame on any nurse manager who would use the threat of the loss of a nurses license as a tool to force them to work mandatory overtime.