Massachusetts Nurse :: November/December 2004

Executive director's message

Raising the bar in the battle for safe RN staffing

Julie Pinkham

With the 2004 MNA Convention over, the members have debated and decided the course for the future. The five-year plan was embraced and the funding provided through a modified approach as dictated by the members. Members amended the proposal on the floor to stagger and lower the initial phase-in of the dues increase (see front page for breakdown) and while adopting the 2006 rate, the membership voted to delete the 3 percent annual inflation factor from this proposal.

The Board of Directors and finance committee will review and adjust the five-year plan on the basis of the modifications members made to the funding plan.

Now that the membership has determined the overall financing structure, the primary goal will be to increase the resources to the labor program. Specifically, the funding will be used to provide staff-to-unit assignments to ensure the bargaining units are well-organized, well-educated and have an effective communication system in place. The first priority is to add staff to ensure assignments that will improve members' access to MNA staff. Additionally, and in conjunction with this effort, further expansion of our labor education program will occur as will increased education on occupational health and safety. All these initial changes are designed to make bargaining units stronger and more responsive to members so you are more powerful in your workplace.

From the standpoint of direct communication and support among and between bargaining units, the regions are now structured in a way to support the needs of the local units. Each unit has a designated seat at the regional level where their unit is located and the region receives yearly funding based on the total number of members residing within the region. The region has the ability to allocate that money directly as it determines. I strongly encourage chairs or their designees to utilize this forum. It provides an unmatched venue for communication regarding contract bargaining and evolving issues with the bargaining units as well as the ability to coordinate strategies by bargaining units within the networks. Ideas and decisions and funding to implement can be approved within a single meeting. Community and legislative links can be fostered with the region improving the ability to resolve contract disputes or other matters more favorably with wider support.

Clearly, the primary goal of creating a legislated standard for safe RN staffing in acute care hospitals will move forward beginning in December, in preparation for the new legislative session that starts the following month. While the ongoing efforts and near passage of the bill last session has pressured some hospitals to improve their staffing, many have not. Without passage of a safe RN standard it is likely those who have seen improvements will see staff disappear.

The momentum for passage is more in our favor – we will need to execute strategies that build to our strengths, namely the credibility of nurses and our organizational numbers. With more than 22,000 members, 90 percent favorability among all Massachusetts nurses for this bill and 86 perent favorability by the public for this bill, our efforts may not require great efforts by a few—but rather smaller efforts by many.

The industry is already pursuing a predictable approach. The double-digit vacancies they clamored about are decreasing—not because they hired more nurses or that your assignment has necessarily lessened. Rather they've simply not filled the positions and declared their vacancy rates reduced. Hospitals that previously claimed double-digit vacancy rates will now claim they are solving the problem and claim vacancy rates less than 10 percent or 5 percent or even 0 percent!

Yet your assignment remains unchanged and the numbers just don't add up to increased RNs at the bedside. We can also expect the industry to begin calling in consultants for re-engineering and re-design solutions, aka, "alternative staffing methods."

Smoke and mirrors will not change reality. If you are on a med/surg floor caring for more than four patients on any shift, the research shows your patients are in harm's way. With five patients they are at a 7 percent risk for mistake, injury and even death; at six they are at a 14 percent risk; at seven they are at 21 percent risk; and at eight it's over a 31 percent risk. Which morbidity or mortality rate is your hospital advocating? We know what we are advocating: minimum, RN-to-patient ratios. Now.