The Transformation of the Massachusetts Nurses Association in Response to Healthcare Restructuring: The [Recent] History of How and Why the MNA Evolved, Transformed, and Restructured

Available for review and download here.

1903-2003: 100 Years of Caring for the Commonwealth

Fact Sheet and Historical Timeline

Below is a timeline of historical highlights of the MNA’s work over the last century.

1903The Massachusetts State Nurses Association is founded during meeting of 300 graduate nurses at Faneuil Hall on February 26 – one of the first of its kind in the nation. Its purpose is first, to secure legislation for the protection of the nursing profession for the benefit of the public, the physician and the nurse by creating a law requiring the registration of nurses; second, to formulate a code of ethics for the nurse of the state; and third, to work for higher standards of nursing practice and a uniform curriculum in nurses’ education.
1904Act to Regulate the Practice of Professional Nursing of the Sick is filed with the Massachusetts State Legislature.
1910MNA succeeds in passing legislation creating Massachusetts Board of Registration in Nursing (BORN). The law calls for a mixed board of nurses, physicians and hospital administrators. On Nov. 15th of that year, MNA President Mary Riddle is issued a license as Massachusetts Registered Nurse #1, the first RN in Massachusetts, and the first chairperson of the Mass. BORN.
1912The vast majority of graduate nurses worked as “private duty nurses,” working in private homes. Hospital nursing was performed by student nurses in the hospital-based training programs, where they were little more than indentured servants. To assist private duty nurses in finding work the MNA established a Central Directory for private duty nurses to help them find work. In the following two decades, the registry grew from 250 to 2400 nurses, the largest non-profit registry in the nation.
1914-18MNA members participate in World War I and assist in mobilizing nurses to assist in responding to the Influenza pandemic in 1918. More than 400 MNA members, 30 percent of its total membership would serve in the war.
1919The Massachusetts Nurse Practice Act is amended to provide for the registration of only graduates of nurse training programs and for a standardized curriculum for the nurse training schools in the state.
1920The 19th Amendment grants women the right to vote.
1923The Goldmark Report, the study of Nursing and Nursing Education in the United States , is published. Gertrude Peabody of Boston’s Visiting Nurses Association and a member of MNA is instrumental in persuading the Rockefeller Foundation to fund the study.
1928MNA drafts and publishes a code of ethics for nurses in Massachusetts and the organization establishes its first headquarters at 420 Boylston St.
1934MNA supports the eight hour work day for nurses.
1938MNA helps pass legislation calling for compulsory registration for graduates of attendant schools of nurses, (later known as LPNs).
1940World War II. MNA takes a leadership role in working with state and federal officials to develop nursing contingency plans for the war effort.
1944Frances Slanger, a native of Roxbury and MNA member is the first Army Nurse killed in action shortly after the D-Day invasion. Her death makes national headlines and draws significant attention to the contributions of nurses to the war effort. In all, more than 3,500 MNA members will serve in the war, representing more than a third of the membership.
1946Nurses returning from war are reluctant to work under the conditions that exist in peacetime hospitals. A labor survey shows that the average wage for a staff nurse is 78 cents an hour, compared to 95 cents per hour for women working in manufacturing. This year, the American Nurses Association will endorse collective bargaining as a means for nurses to achieve better pay and working conditions. MNA will establish a professional placement and career counseling service to assist nurses in finding work in the peacetime economy.
1948First bachelor’s degree program in nursing is established at Boston University.
1950MNA nurses recruited for service in Korea .
1955The MNA membership votes to establish an Economic Security program, authorizing the use of collective bargaining for nurses. The same year, the MNA will be called upon to recruit nurses to help the state address the growing polio epidemic. MNA District 5 responds to an outbreak in the city of Boston by recruiting more than 300 nurses. In recognition of their effort, City Council passed a resolution acknowledging their contributions to the public health and safety.
1957The nurses at Hale Hospital form a union and organize a mass resignation to force the city of Haverhill to grant them a contract and pay increase. The MNA is called in to assist them in their efforts, marking MNA’s first successful effort to use collective bargaining on behalf of nurses.
1958MNA wins one of the most important amendments to the Nurse Practice act, making it mandatory that anyone practicing nursing in the Commonwealth must be registered to do so through the BORN. Before that time, nursing registration was only concerned with defining who could call themselves a registered nurse. Now, only a registered nurse or a licensed practical nurse could practice nursing – period.
1964MNA drafts and wins passage of legislation (Chapter 150 A) authorizing nurses employed in the private sector to engage in collective bargaining activities. Before this, nurses could organize a union, but employers were not required to recognize and/or bargain with the union.
1965MNA begins collective bargaining efforts. Quincy Hospital became the first MNA bargaining unit under the new law, casting an historic 189 to 15 vote in favor of forming a union. Whidden Memorial Hospital would win its vote a few months later. Within four years, MNA organized more than 76 bargaining units throughout the state.
1970Associate degree programs in nursing flourished in the Commonwealth, increasing from 6 to 19 between 1968-1978.
1973Thousands of nurses rally at the State House and at Faneuil Hall to help defeat Governor Francis Sargeant’s attempt to abolish the Board of Registration in Nursing.
1975MNA drafts and passes legislation authorizing Nurses to Practice in the Expanded Role, which opens the door to nurses with advanced education to provide a variety of specialized services, such as the delivery of primary care by nurse practitioners and assistance with birth by certified nurse midwives.
1977MNA drafts and helps pass legislation mandating completion of continuing education credits as requirement for nursing licensure renewal passed. Massachusetts legislature passes statute allowing Massachusetts nurse midwives to deliver babies.
 After 75 years, the MNA finally wins passage of legislation mandating an “all nurse” Board of Registration in Nursing. The struggle for nurses to have complete autonomy over their practice is finally achieved.
1978Cost containment and health care restructuring by the state and federal government, along with cost cutting by health care employers creates deplorable working conditions and low salary levels for nurses that set the stage for more militant approaches at the negotiating table. Nurses at Cape Cod Hospital and Berkshire Medical Center take strike votes for the first time in MNA history. This time they settle without a strike.
1979The MNA supports and helps win passage of the state’s first Patients Bill of Rights, making Massachusetts only the third state to grant such rights to its hospitalized patients. It gives patients the right to know who is caring for them, to inspect their medical records and the right to prompt life-saving treatment without discrimination.
1980On May 28, 450 nurses at Newton Wellesley Hospital go out on strike to force the hospital to recognize their union. This is the first nurses’ strike in Massachusetts and the nation’s first nurse’s’ strike for union recognition.
Later that year, the nurses at the Visiting Nurses Association of Boston will conduct a strike to win a “first contract,” which is the first “economic” strike in MNA history. Over the next three years, MNA bargaining units would wage strikes at Berkshire Medical Center (1981, 69 days), Cape Cod Hospital (1981, 17 days) Burbank Hospital in Fitchburg (1982, at six months, the longest strike in MNA history), and at Lynn Hospital (1983, 42 days).
1983MNA succeeds in passing the first bill authorizing Nurse Practitioners to write prescriptions in long-term care facilities and for certain patients at home. This is the first time registered nurses are allowed to write prescriptions. Limited prescription writing authority is granted to nurse midwives.
1985-86Bill passed to mandate third-party reimbursement for services of psychiatric nurse mental health clinical specialists and nurse midwives.
1986As hospitals continue to cut costs, nurses find themselves working with fewer ancillary support staff and being forced to perform extensive custodial, non-nursing duties. The nurses at Carney Hospital respond by waging a highly successful 36-day strike, winning language prohibiting them from being assigned non-nursing tasks.
1989Throughout the late 1980’s and early 90’s the health care industry attempts to deal with a shortage of nurses by replacing nurses with unlicensed technicians and aides. Nurses at Quincy Hospital and Boston Medical Center are the first to confront these schemes. Nurses at Carney Hospital fight back with an aggressive campaign to prevent this plan from being implemented, winning national recognition for their efforts.
1990Bill passed to allow nurse midwives to write prescriptions.
1991Special Commission on Nursing established by the Massachusetts Legislature.
1992Bill passed to allow nurse practitioners and psychiatric nurse mental health clinical specialists to write prescriptions.
 Brigham & Women’s Hospital nurses ratify a contract which includes a landmark, first-in-the-nation provision guaranteeing disability insurance for those infected with HIV from a work-related exposure.
1994With the deregulation of the health care industry and the introduction of managed care in Massachusetts, the health care industry responds by slashing its nursing staff, laying off thousands of nurses and employing plans to replace nurses with unlicensed personnel. Nurses’ patient assignments double and the care they deliver begins to deteriorate.
 The staff nurses at MNA bargaining units respond by appealing to the MNA Board of Directors for the MNA must take a stand and go public with their concerns. The MNA Cabinet for Labor Relations and the Board of Directors call a joint meeting in Randolph attended by more than 250 nurses from across the state. The nurses pass a resolution declaring that the quality of patient care in Massachusetts hospitals is being jeopardized and that the MNA should wage a campaign to improve patient’s access to safe nursing care. The MNA membership later will pass a resolution launching the MNA Statewide Campaign for Safe Care, an organization-wide public awareness and legislative campaign to improve the quality of patient care by increasing patient’s access to quality nursing care. This is the first time MNA members will agree to publicly and uniformly criticize the intent and practices of the health care industry in their delivery of health care.
 Nurses at Brigham & Women’s Hospital will begin a campaign to draw media and public attention to the issue of poor indoor air quality workplace hazards on the health of nurses in their facility. More than 300 B&W registered nurses will suffer from illnesses related to the problem. group of affected nurses will mobilize a campaign to draw attention to the issue, first within in the MNA, and later throughout the national nursing community. Their efforts will make occupational health and safety a focus of MNA activity for years to come, establishing MNA as a leading voice for improvements in workplace safety to deal with the issues of indoor air quality, latex allergy, ergonomics/back injury prevention and workplace violence.
1995A Blue Ribbon Commission of nursing experts called together by the Safe Care Campaign drafts a legislative agenda to improve patient care. The package includes a bill mandating the identification of health care workers, legislation mandating the collection of patient outcome data compared to nurse staffing levels, and a bill regulating RN staffing levels and providing whistle blower protection to all health care providers
 The MNA wins passage of its legislation requiring all health care providers to wear name badges identifying their licensure status. This bill, part of the Safe Care Campaign, was designed to combat efforts by hospitals to pawn off unlicensed workers as nurses. Now patients would be able to know who is there nurse and who is not.
1996Nurses at Brigham & Women’s Hospital take a 90 percent vote in favor of a strike in their effort to prevent their employer from implementing contract provisions allowing the hospital to replace registered nurses with unlicensed personnel. The strike vote draws extensive state and national publicity to the dangers of such practices, leading the hospital to capitulate and preventing the need for a strike. Following this, 8 other MNA bargaining units will take strike votes winning similar protections.
1998The MNA wins passage of Whistle Blower Protection legislation, preventing health care employers from firing or reprimanding nurses and other providers from reporting unsafe conditions.
1999The MNA, through the work of its newly established Congress on Occupational Health & Safety, wins passage of legislation to protect health care workers from needlestick injuries and to mandate utilization of safe needles and sharps instruments. The initiative was sparked by by a tragic event, when then President Karen Daley, a nurse at Brigham & Women’s Hospital went public with her story of contracting HIV and Hepatitis C from a preventable needlestick caused by a poorly designed needle dispensing system.
2000On March 31st, 615 RNs at St. Vincent Hospital go out on strike over the issues of inadequate staffing and mandatory overtime. The first nurses’ strike in 14 years, the strike against for-profit Tenet Health Care will last 49 days, drawing significant local, state, national and international media coverage to the issue of mandatory overtime. It will end dramatically with a settlement negotiated in the Washington, D.C. offices of Senator Edward Kennedy. The settlement reached will serve as the foundation for contract language to be subsequently negotiated into a number of MNA contracts , and in nurses’ union contracts across the nation.
 The MNA membership, led by the a number of leadership groups within the organization, begins to campaign for a vote for the MNA to disaffiliate from the American Nurses Association. The MNA, which for years had struggled to make the ANA more responsive and aggressive in addressing the needs of front-line nurses, had determined it needed to seek independence from the national federation and pursue new alliances with more like-minded and progressive state nurses’ associations.
2001On March 24th, at the more than 2,400 MNA members, the largest single gathering of nurses in one place in the state’s history, gather at Mechanics Hall in Worcester to cast their vote (82 percent) in favor of disaffiliation from the American Nurses Association.
 The MNA, along with the California Nurses Association, the Maine State Nurses Association and the Pennsylvania Association of Staff Nurses and Allied Health Professionals announce the founding of the American Association of Registered Nurses, a new progressive national organization of nurses dedicated to protecting and advocating for nurses on the front-lines of health care.
 Nurses at Brockton Hospital wage a 103-day strike over issues of unsafe staffing and mandatory overtime, once again drawing significant media coverage and community support. This time, Senator Kerry would step in to broker a settlement to the strike.
 A special Legislative Commission on Nursing and Nursing Practice holds hearings across the state for nurses to testify about the crisis in nursing. In June, a report is issued calling for legislation, proposed by the MNA, to regulate RN to patient ratios and to prohibit mandatory overtime. The report validates what the MNA had contended for years through its safe care campaign.
2002The MNA, in support of its legislation to regulate RN to patient ratios in health care settings, conducts a survey of the public showing that more than 70 percent support legislation to regulate RN to patient ratios. In May, nurses from throughout the state circulate petitions calling for the passage of safe staffing legislation in their communities for eight days. On May 6, ambulances driven by nurses pick up the petitions and deliver 80,000 signatures to the front steps of the state house in an emergency call for legislative action.
 On Dec. 3, the MNA once again files Quality Patient Care/Safe RN Staffing legislation to regulate RN to patient ratios in Massachusetts Hospitals. The measure is essential to protecting patients and to ending a shortage of nurses caused by poor staffing conditions. To date, 100 legislators have signed on as sponsors of the bill.