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A P R I L | M AY | J U N E 2 0 2 2 W W W . N A T I O N A L N U R S E S U N I T E D . O R G N A T I O N A L N U R S E 5 MINNESOTA I n early may, Minnesota Nurses Asso- ciation (MNA) nurses shared the results of their annual report on Concern for Safe Staffing (CFSS) forms which paint a bleak picture of the crisis of understaffing by hospital executives in Minnesota health care facilities. The report documents an explosive 300 percent growth in CFSS forms filed since 2014, up to a total of 7,857 in the last year. In more than 80 percent of cases described by nurses, the hospital man- agers and executives who created the crisis failed to adequately respond to the concerns for patient safety raised by the nurses. "Even one case of patients not receiving the care they deserve due to understaffing by hospital executives is one too many," said Mary C. Turner, RN, MNA president. "Hos- pital executives with million-dollar salaries can afford to make the changes necessary to fully staff our hospitals and put patients before profits. Nurses and patients at the bedside cannot afford to wait for safe staffing." Nurses submit CFSS forms when they are concerned that short staffing may nega- tively impact patient care. Nurses document when patients are potentially harmed, or when, in the nurse's professional opinion, patients did not receive the safe and quality care they required due to understaffing. In 2021, nurses reported 9,381 cases where patient care or treatments were delayed due to short staffing by hospital executives. This can include delays in administering medica- tion, completing a patient assessment, or answering patient call lights. "The problem of short staffing has been going on for as long as I've been a nurse. While hospital executives will offer many different phrases to justify under staffing, the outcome always looks the same: asking fewer nurses to care for more patients with less resources and support," said Angela Becchetti, RN. "The changes nurses are seeking in our contracts, including fair com- pensation in recognition of our sacrifices during the pandemic, and safe staffing, will help nurses to stay at the bedside, where we want to be, doing the jobs we love: providing incredible care to our patients. I hope our hospital executives are listening." Data in the 2021 CFSS report reinforces the trend of "lean staffing" in health care, which hospital CEOs with million-dollar salaries have pursued for years, cutting staff levels for the sake of the bottom line. These policies have driven nurses away from the bedside for years, and the consequences of this corporate approach to healthcare were compounded by the effects of the Covid-19 pandemic. Concerns with hospital manage- ment and short staffing were the top issues identified by MNA nurses in a 2022 study of why they left the bedside. "I never thought I would want to leave my career early, but I came to the conclusion that my moral compass no longer aligned with my employer, especially when it came to short staffing in our hospitals and the safety of nurses and patients," said Jean For- man, a retired RN. "Nurses have submitted Concern for Safe Staffing forms for more than 25 years, as hospital executives have watched reports of unsafe staffing increase and have done nothing to solve the crisis. It is time for action, before more nurses reach the same conclusion I did, that they can no longer care for patients the way they were trained and called to do." To attempt to paper over the short- staffing crisis they created, hospital executives resorted to methods such as giv- ing new nurses patient assignments before they completed orientation; assigning patients to the role of charge nurse, who is meant to remain flexible to provide assis- tance to other nurses on a shift; or assigning untrained or underqualified staff. As a last resort against the understaffing of our hos- pitals by executives, units were closed nearly 1,300 times in 2021. "This report underscores the extent of the crisis which is driving nurses away from the bedside," said Becky Nelson, RN, chair of MNA's Governmental Affairs Commission. "Throughout this pandemic, nurses have heard a lot of words: hero, angel, essential. Now it is time for action. Stand with nurses and patients, not health care profits, and pass the Keeping Nurses at the Bedside Act." To address the chronic issue of short staffing in our hospitals, Minnesota nurses championed the Keeping Nurses at the Bed- side Act. The bill addresses the short-staffing and retention crisis to protect patient care in Minnesota by establishing local, flexible, hospital-based committees of nurses, direct-care staff, 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 is currently under consideration by the Health and Human Services conference committee of the Min- nesota Legislature. Minnesota nurses are also seeking solu- tions to the crisis of understaffing for nurse retention and patient care in their negotia- tions with hospital executives for new contracts this year. Right now, 15,000 nurses in the Twin Cities and Twin Ports are bargaining over fair compensation for sacri- fices made during the pandemic and for the rising cost of living, as well as for solutions to the chronic understaffing of nurses and its impact on patient care. The 2021 Concern for Safe Staffing sum- mary report, as well as reports from previous years, can be found at mnnurses.org/cfss. —Staff report Nurses release latest safe staffing report