National Nurses United

National Nurse Magazine Jan-Feb 2011

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NewsBriefs_Jan 2011 2/24/11 10:18 PM Page 5 work in the UMass Memorial Health Care system. Marlena Pellegrino, RN, a medical surgical nurse at St. Vincent and chair of the nurses' MNA local bargaining unit, presented a foot-high stack of more than 800 reports of unsafe conditions at the facility. She noted that in 2009, the DPH released a report that showed St. Vincent Hospital had more serious medical errors and patient care mistakes than any hospital in the state.  "I am ashamed of these results, and I can tell you without equivocation that our nurses and patients are being placed in jeopardy in this hospital every day and on every shift. It is only because of the true grit of our nurses that there haven't been more serious incidents at this hospital," Pellegrino said. Speakers at both locations made it clear that the problems at Tufts and St. Vincent Hospital, while serious, were not isolated situations, but symptomatic of an industry- gins also pointed out that the industry has been exploiting the current economic downturn to lay off staff, use forced overtime, and float nurses between units simply to cut costs and boost profits. The links between poor staffing and forced overtime to poor outcomes and preventable deaths are well documented. For example, one study found that every patient above four assigned to a registered nurse resulted in a 7 percent increase in the risk of death for all patients under that nurse's care. So when a Tufts or St. Vincent nurse complains about having seven patients at one time, the science demonstrates that all of those patients are at a 21 percent greater risk of death.  Other studies have found that nurses working mandatory overtime are three times more likely to make a medication error, and a brand new study released this month found that nurses working more wide trend impacting nurses and patients throughout Massachusetts and throughout the nation.  "The public needs to know, and the Legislature in Massachusetts needs to be reminded again, that our hospitals are failing us. Patients in Massachusetts and across the nation are being harmed, physically and emotionally every day on every shift, simply because their nurse has too many other patients to care for at one time," said Karen Higgins, RN, who serves as co-president of National Nurses United, the largest union of registered nurses in the country, as well as co-chair of the Coalition to Protect Massachusetts Patients, an alliance of more than 125 healthcare, consumer, and labor organizations in the state that is promoting passage of the safe staffing legislation. Hig- than 12 hours results in an increase in patient deaths in hospitals. The Institute of Medicine has recommended that no nurse ever be required to work more than 12 hours, which is a regular occurrence at Tufts Medical Center.  The safe staffing legislation, the Patient Safety Act, calls upon the Massachusetts Department of Public Health (DPH) to set safe limits on the number of hospital patients a nurse is forced to care for at one time. The bill would also prohibit mandatory overtime, such as forcing RNs to work extra hours or double shifts, and protects against the reduction in the number of other members of the healthcare team, including LPNs, aides, and technicians. Patients would have the right to know and demand safe limits. JANUARY | FEBRUARY 2011 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 This legislation is similar to a law passed in California, which since its implementation in 2004, has led to a dramatic improvement in patient care. A study published last year in the Journal Health Services Research found that the California law is working, resulting in better outcomes for patients, and a reduction in patient deaths compared to states without enforceable limits on patient assignments.  In addition to the Patient Safety Act, the MNA is filing An Act Protecting Patients from Preventable Medical Errors by Prohibiting Mandatory Overtime, which would specifically prohibit hospitals from using mandatory overtime (defined as more than 12 hours or 16 hours in a 24-hour period) as a means of staffing hospitals, except in the case of a declared state or national emergency. Because there is now no statewide standard of care, nurses at both Tufts Medical Center and St. Vincent Hospital are also attempting to achieve safe patient limits through the collective bargaining process. However, absent state laws, the only option for them and other nurses across the state and nation will be to strike for patient safety. Last year 1,200 nurses at Temple University Hospital in Philadelphia and more than 10,000 nurses from several hospitals in Minnesota waged high-profile strikes over this same issue. "Without a legislative solution, we have no choice but to use all means at our disposal to protect our patients," said Pellegrino. For more than a decade, the hospital industry has fought furiously to defeat any regulatory measure that would limit their ability to engage in unsafe staffing practices. Different versions of the legislation have made it to the House and Senate floors over the past 15 years but have never successfully passed through both chambers. Following the press conferences, bedside nurses from each facility headed to the state house to ask legislators to cosponsor both measures, which were filed in January by MNA.  "Something must be done.  The situation is critical, and there are human lives at stake," Tiller concluded. "We need the safe staffing bill and a law to ban mandatory overtime. I, along with my colleagues here today, intend to be up at the state house banging on doors, doing our best to convince our elected officials to end this crisis." —David Schildmeier N AT I O N A L N U R S E 5

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